CPT Codes, Appropriate Modifiers and Accident Insurance

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Complete the following 2 exercises
1. Assign CPT code(s) and appropriate modifier(s) for each statement below:

a) Deep incision with opening of bone cortex, thorax.
b) Hyoid myotomy and suspension.
c) Closed treatment of sternum fracture.
d) Partial excision of rib.
e) Sternal debridement.
f) Needle biopsy, soft tissue, and thorax.
g) Excision of tumor, soft tissue of back.
h) The physician removed a malignant soft tissue tumor from the patient’s flank, and radical resection was performed to remove the tumor and adjacent tissue. The surgical wound was repaired with complex closure. i) Patient underwent biopsy of superficial soft tissues of the back. j) Biopsy, soft tissue of flank, deep

Answer:
a) 21510
b) 21085
c) 21825
d) 21600
e) 21627
f) 21550
g) 21930-21936
h) 21935
i) 21920
j)

2. Write a 1-page essay to answer the following questions below:

Johnny was riding in his mother’s car when another car hit them. He suffered several leg and rib fractures and was taken to the local hospital for treatment. His injuries included a closed fracture of the right Tibia, and closed fracture of the 3rd and 4t ribs on the right side. Treatment included the closed reduction of his fractures. The hospital submitted an insurance claim to his parent’s medical insurance for payment. The insurance company denied payment.

1. How could this have happened when the insurance was in force at the time of the accident? 2. What potential codes describe Johnny’s injuries and procedures?

Answer:

The person submitting forms to the insurance company may have put information incorrectly onto the document. This can create a problem with insurance companies and in turn can cause more problems. It is important for a medical professional to be careful and diligent as it will not only save time for the physician but also for his office. Not to mention, the patient will be less...
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