Inpatient coding and outpatient scenarios 1. List the tree goals of Physician Payment Reform. Decrease Medicare expenditures, redistribute physician’s payments more equitability, and ensure quality health care at a reasonable rate. 2. Mr. Jones is admitted to the hospital by the orthopedic surgeon for severe hip pain. The ortho surgeon provides an initial hospital visit during which it’s determined that Mr. Jones has a fractured hip that will require surgical intervention. Mr. Jones is taken later that day to the OR, where the doctor performs the surgical procedure to repair Mr. Jones’ hip. Which modifier would you use for the hospital visit? Modifier -57
3. List and define the three components of the relative value.…show more content…
CPT Code: 99214 10. What are the three key components that are present in every patient case except counseling encounters or time-based codes, and enable the coder to choose the appropriate level of service? History, exam and MDM 11. CPT Code: 99936 12. CPT Code: 99341
13. What are the four levels of history type? Problem focused, expanded problem focused, detailed and comprehensive 14. CPT Code: 99281
ICD-9CM Code: 976.5 15. CPT Code: 99231 16. If a patient were discharged from the hospital with a diagnosis of probable myocardial infraction without a history of MI in the past, what ICD-9 code would the document for this stay?
Cannot code a probable diagnosis so the symptom would be coded 410.9 17. CPT Code: 15944
ICD-9-CM Code: 410 18. What are the three contributing factors of medical decision-making complexity?
Counseling, coordination of care nature of presenting problem and time. 19. CPT Code: 25600 20. Name four of five graft types represented in the musculoskeletal subsection.
Bone graft, tissue, fascia, cartilage and tendon 21. CPT Code: 20661 22. CPT Code: 75625 23. CPT Code: 33208 24. CPT Code: 33224 25. CPT Code: 58558
ICD-9-CM Code: 621.0 26. CPT Code: 77057 27. CPT Code: 70551