File View Options Reference Help Contact Us M Ped0eeeee ICD-10 Summary [ CPTPr 55000 |Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication CPT CDR HCPCS Anesth Direct Code res Eile View Options. Reference Help Contact Us Version Total 1223 o3 o 13X $899.16 Age: 50 Sex: Female From Date: 07/30/2022 ICD-10 Summary Through Date: 07/30/2022 LOS: 1 - Add Diagnosis Direct Code B3 Est Reimb — Medicare APC - HOPD Total $899.16 — = Next Patient Sequestration 4,4 o> Amount - Medicare Payment Before $731.02 Sequestration cmMs $716.40 Copay $182.76 Tot Adj Wt 9.63 oPPs $899.16 05311 45378 Tot $899.16 H $716.40 C APC1L $182.76 U 1 W 9.63 P1.00 OPPS HCPAPC 05311 HCPWT 9.63 Status Inlier Payment(s) Claim Type (Medicare APC - HOPD) o9 Other APC Overall Claim Disposition Assessment: 3M - Coding with CPT and HCP... X No edits present on claim. APC Bill Type Hospital Outpatient: Admit Through Discharge Claim APC Condition Code 9999 No/Unknown Condition Code Your work has been saved and submitted Written Oct 18, 2023 1:25 AM - Oct 18, 2023 1:25 AM o Attempt 2 of Unlimited Attempt Score 0/11-0% Overall Grade (Highest Attempt) 9 /11-81.82%
