MO 232 Week 8 Worksheet (1)

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Mt Hood Community College *

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232

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Medicine

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Apr 3, 2024

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E/M Week 8 Assignment Reading Step by Step Chapter 26 Medicine Section pgs. 627-660 2020 CPT Manual Page 639-640 (Green Tinted Pages) Review all Subsection Guidelines the entire section page 641-754 Work as you have time saving your document along the way. When completed, attach it to the assignment feature in the course. This will cover the first half of the section, next week the assignment will cover the rest. I will review it and send comments and attach the key in your feedback . PLEASE note: Your document must be saved as a .doc, or pdf for me to open it for correction. ____________________________________________________________________________ Use CPT/HCPC Only Questions (no ICD-10 Codes for THIS section) some answers will require two codes such as vaccine and administration. (3 pts each) 1. The differential diagnosis was amyotrophic lateral sclerosis versus chronic obstructive pulmonary disease, and she was referred for needle EMG examination of the diaphragm Code only the EMG, no visit. _ 95866 ______________ 2. A 23-year-old female patient presented to the physician’s office for IV normal saline for dehydration. It took one hour, no other infusion service was provided that day. There was not a separate visit encounter documented. _ 96360 _______________ 3. A 19-year-old female patient presented to the physician’s office for tetanus immune globulin to be administered intramuscularly. No other service was provided at this encounter. _ 90389, J1670 ______ 4. Plan: Exercise treadmill stress test, with supervision and report. Physician team owns all equipment_ 93015 ________ a. 5. ACUPUNCTURE TREATMENT: (e-stim) stands for electrical stimulation First insertion with 15mins:sitting: Gb20,Du20,24,KI3, LV3-estim First insertion with 15mins:Ashi on the upper arm and Bl12,15, 17,19-estim Re-insertion with additional 15mins:BL23,25, Du16-estim -_ 97813, 97814x2_ ________________________ _____________________
Case Coding: Review these cases for CPT(s); Modifiers and ICD-10(s). Remember there may be more than one of any of these used for the case. Some cases have FYI hints to appropriately choose a modifier, or pathology results for ICD-10. Not all cases will have modifiers, some may not include enough information to choose an ICD-10 or CPT code. If not enough please tell me what info you think is missing, so you can receive credit. You may notice more abbreviations please post a question if you have one. 10 pts each 1. An 18-month-old boy was brought to his regular physician’s office for his 18 month checkup. According to his mother, he was doing just fine. He was eating table food and sleeping through the night. Progress note indicates the following: SUBJECTIVE : Patient is here for his 18-month checkup. His mother reports no problems and not recent illnesses. His is eating table food, sleeping through the night, and going to a play group twice a week. He is walking and running without difficulty and does not tire easily. He plays appropriately with others his age. OBJECTIVE : Weight, 22lb., length, 31 in.; temperature 98.6F HEENT: NI, ears, NI, pharynx, NI Lungs: Clear Heart: Heart tones normal, no extra sounds, no trill Abdomen: No masses, no organomegaly Genitourinary: Both testicles descended Extremities: Normal legs straight Central nervous system: Normal for age Skin: No lesions Denver Developmental Screening Test: Pass all ASSESSSMENT : Normal 18-month check PLAN : DT A -4 Anticipatory guidance and accident prevention discussed with mother. _ Z00.129, 99392 __________________________ 2. CMT is Chiropractic manipulative Treatment A 30-year-old administrative assistant complained of pain and weakness in the right hand and elbow that worsened throughout her workday. A brief evaluation with the chiropractor showed that CMT was clinically indicated on the right elbow and hand. Manipulation to the right elbow, right hand, and the right wrist was performed. A long arm splint was provided to the patient for comfort. _ M79.651, M79.641, 98941, L3912? __
3. A 73-year-old female patient presented to the physician’s office for chemotherapy administration. Treatment protocol consisted of an IV infusion of carboplatin 50 mg for 35 minutes and docetaxel 10 mg for 60 minutes. Patient also received .5 mg of dexamethasone infused over 15 minutes and ondansetron infused over 15 minutes. All infusions were sequential. The patient had cancer of the larynx . _ __ C32.9, 96413-52, 96413, 96365-52, 96365, 96409 ____________________________________________ 4. The patient had a previous systemic reaction to penicillin and subsequently needed to be treated with penicillin for streptococcus infection. The 500 mg penicillin was infused gradually over a period of 1 hour by IV in a carefully controlled environment. This type of desensitization required frequent monitoring of vital signs and constant observation. Appropriate monitoring and safety measures were available during the process. _ Z88.0, T88.6, 95115 __ Do not charge for penicillin nor infusion code. 5. A 53-year-old received deep-brain stimulation bilaterally for medically refractory Parkinson disease. The patient returned to the office for reprogramming of the devices. the system programming was checked to ensure proper functioning; the physician tested combinations of the implant parameters while assessing the degree of symptom and side effect improvement or worsening after each programming change. Electronic analysis and programming of an implanted permanent single-ray electrode system and subcutaneous generator/transmitter was performed. After each round of reprogramming the patient waited in the office for the new stimulation therapy to take effect. After a brief wait, the stimulator was again reprogrammed to try to achieve better results. After the patient’s device was programmed to achieve maximal comfortable stimulation, the physician provided the patient and family members with detailed instructions regarding stimulator operation and precautions. The overall reprogramming session, including analysis, four reprogramming sessions, three waiting periods, and the final instructions took three hours. In addition, detailed history and
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physical examination and moderate-complexity medical decision making were provided concerning the patient’s medication regime, to address concurrent medical problems, and to counsel the patient and family about psychosocial difficulties encountered in coping with moderately advanced Parkinson disease. (There is a visit and programming here).. _ G20, 64569, L8679 ____________