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1. Procedure and CPT® Code Selection:

The cardiologist provided remote monitoring over a 30-day period for a hemodynamic pulmonary artery pressure monitor implanted in a patient with congestive heart failure.

CPT® Code 93264 is appropriate for remote monitoring of a hemodynamic system for up to 30 days. This code includes services such as weekly data transmissions, interpretation, trend analysis, and reporting—exactly as described in this case.

2. Rationale for Excluding Other Options:

Code 93286 is for in-person interrogation and programming of pacemakers or defibrillators, not for remote monitoring of a hemodynamic monitor, making it incorrect.

Code 93288 is for interrogation device evaluation (remote), specifically for pacemakers or defibrillators, and does not apply to a pulmonary artery pressure monitor.

Code 93279 is for in-person programming of certain cardiac devices, which does not match the remote monitoring described in this scenario.

3. AAPC and CPT® Coding Guidelines:

AAPC and CPT® guidelines specify that 93264 is the correct code when reporting remote hemodynamic monitoring for a pulmonary artery pressure device over a period of up to 30 days, including data review and interpretation.

Therefore, the correct answer is B. 93264.

1. Procedure and CPT® Code Selection:

The urinalysis performed was non-automated and without microscopy.

CPT® Code 81002 is appropriate for a non-automated urinalysis without microscopy. This code accurately reflects the test performed in the office.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code R30.0 is used for dysuria, which was one of the patient's presenting symptoms.

ICD-10-CM Code R10.30 is used for lower abdominal pain, another presenting symptom.

Since the urinalysis ruled out a urinary tract infection, N39.0 (UTI) is not appropriate as a final diagnosis.

3. Rationale for Excluding Other Options:

Code 81000 (in options A and B) is for a urinalysis with microscopy, which was not performed here.

N39.0 is used when a UTI is confirmed, which is incorrect for this case since the urinalysis was negative, ruling out UTI.

4. AAPC and CPT® Coding Guidelines:

AAPC guidelines recommend coding based on the symptoms when a specific diagnosis (such as UTI) is ruled out. Therefore, R30.0 and R10.30 are appropriate symptom codes for this encounter.

Thus, the correct answer is C. 81002, R30.0, R10.30.

99291: This code is used for the first 30-74 minutes of critical care, evaluation, and management of the critically ill or critically injured patient.

99292: This code is used for each additional 30 minutes of critical care service beyond the first 74 minutes.

The documentation indicates that the patient received a total of 45 minutes of critical care, which involves continuous IV insulin for diabetic ketoacidosis, administration of antiemetics, and admission to the ICU. The critical care time documented justifies the use of 99291 for the first 30-74 minutes and 99292 for each additional 30 minutes.

References:

CPT® Professional Edition, AMA

1. Procedure and CPT® Code Selection:

The patient underwent a repair of a ruptured aneurysm in the popliteal artery, involving incision, dissection, clamping, removal of the aneurysmal section, and patch grafting.

Code 35151 is the correct CPT® code for the repair of an aneurysm in the popliteal artery, as it specifically describes aneurysm repair in this location.

Code 35081 applies to aneurysm repair in the abdominal aorta, which does not pertain to the popliteal artery location.

Code 35152 is for an aneurysm repair involving the popliteal artery with vein graft, but there is no mention of a vein graft in this scenario, only a patch graft.

Code 35045 is used for repair of an aneurysm in the brachial artery and does not apply to the popliteal artery.

2. AAPC and CPT® Coding Guidelines:

According to AAPC guidelines, CPT® codes for aneurysm repair should be chosen based on the specific artery involved. Code 35151 is precisely for popliteal artery aneurysm repair without a vein graft, making it the most accurate choice.

Thus, based on CPT® guidelines and procedural details, the verified answer is B. 35151.

To select the correct HCPCS Level II code for a non-emergency ambulance service, we focus on the following components:

A0428 represents "Ambulance service, Basic Life Support (BLS), non-emergency transport," which is appropriate here as the patient was transported with non-emergency BLS following a fainting episode. This eliminates options B and D, which indicate "emergency" (A0429).

QM Modifier indicates "Ambulance service provided under arrangement by a provider of services," relevant when a physician arranges the ambulance transport.

PH Modifier specifies "Physician’s office to hospital" transport, matching the scenario where the patient was taken from the physician’s office to the hospital.

Thus, A0428-QM-PH accurately describes a non-emergency BLS transport arranged by a provider from a physician's office to the hospital, aligning with choice A.

1. Procedure and CPT® Code Selection:

The patient requires a surgical nasal sinus endoscopy to repair a cerebrospinal fluid (CSF) leak caused by a skull fracture that resulted in CSF draining into the nasal passage.

Code 31291 is the correct CPT® code for an endoscopic repair of a cerebrospinal fluid leak in the sphenoid sinus. This procedure code is appropriate because it specifically addresses surgical endoscopy for CSF leak repair in the sinus region.

Other codes provided, such as 31287 (nasal/sinus endoscopy with balloon dilation) and 31235 (nasal endoscopy with biopsy), do not match the description for surgical repair of a CSF leak and are therefore inappropriate for this case.

2. Diagnosis and ICD-10-CM Code Selection:

ICD-10-CM Code S02.19XA is used to describe a fracture of the anterior cranial base, which fits the described injury of the skull with cerebrospinal fluid leakage.

External cause code V47.5XXA is used for motor vehicle accidents involving a car hitting a stationary object.

Y92.411 is the appropriate code to describe the location of the accident as a highway.

3. Exclusion of Additional Procedure Codes:

There is no need for a second endoscopy code or a modifier, as 31291 fully describes the endoscopic repair procedure for the CSF leak.

4. AAPC and CPT® Coding Guidelines:

Per AAPC guidelines, procedure codes for sinus endoscopy are chosen based on the specific type of intervention (e.g., CSF leak repair). The guidelines for ICD-10-CM stress including external cause codes and location codes for trauma cases related to motor vehicle accidents.

Thus, the correct answer based on CPT® and ICD-10-CM coding standards is B. 31291, S02.19XA, V47.5XXA, Y92.411.

The CPT code 10005 is for fine needle aspiration biopsy, including ultrasound guidance, for the first lesion. CPT code 10006 is for each additional lesion with ultrasound guidance. Since the provider aspirated tissue from three nodules, the coding should be 10005 for the first nodule and 10006 x 2 for the additional two nodules.References: AMA's CPT® Professional Edition (current year)

99222: This code is used for initial hospital care, per day, for the evaluation and management of a patient, which requires a detailed or comprehensive history, a detailed or comprehensive examination, and medical decision making of moderate complexity.

The documentation shows a detailed history (including HPI, ROS, PMH, SH, and FH) and a detailed examination (covering multiple organ systems). The medical decision making involves the management of an acute asthma exacerbation, which includes admitting the patient to observation status, administering oral steroids, and planning for further diagnostic testing.

References:

CPT® Professional Edition, AMA

The patient with malignant lymphoma is administered Rituximab (800 mg) and Benadryl (100 mg) intravenously.

Procedure Description:

Administration of Rituximab (800 mg) intravenously.

Administration of Benadryl (100 mg) intravenously.

HCPCS Level II Coding:

J9312: Injection, Rituximab, 10 mg.

For 800 mg, report 80 units of J9312.

J1200: Injection, Diphenhydramine HCl, up to 50 mg.

For 100 mg, report 2 units of J1200.

References:

HCPCS Level II Code Book (current year).

HCPCS Level II coding guidelines for intravenous drug administration.