E/M
MDM is designed as straightforward, low, moderate and high complexity. These three criteria help decide MDM
amount of diagnoses, amount or complexity of data and risk of comorbidities
Multiple anesthesic administrations are billed using this
the most complex procedure
An operative repair of the eardrum for a small tear
myringoplasty (a tympanostomy is for a large tear)
when a consulting physician provides opinion or advice to the requesting radiologist in a written report this modifier is used with the cpt code
26
CPT adjusts codes on this schedule
Once a year in January
This visit is coded with 99446-99449 and reported when one physician requests the assessment and mgmt advice of another for pt treatment
Interprofessional telephone/internet consultation
A certified registered nurse anesthetist provides anesthesia for a C-section of a patient who did not have an epidural during labor
01961
Tube removal codes are:
Unilateral
Primary
Add-on
unilateral
a pathologist examined three loose bodies from a joint, submitted separately, performing both gross and microscopic examinations, it is reported with this/these code(s)
88304, 88304, 88304
correct, timely and complete documentation are important elements for
good (proper) coding
A peds specialist is on standby for 30 min during difficult delivery of a high risk pt. The OB delivered the baby and the peds performed resuscitation. This code is reported
99465
a 32-month toddler diagnosed with leukemia requiring staged chemotherapy. A PICC line is required. This code is sent for billing.
36568
A patient with renal calculus on the right kidney has lithotripsy performed via cystoscopy with insertion of a double J stent.
52536
in hydration coding this is prepackaged and does not include added electrolytes
IV fluid
The (+) in the CPT book indicates
add-on codes
99386
The code for initial pericardiocentesis
33010
A pt who has been going to a pain clinic for 18 months but has not responded to conservative tx or injections is scheduled to have intracranial neurostimulator electrodes place in the cortex via burr holes for longer term pain relief
61850
there are two code families for cardiac catheterizations
one for congenital heart disease and one for all other conditions
codes deleted every year are included in this appendix
Appendix B
If an ov with comp history/exam and high MDM results in a pt being admitted on the same day by the same physician this code should be reported
99223
The codes for performing a posterior lumbar arthrodesis of the L3-L5 vertebra
22612, 22614
In excising chalazion for both right and left upper eyelids of a patient
67805
flexible endoscopic evaluation of swallowing by cine or video recording interpretation and report only
95613
where the vascular families can be found
appendix L