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21.The physician on duty examined the patient and determined that patient was ready for discharge. The physician spent 25 minutes on the hospital discharge of an inpatient discharge. What is the correct procedure code?
22.An forensic pathologist performed a gross post=mortem examination on a stillborn infant. The exam included the infant’s brain, but did not include the infant’s spinal cord. How should the pathologist code for this service?
24.A pediatric patient with a history of asthma and pneumonia presented to the office with severe respiratory distress. The pediatrician performed a detailed history and comprehensive examination, and diagnosed the patient with status asthmaticus. A pulse oxygen level was taken and it was determined that the patient’s blood oxygen level was at 88%. The patient was started on a nebulizer treatment at 0950 hours, which lasted until 1015 hours. The physician then re-checked the patient and determined that the patient’s breathing had only slightly improved. A pulse oxygen level was taken again and it was determined that the patient was at 92%. The physician then ordered another nebulizer treatment, which was started at 1032 and continued until 1054. After this second breathing treatment, an additional pulse oxygen level was taken and the patient’s blood oxygen level had risen to 97%. The pediatrician then determined that the patient needed to be sent for chest x-rays to determine whether or not pneumonia was present in the lungs. Due to the resulting amount of data and risk, the pediatrician considered the MDM of high complexity. The total time spent with the patient was 1 hour 45 minutes.
What E&M codes would you use to code for the office visit?
25.HOSPITAL CHARGE SHEET PATIENT: Carson, Cason AGE: 10 DATE OF ADMISSION: 01/02/2014 DIAGNOSIS: Coccidiomycosis Meningitis DATE OF DISCHARGE: 01/08/2014
The patient was admitted on 01/02/2014 complaining of a severe headache and hyperpyrexia. An lumbar puncture determined on 01/02/2014 that the patient was suffering from coccidiomycosis meningitis. The patient was administered antibiotics and admitted to the hospital for observation and management of the condition. The patient’s condition improved slowly with a regression on 01/05/2014, at which time the antibiotics were changed. After the change in medication, the patient’s condition rapidly improved and by 01/07/2014, the patient no longer developed a fever or headache when not on pain medications. On 01/08/2012, the physician spent 20 minutes managing patient discharge, with instructions to continue antibiotics and pain medications, as needed.
What E&M service codes would be reported for this service?
