Answer the following given Questions:

Note: It is recommended that you save your response as you complete each question.

Using your CPT coding manual, and review of the online lessons for the Musculoskeletal and Respiratory System within the Surgery Section, correctly assign codes to the following practice scenarios. You may wish to print this page in order to write down your code(s) assignment and your path through the Alphabetical Index.

Question 1
Amanda Wright is brought to the ER after falling off her bicycle. The ER physician , Dr. Wood, does an expanded problem-focused H&P and makes a low complexity analysis. He diagnoses a Colles fracture. He summons an orthopedic surgeon, Dr. Nickles, who performs manipulation on a closed basis to treat the fracture. Dr. Nickles then applies a short arm cast and releases the patient. Code for Dr. Wood.

Question 2
Dr. Boen, an orthopedist, is called to see Mike Disaster who was involved in a bicycle crash. Upon reviewing the x-rays ordered by the ER physician, Dr. Boen performs an open reduction and internal fixation of fractures of the radial and ulnar shaft, repairs a laceration of a flexor muscle in the forearm, and closed reduction of a fracture of the lateral condyle of the distal femur with manipulation. Code for Dr. Boen. (Hint: the open treatment is more service intensive for sequencing; and watch the indentation of the Alphabetical Index.)

Question 3
David Lewis is seen in the ER with fractures of the 3rd and 4th toes (phalanges) on the left foot. Dr. Johnson does an expanded problem-focused H&P and makes a low complexity analysis. Dr. Johson performs a closed treatment without manipulation of both phalanges. Code for Dr. Johnson.

Question 4

Toby Thompson is seen by Dr. Bend for a dislocation of the elbow and fracture of the scapula. Dr. Bend performs an open reduction of the scapular fracture with internal fixation and closed manipulation of the elbow dislocation under general anesthesia. Code for Dr. Bend. (Hint: Which procedure is more service intensive? It should be sequenced first.)

Question 5

Adam Ansel is seen by his orthopedist, Dr. Becker, for a fracture of the left talus and a dislocation of the metacarpophalangeal joint of the right hand, 3rd finger. Dr. Becker performs an open reduction and internal fixation of the talus fracture. He also performs an open reduction of the dislocation under anesthesia. (Hint: Either could be sequenced first depending on the reimbursement value; more information would be needed for sequencing.)

Question 6

Clint Westwood is admitted to Sinclair Memorial Hospital on 11/1 by Dr. Zorba. That same morning Dr. Zorba performs a total knee replacement on Clint. Dr. Zorba sees him on 11/2 and 11/3 performing a problem-focused H&P and making a straightforward analysis. On 11/4, Dr. Zorba discharges Clint after exam and instructions.

Question 7

Robert DeViro is seen in the ER by Dr. Hunt as a result of an auto accident. Dr. Hunt diagnoses a dislocated hip and a fracture of the tibial and fibular shafts. An expanded problem-focused H&P and moderate complexity analysis was documented. Dr. Hunt manipulates the dislocation under local anesthesia. The fractures are nondisplaced and do not require manipulation, so he applies a shortleg cast. The patient will follow up with Dr. Hunt in his office. Code for Dr. Hunt. (Hint: Sequence based on intensity of service for the procedures.)

Question 8

Dr. Lowe, an orthopedist, sees Mrs. Topper who has a closed fracture of the tibial shaft. She was previously treated by another physician who casted the fracture after manipulation. Mrs. Topper complains of pain in the fracture area, so Dr. Lowe x-rays the leg. He finds that the fracture is not completely reduced. He manipulates it again and then immobolizes it. Code for Dr. Lowe. (Hint: The patient is still in the global surgical package period.)

Question 9

Scott Bayo is seen in the Ambulatory Surgery Center by Dr. Klip for a synovial biopsy via arthrotomy on the second metacarpophalangeal joint of the third finger, left hand. The postoperative diagnosis is tenosynovitis, 3rd finger on the left hand. Code for Dr. Klip

Question 10
Patient is seen in the office as an established patient with complaint of a lump in the upper thigh of the left leg. Dr. Harry does an problem-focused history and examination and makes a straightforward medical decision. Dr. Harry performs a needle biopsy of the rectus muscle of the upper left thigh.

Question 11
A new patient is seen in Urgent Care with a complaint of uncontrolled epistaxis. The physician does an expanded problem-focused H&P and makes a low complexity analysis. He notes bleeding in the anterior nasal cavity. The patient's history reveals a Factor IX clotting deficiency disorder (hemophilia Type B). The physician cauterizes and packs the anterior nasal cavities bilaterally. Code for the physician.

Question 12

A patient is seen for OP surgery for chronic sinusitis and antrochoanal polyps on both sides. The physician performs a Caldwell Luc procedure with removal of antrochoanal polyps from both sides.

Question 13
A patient is seen in ambulatory surgery for vocal cord nodule. The procedure performed is a flexible fiberoptic larynogoscopy with biopsy of the vocal cords. The pathology report indicates adenocarcinoma of the right vocal cord. Code for the surgeon.

Question 14

Richard Burns is seen in surgery on 10/30 for carcinoma of the left lower lobe of the lung which is a primary cancer. Dr. Marlin performed a complete excisional pneumonectomy of the left lower lobe. On 10/31, Dr. Marlin see Richard in follow-up to the surgery. Code for Dr. Marlin. (Hint: Be careful with the wording!)

Question 15

A patient was seen in ambulatory surgery for closure of a temporary tracheostomy. Code for the surgeon.

Question 16

Sally Suthers was seen in outpatient surgery for a scheduled needle biopsy of a lung mass today. Sally was previously seen in the offie where a chest x-ray revealed a mass in the upper lobe of the right lung. Patient has a history of COPD and has a 30-year history of smoking. Code for the surgeon.

Question 17

Donald Bryant was seen in the office for an incision and drainage of a simple inguinal lymph node abscess. Code for the physician

Question 18

Cindy Lew was seen in ambulatory surgery for a direct-rigid bronchoscopy with bronchial dilation due to chronic bronchial stenosis. Code for the physician.

Question 19
Darla Darling is seen by the ENT for ambulatory surgery for a deviated nasal septum, nasal airway obstruction, and nasal polyps. The ENT performs an excision of three (3) polyps with submucous resection of nasal septum. Code for the ENT. (Hint: Either could be sequenced first as more infomation is needed regarding payment; facility setting vs. office setting.)

Question 20

Tommy Tucker was seen in outpatient surgery for chronic hoarseness and laryngeal pain. The ENT performed a direct microlayngoscopy with right vocal cord stripping under general anesthesia. Code for the ENT.