Exam 38176000

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1.) The first goal of the physician payment reform is to redistribute payments more equitably by ensuring that physicians receive a fair payment for services rendered. The next goal is to decrease the amount that Medicare pays out by promoting preventative care and preventing unnecessary hospital stays. The third goal is to ensure that medical treatment be available for all patients by ensuring quality healthcare at a reasonable rate. 2.) Modifier -25 would be the appropriate choice. It is a separately identifiable service provided by the same physician on the same day. 3.) Medicare pays physicians for services based on three basic components called relative value units. The first is physician work which is the time, skill, and training it takes to provide a particular service. The next is practice expense which is everything that goes into running a practice, like rent, equipment, supplies, ect.. The last of these is malpractice which covers the cost of professional liability expenses. 4.) The first types of people that are eligible for Medicare are those who are age 65 and over. The second are people who are disabled and drawing social security disability, and the third are people who are in the end stage of renal disease. 5.) The six basic location methods to locate main terms in the index of the CPT manual are, service or procedure, anatomic site, condition or disease, synonym, eponym, and abbreviation. 6.) 99253 is the appropriate E/M code. The consultation was with a detailed history, a detailed exam, and MDM of low complexity. 7.) Of the four elements of history the first is the chief complaint. Second is the history of present illness. Third is the review of systems, and fourth is past, family, and/or social history. 8.) The complexity of medical decision making is based on these three elements. First is the number of diagnosis or management options, second is the amount and/or complexity of data to review, and third is the risk of complication or death if untreated. 9.) The appropriate CPT code for this scenario is 99214. There is a detailed history, a detailed exam, and a MDM of moderate complexity. 10.) There are three key components that are present in every patient case except in counseling encounters and time based codes, that enable the coder to choose the appropriate level of service. These components are history, exam, and medical decision making. 11.) The appropriate CPT code for this clinic note is 99396. It is a 42 year old female who presents for a routine physical exam, which is a preventative measure. 12.) This case is a home visit with a problem focused history, a problem focused exam, and a straightforward MDM. Therefore the appropriate CPT code would be 99341. 13.) There are four levels of history type. These are problem focused, extended problem focused, detailed, and comprehensive. 14.) The appropriate CPT code is 99281. The appropriate ICD-9 code is 918.1. 15.) This scenario has a problem focused history, a problem focused exam, and a MDM that is straightforward or of low complexity. Therefore the appropriate CPT code is 99231. 16.) This patient diagnosis was a probable myocardial infarction without a history of MI in the past. So the correct ICD-9 code would be 410. 17.) The correct CPT code is 13160. The correct ICD-9 code is 998.32. 18.) There are three contributing factors of medical decision making complexity. These are the number of diagnoses, the risk of morbidity, and the amount of data. 19.) In this scenario the patient has a fracture of the distal radius. The correct CPT code for that is 25600. 20.) There are five graft types represented in the musculoskeletal subsection. Four of these are bone graft, tissue, fascia, and cartilage. 21.) The procedure performed in this scenario is the placement of a halo. The correct CPT code for this scenario is 20661. 22.) The procedure in this scenario is a left heart...
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