MedicineB

.docx

School

University of Houston *

*We aren’t endorsed by this school

Course

2301

Subject

Medicine

Date

Feb 20, 2024

Type

docx

Pages

2

Uploaded by ConstableGiraffe3016 on coursehero.com

A 60-year-old established patient comes into her local retinal specialist for an evaluation of her age-related dry macular degeneration. The doctor performs an intermediate evaluation including history and external evaluation and then orders an OCT to see imaging of the patient's retina. He then tells her he would like to see her on a 3- to 4-month basis to keep an eye on her AMD.  How would this be billed? Correct answer: 92012, 92134 You will first look up the code for the evaluation, in the index of the CPT book. Under ophthalmology, diagnostic, eye exam, established patient, you will find the code range 92012-92014. Turning to the Medicine section, you will see that the code range is separated by the eye exam level. In this question, the evaluation level is intermediate, so the correct code for this part of the question is 92012. For the next part of the question, you will turn back to the index and look up ophthalmology, diagnostic, computerized scanning, posterior, which gives you the code range 92133-92134. Turning back to the Medicine section, the difference between the two codes in this range is the part of the eye being scanned. For the retina, which is the eye part being scanned in the question, the correct code is 92134. Code 92014 is for a comprehensive eye examination. The question states that only an intermediate eye examination is being performed, so this would not be the correct answer. Code 92225 is for an extended ophthalmoscopy, with retinal drawing. This is not what the question asks for, so this is an incorrect answer. Reference: AMA CPT® 2023 Professional Edition. Pg 742, 743. After suffering from GERD for years, the patient's GI doctor decides to perform an acid reflux test, with pH electrodes, through the nostrils to figure out the cause. How would this test be billed?
Correct answer: 91034 In the index of the CPT book, you will look up acid reflux test, esophagus. This gives us two code ranges: 91034-91035 and 91037-91038, which can be found in the Medicine section. The main difference between these two ranges is what kind of electrodes are used. In the case of this question, pH electrodes are used through the nostril. This means that code 91034, which is for GERD test, with nasal catheter pH electrodes placement, will be the correct answer to this question. Code 91035 is for the same test, but with mucosal attached telemetry pH electrode placement. The question asks for through-the-nostril placement, so this would not be the correct answer. Code 91030 is for esophagus, acid perfusion test for esophagitis. This is not what the question asks for at all, so this would be incorrect. Code 91010 is for esophageal motility study. This is also not what the question asks for at all, so this is also incorrect. Reference: AMA CPT® 2023 Professional Edition. Pg 740.
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