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Transcript of Slide 0 CPT - Medicine Section – Medical Coding II Messick Adult & Technology Center MEDICINE...
Slide 1CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
MEDICINE SECTIONMEDICINE SECTION
Slide 2CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Medicine (90281-99602)Medicine (90281-99602)
Many specialized types of testing can be found in the Medicine section (e.g., biofeedback, audiologic function tests, electrocardiograms).
Codes in this section do not do not usually include the supplies used in the testing, therapy or diagnostic treatments unless specifically stated in the code description.
• For Example: For Example: there are codes for the codes for the prescription prescription and and fittingfitting of an artificial eye, of an artificial eye, one code include the one code include the supply of an artificial eye supply of an artificial eye and one code does not.and one code does not.
Slide 3CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Medicine (90281-99602)Medicine (90281-99602) Reading the entire code description is critical Reading the entire code description is critical to
ensure that you do not unbundle the services by reporting services already included in the code.
You should code suppliessupplies,, including drugs separately unless otherwise instructed in the code information.
CPT Code 99070CPT Code 99070 is the supplies and materials code used to identify the supplying drugs, trays, supplies, or materials needed to provide the service or the specific HCPCS supply code.specific HCPCS supply code.
Slide 4CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Immunizations(90465-90479)Immunizations(90465-90479)
There are two types of immunization – activeactive & passivepassive
Active ImmunizationActive Immunization is the type given when it is anticipated that the person will be in contact with the disease.
• Active immunization Active immunization agents can be can be toxoidstoxoids or vaccinesvaccines.
• ToxoidsToxoids are bacteria that have been made nontoxic; when injected.
They produce an immune response that builds protection against a disease.
• VaccinesVaccines are viruses that are given in small doses and cause an immune response.
Slide 5CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Immunizations(90465-90479)Immunizations(90465-90479)
Passive Immunization Passive Immunization does not cause an immune response.
• The injected material contains a high level of antibodies against a disease (e.g., rabies, hepatitis B, tetanus), called “immune globulins”.
The three subsections three subsections in the MedicineMedicine section are:
1. Immune Globulins
2. Immunization Administration for Vaccines/Toxoids
3. Vaccines, Toxoids
Slide 6CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Immune Globulins (90281-90399) Immune Globulins (90281-90399)
Identifies immune globulin product
Example: Example: Botulism Antitoxin Report administration separately
Slide 7CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Immune Globulins Codes Divided By (90281-90399) Immune Globulins Codes Divided By (90281-90399)
Type
ExamplesExamples: Rabies, hepatitis B Method
Examples: Examples: Intramuscular, intravenous, subcutaneous
Dose
Examples: Examples: Full dose, minidose
Slide 8CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Immunization Administration for Vacines/Toxoids (90465-90474)Immunization Administration for Vacines/Toxoids (90465-90474)
Immunization Administration Immunization Administration subsection codes are reported in conjunction with the Vaccines, Toxoids subsection.
The Methods of Administration are: Percutaneous Intradermal Subcutaneous Intramuscular Jet Intranasal Oral
Slide 9CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Report Administration for Each Dose— Single or CombinationReport Administration for Each Dose— Single or Combination
ExampleExample: : Patient (10 years old) receives three separate injections
90471, 90471, Administration of tetanus 90472, 90472, Administration of rubella 9047290472, Administration of diphtheria
• OR depending on payer: 90471, 90471, Administration of tetanus 90472 x 2, 90472 x 2, Administration of rubella & diphtheria
Slide 10CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Vaccines & Toxoids - (90476-90749)Vaccines & Toxoids - (90476-90749)
Many codes are age-specificage-specificExample
90658, 90658, Influenza vaccine, for ages 3 & over
Codes for products for single diseases Example
90703, 90703, Tetanus
Codes for combination diseases Example
90701,90701, Diphtheria, tetanus, & whole cell pertussis (DTP)
Slide 11CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Vaccines & ToxoidsVaccines & Toxoids
Some vaccines given on schedule
Example Example
• 9063390633, , 2-dose hepatitis A vaccine 1st dose 1st visit 2nd dose 2nd visit
Slide 12CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
RememberRemember Do not use modifier -51 with Vaccine/Toxoid
codes• Depending on payer
List each code multiple times or Use times () symbol & indicate number
Important Reporting Rule Important Reporting Rule If vaccine administered during office visit (not
related to E/M) • Report E/M service (with modifier -25) plus
vaccine + administration Office visit for vaccine only: Code only vaccine,
NO E/M serviceNO E/M service
Slide 13CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Immunization Injection PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Immunization Injection PERFORMANCE EXERCISEPERFORMANCE EXERCISE
A parent takes a 9-year-old child’s physician for an oral poliomyelitis vaccine. The physician’s assistant evaluates the (established patient) and administers the vaccine orally to the child.
90712 – (Vaccines, Poliovirus, Live, Oral)
90473 – (Immunization Administration. One Vaccine/Toxoid)
99211-25 (E/M) NOTE:NOTE: Medicare does not allow an E/M Medicare does not allow an E/M service to be submitted when the only service is the service to be submitted when the only service is the administration of a vaccine.administration of a vaccine.
Slide 14CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Routine Vaccinations for Those Over 8Routine Vaccinations for Those Over 8
Influenza• Substance (vaccine): 90657-90658
• Administration G0008G0008 HCPCS (Medicare only) 90471/9047290471/90472
PneumococcalPneumococcal• Substance (vaccine): ): 9073290732
• Administration G0009G0009 HCPCS (Medicare only) 90471/9047290471/90472
Slide 15CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Psychiatry (90801-90802)Psychiatry (90801-90802)
Psychiatric treatment at same time as E/M service, report• One code for psychotherapy with E/M
Time major billing factor• Codes divided on time
• Record indicates session time
Slide 16CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Psychiatry - (90801-90802)Psychiatry - (90801-90802)
Many services provided in partial hospital settings• Patient in hospital during day, return to home for
evenings & weekends Codes divided by
• Interactive or insight oriented
• Inpatient or outpatient
• With or without E/M
• Individual or group
Slide 17CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Psychiatry - (90801-90802) PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Psychiatry - (90801-90802) PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Individual medical psychotherapy in office for 30 minutes.
90804
Psychological testing, 2 hours, administered by a physician.
96101 x2
Psychiatric evaluation of tests, medical records, or hospital data to make appropriate diagnosis.
90885
Slide 18CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Biofeedback (90901-90911)Biofeedback (90901-90911)
Biofeedback is a process of giving a person self-information.
The information is used by patients to gain some control over their physiologic processes, such as blood pressure, heart rate or pain
Patient are trained in biofeedback by professional, then continues the therapy on their own.
Biofeedback is often part of the individual’s psychophysiologic therapy.
Slide 19CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Biofeedback (90901-90911) PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Biofeedback (90901-90911) PERFORMANCE EXERCISEPERFORMANCE EXERCISE
A 52-year-old man is referred to the physician by his primary care physician for biofeedback to help regulate his blood pressure. The physician conducts a 60-minute session during which the patient is trained in the use of biofeedback.
90901
Slide 20CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Dialysis (90918-90999)Dialysis (90918-90999)
Cleanses blood• Temporary (non-ESRD)
• Permanent (ESRD) Two parts to report ESRD (end stage renal
disease) dialysis services: • Physician service & hemodialysis procedure
Slide 21CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
ESRD Physician Services (90918-90925)ESRD Physician Services (90918-90925)
Includes:• Establishment of dialyzing cycle
• Physician services
• E/M outpatient dialysis visits
• Telephone calls
• Patient management during dialysis Reported for month: 90918-9092190918-90921
• Less than full month of service: 90922-9092590922-90925 per day
• Codes divided on age
Slide 22CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Hemodialysis Services (90935-90940)Hemodialysis Services (90935-90940)
Hemodialysis procedureHemodialysis procedure• Used for ESRD & non-ESRD
Billed per day for inpatients receiving ESRD Includes all physician E/M services related to
procedure• Use modifier -25 -25 if separate E/M service provided
Slide 23CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Miscellaneous Dialysis Procedures (90945-90999)Miscellaneous Dialysis Procedures (90945-90999)
Describes other dialysis procedures
Example: Example: Peritoneal dialysis in which toxins are passively
absorbed into dialysis fluid
Peritoneal DialysisPeritoneal Dialysis Services billed on per-day basis for inpatient ESRDESRD (end
stage renal disease) patients Patients can receive training in self-dialysis
• Reported with 90989-9099390989-90993
• Codes divided by completecomplete or partialpartial training program
Slide 24CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Dialysis (90918-90999) PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Dialysis (90918-90999) PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Hemodialysis with a single physician evaluation, inpatient
90935
Peritoneal dialysis with repeated physician evaluation, inpatient
90947
Slide 25CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Gastroenterology (91000-91299)Gastroenterology (91000-91299)
For tests & treatments of esophagus, stomach, & intestine
Codes usually reported with E/M or ConsultationConsultation Service code
Caution: Caution: Many bundled services
Slide 26CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Gastroenterology (91000-91299) PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Gastroenterology (91000-91299) PERFORMANCE EXERCISEPERFORMANCE EXERCISE
A gastroesophageal reflux test with nasal catheter intraluminal impedence electrode for detection of reflux, 2 hours
91038
Gastric intubation and aspiration for treatment of ingested poison
91105
Slide 27CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
General Ophthalmology (92002 -92499)General Ophthalmology (92002 -92499)
Contains E/M codes Definitions for new & established patients same
as for E/ME/M section Codes for bilateral services
• If only one eye, use modifier -52 (reduced service)
Slide 28CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Ophthalmologic Services (92502-92700)Special Ophthalmologic Services (92502-92700)
For special evaluations of visual systemvisual system Goes beyond those usually provided in
evaluation May be reported in addition to basic visual
service
Slide 29CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
General Ophthalmology (92002 -92499)PERFORMANCE EXERCISEPERFORMANCE EXERCISE
General Ophthalmology (92002 -92499)PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Fitting of contact lens for treatment of a cataract, including the lens
92070
New patient, comprehensive ophtalmologic examination
92004
Slide 30CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Otorhinolaryngologic Services (92502-92700)Special Otorhinolaryngologic Services (92502-92700)
Special treatmentstreatments & diagnosticdiagnostic services
ExamplesExamples Nasal function tests (rhinomanometry) &
audiometric tests
All hearing tests bilateral unless indicated one ear in description
Slide 31CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Otorhinolaryngologic Services (92502-92700)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Special Otorhinolaryngologic Services (92502-92700)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Screening test, pure tone, air only
92551
Nasal function study
92512
Slide 32CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Therapeutic Services and Procedures(92950-92998Therapeutic Services and Procedures(92950-92998
Under this section you will find noninvasive cardiovascular service codes, such as cardiopulmonary resuscitation (CPR) and cardiopulmonary resuscitation (CPR) and cardio-conversion.cardio-conversion.
Percutaneous translumeninal coronary angioplasty (PTCA) codes are also found in this section.
Slide 33CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Echocardiography – 93501-93350Echocardiography – 93501-93350
Echocardiography – is an ultrasound examination of the heart heart chambers/valueschambers/values, the adjacent vesselsadjacent vessels, and the pericardiumpericardium.
Slide 34CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Cardiac Catheterization (93501-93350)Cardiac Catheterization (93501-93350)
Codes – report cardiac catheterizationcardiac catheterization, which is a diagnostic medical procedure performed of the heart.
In this section, you report the catheter placement, injectionplacement, injection, and guidanceguidance services with the follow codes:• Catheter placement Catheter placement 93501-9353393501-93533
• Injection 93539-93545Injection 93539-93545
• Guidance Guidance 93555-9355693555-93556
Slide 35CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Noninvasive Vascular Diagnostic Studies (93875-93993)Noninvasive Vascular Diagnostic Studies (93875-93993)
Codes in this subsection are used to identify procedures that are conducted to study veins veins and arteries arteries other than the heart and great vessels.
These studies use the same devices as are used in heart and great-vessel echocardiography, except the divisionsdivisions are based on the location location of the vein or artery being studies.
Slide 36CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Noninvasive Vascular Diagnostic Studies (93875-93993)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Noninvasive Vascular Diagnostic Studies (93875-93993)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
A patient is referred for a single-level, bilateral venous occlusion plethysmography of leg.
93965
A 34-year-old patient presents with a history of inability to sustain an erection. The physician uses a duplex scan to conduct a complete study of the arterial and venous flow of the penis.
93980
Slide 37CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Pulmonary (94002-94799)Pulmonary (94002-94799)
Codes in Pulmonary subsection include codes for therapiestherapies, such as nebulizernebulizer treatments and incentive sspirometrypirometry, and for diagnostic testdiagnostic test, such as pulmonary function test.
A nebulizer nebulizer is a device that produces a spray, which is inhaled, used to treat patient with asthma, etc.
Slide 38CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Pulmonary (94002-94799)PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Pulmonary (94002-94799)PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Pulmonary stress test, simple
94620
Bronchodilation responsiveness evaluation with spirometry before and after bronchodilator treatment.
94060
Slide 39CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Allergy Testing (95004-95075)Allergy Testing (95004-95075)
Sensitivity testing using various types of tests
ExamplesExamples PercutaneousPercutaneous, , intracutaneous,intracutaneous, inhalationinhalation
Tests use numerous substances
ExamplesExamples Extracts,Extracts, venomsvenoms, , biologics,biologics, && foodsfoods
Type Type & numbernumber of tests based on physician’s judgment
Slide 40CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Allergy Testing - (95004-95075)Allergy Testing - (95004-95075) Medical record will indicateMedical record will indicate
• Number of tests
• Type of test
• Method of testing
Allergen Immunotherapy (95115-95199) Allergen Immunotherapy (95115-95199) Codes divided into three servicesCodes divided into three services
• Injection only
• Prescription & injection
• Provision of antigen (substance) only Physician service bundled into Immunotherapy Physician service bundled into Immunotherapy
codescodes
• If separate E/M service provided, report separatelyreport separately
Slide 41CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Allergy & Clinical Immunology (95004-95199)Allergy & Clinical Immunology (95004-95199)
Divided into twotwo subheadings
• Allergy Testing Allergy Testing (95004-95078)(95004-95078)
• Allergen Immunotherapy Allergen Immunotherapy (95115-95199)(95115-95199)
Percutaneous test using allergen extracts, immediate type reaction, 10 tests.
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
95004 x10
Single injection of allergen using extract provided by the patient.
95115
Slide 42CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Neurology & Neuromuscular Procedures (95805-96004)Neurology & Neuromuscular Procedures (95805-96004)
Contains codes to report tests:
ExamplesExamples Sleep tests Muscle tests (electromyography) Range-of-motion measurements Electroencephalogram (EEG) Neurostimulator procedures
Many bundled services Services usually provided in addition to E/M E/M
serviceservice
Slide 43CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Neurology & Neuromuscular Procedures (95805-96004)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Neurology & Neuromuscular Procedures (95805-96004)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Awake and drowsy EEG and photic stimulation in clinic
95816
Range of motion measurement and report on both legs
95851 x2
Slide 44CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Central Nervous System (CNS) Assessments/Tests (96101-96125)Central Nervous System (CNS) Assessments/Tests (96101-96125) Used to reportUsed to report
• Psychological tests
• Speech/language assessments
• Developmental progress assessments
• Thinking/reasoning examinations
CNS Assessments/TestsCNS Assessments/Tests
Codes based on per-hourper-hour basis• Except for basic developmental testing
Includes written report of results
Slide 45CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Central Nervous System (CNS) Assessments/Tests (96101-96125)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Central Nervous System (CNS) Assessments/Tests (96101-96125)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE A young executive is referred for an 80-minute Minnesota
Multiphasic Personality Inventory (MMPI) (MMPI) test by his employer. The employer requests the testing for all newly hired executives who will be working with highly sensitive government documents.
96101
A 14-year-old is seen in the office for a 70-minute assessment of the child’s attention span. The child is experiencing increasingly severe episodes of daydreaming. The physician conducts a clinical assessment of the child’s cognitive function.
96116
Slide 46CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Chemotherapy Administration (96401-96549)Chemotherapy Administration (96401-96549)
Represents only Represents only preparation & preparation & administration of administration of chemotherapychemotherapy• If separate E/M service
provided, report E/M code plus –25–25
Chemical can be Chemical can be administered administered (injected) into (injected) into • Lesion
• Vein
• Tissue
• Muscle
• Artery
• Cavity
• Nerve
Slide 47CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Chemotherapy Administration (96401-96549)Chemotherapy Administration (96401-96549)
Intravenously injected chemicals, two methods of delivery of chemical• IV push quickly puts chemical into vein
• IV infusion delivers chemical over longer period of time
CodesCodes often divided on timetime of injection procedure
Example Example
• 9641396413, , Chemotherapy administration, intravenous push, up to 1 hour
Slide 48CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Chemotherapy Administration Chemotherapy Administration Chemical agent (substance) reported separately
using 96545 96545 or HCPCS J HCPCS J code Special supplies (e.g., special needles) reported
separately using 99070 99070 or HCPCS code HCPCS code
Report any intra-arterial catheter placement with 36620-36640 36620-36640
Injections with ChemotherapyInjections with Chemotherapy
Report separately any analgesicanalgesic or antiemeticantiemetic (for vomiting) • Before or after chemotherapy
Slide 49CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Chemotherapy Administration (96401-96549)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Chemotherapy Administration (96401-96549)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Chemotheraphy administered subcutaneously with local anesthesia
96401
Chemotheraphy administered intravenously using the infusion technique for 50 minutes
96413
Slide 50CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Photodynamic Therapy (96567-96571)Photodynamic Therapy (96567-96571)
Used in conjunction with the codes for bronchoscopy for bronchoscopy or endoscopyendoscopy.
An agentagent is injected into the patient and remains in cancerous cell longer than in normal cells.
After the agent is dissipated from the normal cells, the patient is exposed to laser lightlaser light.
The agent absorbs the light and the light produces oxygenlight produces oxygen, destroying the cancerous cells.
CodesCodes for endoscopic application are divided on the basis of timetime- the first 30 minutes first 30 minutes & each additional 15 minutes.additional 15 minutes.
External application is based on each exposure sessionexposure session.
Slide 51CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Dermatological Procedures (96900-96999)Special Dermatological Procedures (96900-96999)
Usually used by a dermatologist who sees a patient in an office on a consultation basis.• Separate E/M Consultation code are used
Treatment of skin conditionsTreatment of skin conditions• ActinotherapyActinotherapy—with ultraviolet light
• PhotochemotherapyPhotochemotherapy—with light-sensitive chemicals & light rays
Slide 52CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Dermatological Procedures(96900-96999)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Special Dermatological Procedures(96900-96999)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
A 16-year-old patient sees a dermatologist in consultation, at which time the physician does a problem focus history and physician examination regarding the patient’s acne. The physician prescribes and provides a treatment of ultraviolet light therapy.
1.1. 99241 -25 99241 -25 ( Consultation, Office and/or Other Outpatient)
2. 96900 2. 96900 (Ultraviolet Light Therapy)
Slide 53CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Dermatological Procedures(96900-96999)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Special Dermatological Procedures(96900-96999)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Photochemotherapy is provided for a 34-year-old consultative patient with severe dermatosis. The patient receives 8 hours of treatment. The physician provides a comprehensive history and physical examination with moderately complex medical decision making.
1.1. 99244 -25 99244 -25 ( Consultation, Office and/or Other Outpatient)
2. 96913 2. 96913 (Photochemotherapy)
Slide 54CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Physical Medicine & Rehabilitation (97001-97799)Physical Medicine & Rehabilitation (97001-97799)
Used by physicians & therapists to report services for variety of treatments
ExamplesExamples Traction Electrical stimulation (used to help heal fractures)
Patient TrainingPatient Training• Gait training
• Functional activities
Codes often have time components
Example: Example: 9750497504, Orthotics fitting & training, per 15 15 minutes
Slide 55CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Physical Medicine & Rehabilitation (97001-97799)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Physical Medicine & Rehabilitation (97001-97799)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Initial prosthetic training, 30 minutes
97761 x2
Physical medicine treatment procedure, gait training, 30 minutes.
97116 x2
Slide 56CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Active Wound Care Management (97602-97606)Active Wound Care Management (97602-97606)
Debridement Debridement • Negative pressure wound therapy (NPWT)
pump draws fluid off the wound and then negative pressure draws the edges of wound together
• Nonselective: Healthy tissue removed along with necrotic tissue
Each code for ongoing care reported on per-session basis
Slide 57CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Osteopathic & Chiropractic Services(98925-98943)Osteopathic & Chiropractic Services(98925-98943)
Both inpatient & outpatient inpatient & outpatient settings Physician services Physician services bundled into codes Codes divided by body areabody area
Slide 58CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Services, Procedures, & Reports (99000-99091)Special Services, Procedures, & Reports (99000-99091) Handling & conveyance of laboratory specimens
• 99000-9902299000-99022
Postoperative follow-up visits included in surgical package• 9902499024
Office visits after posted hours or in locations other than office • 99050-99056 99050-99056
Slide 59CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Services, Procedures, & Reports (99000-99091)Special Services, Procedures, & Reports (99000-99091)
Supplies & materials • 9907099070
Hospital-mandated on-call services• 99026-9902799026-99027
Slide 60CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Services, Procedures, & Reports (99000-99091)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Special Services, Procedures, & Reports (99000-99091)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Sally, a 43-year-old woman, presents with the complaint of a seizing pain in the area of her lower left hip. The chiropractor conducts an assessment of the patient and provides chiropractic alignment to two spinal regions.
98940
Osteopathic lumbar manipulation (OMT), one region
98925
Slide 61CPT - Medicine Section – Medical Coding IIMessick Adult & Technology Center
Special Services, Procedures, & Reports (99000-99091)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
Special Services, Procedures, & Reports (99000-99091)
PERFORMANCE EXERCISEPERFORMANCE EXERCISE
What Medicine code is reported in addition to the basic service code when a service is provided after hours on Sunday.
9905099050
Conveyance of a specimen from the physician’s office to a laboratory.
9900099000
Supplies provided for an office visit exceeding those usually used.
9907099070