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Feb 20, 2024
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Uploaded by ConstableGiraffe3016
A nine-year-old patient who has had a cochlear implant all his life
goes into his audiologist's office for his yearly reprogramming of the implant. Which CPT code best describes this?
Correct answer: 92604
In the index of the CPT book, you will look up cochlear device, programming. This gives us two codes: 92602 and 92604. The main difference between the two codes is the age of the patient. In the case of this question, the patient is nine years old. This fact makes code 92604 the correct answer to this question.
Code 92602 is also for subsequent reprogramming of a cochlear device, but this code
is for patients under seven years of age. Therefore, this is not the correct answer. Code 92601 is for the diagnostic analysis of cochlear implant, patients younger than seven years of age, with programming. This is an initial visit for programming, plus the age of the patient is not what the question states; therefore, this is also not the correct answer. Code 92605 is for the evaluation for prescription of non-speech-
generating augmentative and alternative communication device, face-to-face with the patient, first hour. This has nothing to do with what the question asks for, so this would
be incorrect.
Reference:
AMA CPT® 2023 Professional Edition. Pg 750.
A physician sees a patient after they complained of various events of chest pain, shortness of breath, and irritability. The PCP believes it may be severe anxiety, so he gives various interventional tools that the patient can use to overcome this anxiety, including coping mechanisms and minimalizing psychological barriers. This session lasts 30 minutes, and the patient was seen by himself.
Which CPT code would be used for the assessment?
Correct answer: 96158
This is one of those rare codes which is easier to look up in the book than in the index. In the Medicine section of the CPT book, you will turn to the Health and
Behavior Assessment and Intervention part. The second code of this part of the section, 96158, is a health behavior intervention, individual, face-to-face, initial 30 minutes. The question states that a 30-minute visit is performed to fully examine why the patient is having chest pains, irritability, and shortness of breath, and the physician
gave interventional tools to help aid in the patient's recovery. Code 96158 is the correct code because the doctor specifically performed this assessment service, which is different from an E/M service.
Code 96159 is an add-on code for health and behavior intervention, individual, each additional 15 minutes. The question does not state that an intervention was performed, so this is incorrect. Code 90791 is for a psychiatric diagnostic evaluation. The evaluation performed is not psychiatric, it is behavioral, and so this is also incorrect. Code 96167 is for a health and behavior assessment with the family and the
patient present. The assessment is only performed on the patient, so this is not the correct answer.
Reference:
AMA CPT® 2023 Professional Edition. Pg 826.
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