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A 77-year-old female found to have a right ureteropelvic junction (UPJ) obstruction with poor drainage of the kidney underwent a retrograde and ureteral stent placement previously. She is now...
An endopyelo...
The American Medical Association (AMA) has published two new codes for smoking and tobacco use cessation counseling visit (99406 and 99407). If our hospital respiratory therapists provide thi...
Yes, it woul...
This patient with a diagnosis of bony exostosis and scarring and fibrosis of the extensor tendon underwent an exostectomy of the right second toe metatarsal head with excision of extensive scarring...
Report CPT c...
A patient is admitted to the emergency room with abdominal pain, nausea, vomiting and gas. The nurse inserts a naso-gastric tube per physician’s order and documents the insertion. Wou...
CPT code 437...
A patient with a deviated nasal septum underwent a septoplasty. It was also noted that both inferior turbinates were hypertrophic thus reducing his nasal airway. The surgeon performed a...
Report CPT c...
A 38 year old female with a history of subtotal colectomy and ileorectal anastomosis due to ulcerative colitis presents to our facility for proctoscopy and ileoscopy with biopsy. The patient ...
Currently, t...
A patient presents for an excision of a lesion on the back. The surgeon fails to document the lesion size or the margins in the operative report. The pathology report has the total size of th...
According to...
A patient with a history of a total laryngectomy and tracheoesophageal puncture was seen for a blocked tracheoesophageal fistula and aphonia. Previous attempts in the office to clear the fist...
It would be ...
A patient with cataract of the left eye presents for cataract extraction. It was also noted prior to surgery that the patient had a significant amount of astigmatism due to a pterygium.  ...
The incision...
A patient with pancreatic and biliary stents presents for removal of the stents via esophagogastroduodenoscopy (EGD). The physician uses a videoduodenoscope and removes both the biliary and p...
According to...