Eye And Ear

Front 1

Blanks develop in the sensitive lens of your eye as opaque clumps of tissue. Since the lens focuses light into crisp images, just like a camera lens, this causes a particular loss of vision. Symptoms include dimness, selective blurriness, night blindness, double vision, yellowish or grey colors, or blocked regions of view. Cataracts form in old age, or can accompany other diseases such as diabetes. When diagnosed early, they are surgically removed with a high rate of success.

Back 1

Cataracts

Front 2

A blank blank is an eye condition characterized by a centralized clouding of the lens that interferes with one’s vision. Risk factors for this form of cataract development include advanced age, certain existing medical conditions and lifestyle factors. Treatment for a nuclear cataract generally involves surgery to replace the affected lens. As with any invasive medical procedure, cataract surgery does carry some risk for complication, including excessive bleeding and infection.

Back 2

nuclear cataract

Front 3

An blanklens is a medical device which can be implanted in an eye to replace a lens which has been removed. blank lenses are classically used in the treatment of cataracts, with the cataract being removed and replaced with an artificial lens, although they can also be used to correct certain types of vision problems. The technology behind intraocular lenses has been around since 1949, when the first one was implanted in Britain, but it has improved significantly since the early days, with a number of options available to patients today.

Back 3

intraocular

Front 4

Index to Procedures: Phacoemulsification cataract extraction and intraocular lens implantation

Back 4

1.Index to Procedures: Phacoemulsification, 13.41 (Extraction portion)
2.Index to Procedures: Insertion, Lens, 13.71 (Insertion portion)

Front 5

Index to Diagnosis:Nuclear and cataract right eye

Back 5

1. Catarct
2.Nuclear (Nuclear Sclerosis)
3.366.16

Front 6

Procedure Performed: Phacoemulsification cataract extraction and intraocular lens implantation (Right)
CPT?

Back 6

Procedure Performed: Phacoemulsification cataract1 extraction2 and intraocular3 (intracapsular) lens implantation
Procedure Performed: Phacoemulsification cataract extraction and intraocular lens implantation. 66984-RT

Front 7

Procedure Performed: Pars plana vitrectomy with repair of macular hole right side
(CPT)

Back 7

1. Vitrectomy, 2. Pars Plana Approach, 3. Pages 67036-67043, 4. 67402 (see page 355, operating microscope, which lists codes that already include the operating microscope.
5. CPT: 67042-RT

Front 8

Index to Disease: Macular hole in the right eye

Back 8

Degeneration, Macula, Hole, 362.54

Front 9

Procedure name: Bilateral congenital protruding ears

Back 9

Otoplasty

Front 10

Procedure Performed: Otoplasty (Bilateral)

Back 10

1. Otoplasty
2. Bilateral
3. 69300-50

Front 11

Preoperative Diagnosis: Bilateral congenital protruding ears

Back 11

Protrusion, ear, congenital, 744.29

Front 12

A bnalk and blank implant is an artificial hearing aid that is surgically implanted in a person who has significant hearing loss. The term “bilateral” means that both ears are implanted with a device, rather than just one ear. There is an external and an internal component to a cochlear implant. An external earpiece converts sounds to electrical currents and transmits them to the internal receiver. The current then reaches the auditory nerve, allowing the patient to “hear” the sounds.

Back 12

bilateral cochlear

Front 13

Procedure Performed: Cochlear device implantation on the left ear.

Back 13

Cochlear Device
Insertion 69930
Procedure Performed: Cochlear device implantation. 69930-LT

Front 14

Preoperative Diagnosis: Mixed conductive and sensorineural hearing loss.

Back 14

1. Index to Diseases
2. Deafness
3. Conductive
4. Unilateral (389.21)

Front 15

Index to Procedures:
Procedure Performed: Cochlear device implantation

Back 15

1. Index to Procedures
2. Implant
3. Cochlear (electrode)
4. Channel (single)
5. 20.97

Front 16

The patient cut her fingers at home with an electric knife. She went to the emergency room at Seattle Grace Hospital. She was taken to the operating room for repair of the open wounds on the right index and right middle fingers. Procedures performed: repair of digital nerves (neurorrhaphy)1, one nerve on each finger using an operating microscope1. A complex wound repair1 on the right hand (palm) of 6.5 cm was also performed.

Code only the CPT Fingers

Back 16

Procedures performed: repair of digital nerves (neurorrhaphy)
1. Repair
Nerve
Suture 64831-64876
64831
Suture of digital nerve, hand or foot; one nerve
64832
each additional digital nerve (List separately in addition to code for primary procedure)
64831-F6, 64832-F7

Front 17

The patient cut her fingers at home with an electric knife. She went to the emergency room at Seattle Grace Hospital. She was taken to the operating room for repair of the open wounds on the right index and right middle fingers. Procedures performed: repair of digital nerves (neurorrhaphy)1, one nerve on each finger using an operating microscope1. A complex wound repair1 on the right hand (palm) of 6.5 cm was also performed.

Code only the CPT microsurgery

Back 17

Microsurgery
Operating Microscope 69990

Front 18

The patient cut her fingers at home with an electric knife. She went to the emergency room at Seattle Grace Hospital. She was taken to the operating room for repair of the open wounds on the right index and right middle fingers. Procedures performed: repair of digital nerves (neurorrhaphy)1, one nerve on each finger using an operating microscope1. A complex wound repair1 on the right hand (palm) of 6.5 cm was also performed.

Code only the CPT Complex Wound Repair

Back 18

Repair
Wound
Complex 13100–13160
13131
Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm
13132
2.6 cm to 7.5 cm
13132-51 (Multiple Procedures)

Front 19

The patient cut her fingers at home with an electric knife. She went to the emergency room at Seattle Grace Hospital. She was taken to the operating room for repair of the open wounds on the right index and right middle fingers. Procedures performed: repair of digital nerves (neurorrhaphy)1, one nerve on each finger using an operating microscope1. A complex wound repair1 on the right hand (palm) of 6.5 cm was also performed.

Back 19

Repair of digital nerves (neurorrhaphy), one nerve on each finger using an operating microscope. A complex wound repair on the right hand (palm) of 6.5 cm. 64831-F6, 64832-F7, 69990, 13132-51.

Front 20

A 36-year-old male patient was taken to the operating room at the ambulatory surgery center for an excision of a chalazion of the left upper eyelid

Back 20

Chalazion, Excision, Single, 67800) (Upper eyelid, E-1)

CPT: 67800-E1

Front 21

A 16-year-old female patient was taken to the operating room at the ambulatory surgery center for a removal with a small incision of an embedded foreign body in the right upper eyelid

Back 21

Eyelid, Removal, Foreignbody, 67938) (Upper right eyelid,E-3)

Front 22

A 68-year-old female patient was seen today for destruction of a lesion removed from her left cornea by thermocauterization.

Back 22

(Lesion, Cornea, Destruction, 65450, LT)
65450-LT

Front 23

4. A 46-year-old male patient comes in to see the optometrist because of dry eye syndrome. The optometrist closes the lacrimal punctum by placing plugs in each lower lid (Lower Right E-4, and Lower Left E2) . (Hint: There are two CPT codes with three modifiers (total).)

Back 23

Lacrimal Punctum, Closure, By Plug, 68761
68761-E2, 68761-51-E2

Front 24

A 38-year-old female patient was brought to the operating room to have an orbitotomy with bone flap and malignant neoplasm of the orbit of the right eye (RT) removed. The patient tolerated the procedure well.

Back 24

0.Orbitotomy, w/Bone Flap/Lateral Approach, 67420-RT

Front 25

A 61-year-old male patient has a large malignant neoplasm in the left external auditory canal. He in the operating room under general anesthesia, we will proceed to perform a radical excision including a neck dissection

Back 25

Lesion, Auditory Canal, External, Radical with Neck Dissection, 69155, Left
69155-LT

Front 26

A three-year-old boy has congenital atresia of both external auditory canals. He was brought to the operating room and given general anesthesia. The external auditory canals were treated surgically with a single stage reconstruction

Back 26

0. Reconstruction, Auditory Canal, External, 69310-69320
Bilateral procedures, 69320-50

Front 27

A five-year-old girl suffers from chronic serous otitis media. She was taken to the operating room and put under general anesthesia. We proceeded to perform a tympanostomy and placed bilateral ventilating tubes

Back 27

69436-50

Front 28

A 59-year-old female patient diagnosed with hearing loss of combined types in the left ear. She is brought into the operating room and given general anesthesia. We are performing a tympanoplasty, mastoidectomy, reconstruction of the canal wall, and ossicular chain reconstruction

Back 28

Tympanoplasty, w/Mastoidectomy, Left side of the body, 69644-LT

Front 29

A six-year-old girl was taken to the pediatrician‘s office. The pediatrician removed a bead from the right external auditory ear canal under local anesthetic

Back 29

Auditory Canal, External, Removal, Foreign Body, 69200, right side of the body, RT 69200-RT

Front 30

She is brought to the operating room today and was given general anesthesia. She was prepped and draped in the usual fashion. We proceeded with a valvuloplasty, aortic valve with transventricular dilation. She was placed on cardiopulmonary bypass during the procedure.
5 months ago, today we are performing the same procedure. CPT:

Back 30

1. Valvuloplasty, Aortic Valve
33400
2. 33403
1. Reportion, Coronary Artery Bypass Valve Procedure 33530
CPT: 33403, 33530

Front 31

Procedure Performed: Valvuloplasty, aortic valve with transventricular dilation
Operative Note: This 38-year-old female patient who has a diagnosis of rheumatic aortic stenosis. She has had this same surgery 5 months ago, today we are performing the same procedure due to restenosising of the aortic valve. We will perform a cardiopulmonary bypass on her aortic valve.

Index to Procedures

Back 31

Valvuloplasty/Aortic Valve/35.11
Read the notes above requring Cardiopulmonary bypass
35.11, 39.61

Front 32

Operative Note: This 38-year-old female patient who has a diagnosis of rheumatic aortic stenosis

Diagnosis:

Back 32

Stenosis/Aortic/Rheumatic
395.0

Front 33

An 18-year-old male patient was involved in a rollover motor vehicle accident on the highway; he was the driver. He was brought to the emergency room for evaluation. He had a CT scan of the chest revealing a left lung laceration and chest wall contusion but no open wound. The patient was taken immediately to the operating room where the physician performed removal of a single segment of the lung.

CPT

Back 33

1 - The hint on this question advises that you are only coding for the surgeon who performs the surgery. The procedure done was a removal of a single segment of the lung. This is only once CPT code. To find this code you would use the index and look up Removal, Lung, Single Segment. Don’t forget your modifier LT on this one (was done on the left lung).

Front 34

A 28-year-old female patient has been bothered with excessive tearing and was found to have an obstruction in the right lacrimal duct. Today at the ambulatory surgery center she was given general anesthesia and the physician performed an endoscopic dacryocystorhinostomy. Postoperative diagnosis is granuloma of the lacrimal passage.

Back 34

2 - Again, the hint lets us know that we are just coding for the doctor who does the procedure. There is one CPT code with modifier. To find the appropriate code we would look up the term dacryocystorhinostomy in the index. Be careful here, this was done using and endoscope.

Front 35

INDICATIONS: The patient is seen for excision of skin lesions of the left ankle and a hemangioma of the waistline with recent changes including size, color/pigment, and chronic irritation with bleeding.
PROCEDURES:
1. Excision of a 2.5 cm hemangioma on the waistline with extensive undermining and closure.
2. Excision of suspicious 1.5 cm lesion of the left ankle with extensive undermining and closure.
OPERATION IN DETAIL: After sterile preparation and draping in the normal sterile fashion and local anesthetic, the lesions were approached. The ankle lesion was elliptically excised. Extensive undermining was required in order to close the large defect caused, since the halos of the lesion also required excision.

Back 35

#1 - On this question we have two diagnosis codes, one for the hemangioma of the waist and one for the skin lesion on the ankle. You will want to look up hemangioma in the index and keep in mind this is of the skin on the waist. We also have a code for the lesion on the ankle, again look up Lesion, skin to find this code.