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Question: Evaluation and Management and Medicine Discussion . 1. Explain the difference between the coding ...

Evaluation and Management and Medicine Discussion

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1. Explain the difference between the coding of immune globulins and immunizations, how is the administration coded?

2. Explain in detail how to code for coronary therapeutic services and procedures

Explain how to code cardiac catheterizations (93451-93533) and injection procedures (93561 - 93571)

3. Explain what is considered when determining the medical decision making key components of the evaluation and management codes

Explanation / Answer

1.Coding of immunizations;

A compant refers to each antigen in a vaccine that prevent diseases caused by organism 90460 and 90461

99393 _preventive services

90649_HPV vaccine

90460_administration first component (1unit)

90715_Tdap vaccine

90460_administration of first component (1 unit )

90461_2 additional component (2 unit )

90660_influenza vaccine, live,for intranasal use

90460_administration first component (1 unit )

Immunoglobulin coding administration;

J1567_Immunoglobulin, liquid

Q4087_octagam injection

Q4088_gammagard liquid injection

Q4091_flebogamma injection

Q4092_gamunex injection

Q4089_Rhophylac injection

Q4090_HepaGam B injection

2.codes of coronary therapeutic services and procedures 92920_92934

For coronary angioplasty, coronary arteries and coronary artery bypass grafts. These new codes replace codes 92980_92984and 92995_92996.

Codes 92920 through 92934 angioplasty, aterectomy, placement of intracoronary stent and a combination code.

Codes 92937 _92944 coronary therapeutic services and procedures on coronary bypass grafts, coronary revascularization service occuringduring myocardial infraction and coronary revascularization services with the presence of chronic total occlusion.

Code of cardiac catherzation (93451_93533)

Cardiac catherzation codes 93451_93461include all of the mapping angiography the physician performance in order to place the catheter. Including any injection, imagine Sand I and report .these codes do not include that contract injection and imaging and report for imaging that is separately identifiable by a specific procedures.

93452_93461 include contrast injection, imaging SandI and report on the imaging that is typically performed.

Left heart catherzation codes 93452_93453 and 93458_93461include intra procedural injection of left ventricular or left atrial angiography and imaging performed.93454_93461 include intra procedural injection for coronary angioplasty .

93531 right and retrograde left heart catch for congenital anomalies

93532 combined right and transseptal left heart catherzation through intact spectum

93533 combined right and transseptal left heart cath through existing septum

Injection procedures 93561_93571

93561 cardiac catherzation injection procedures

93562 cardiac output

93563coronary angiography with catherzation for congenital anomalies

93564 bypass graft for congenital anomalies

93565 left heart angiography

93566 right hearth angiography

93567 left supra valvular ascending atrophy codes

93568 pulmonary angiography

93571 intravascular coronary flow measures

93572 additional vessels coronary flow

3.evaluation and management qualified provides maximise payment and reduce stress aassociation with audits by understanding.

Services for use billing purpose. Majority of patients visit require evaluation and management code.among other things are determined by the visit complexity and documentation requirements.

Code 1995

Chief complaints _purpose for the patient en counter, typicallyin the patient own words

History of presents illness

Location

Timing

Quality

Severity

Duration

Signsand symptoms

Context

Reviews of symptoms

Past family social history

Examination;

Problem focused

Expanded problem focused

Comprehensive general multi system examination

Medical desician making

Diagnosis and amount of data analysed and determine managementoptions

Straight forward

Lower complexity

High complexity

Moderate complexity

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