PCMA Chapter (On the Job) 16-"Sophia DiStefano, a five-year-old female, experienced three bouts of otitis media...

PCMA Chapter (On the Job) 16-"Sophia DiStefano, a five-year-old female, experienced three bouts of otitis media within the past seven months and was diagnosed with chronic otitis media. Following an audiometry screen two weeks ago, Dr. Salpega recommended surgery to correct the underlying problem. Sophia's mother signed an informed consent for the procedure. Today, Dr. Salpega performs a bilateral tympanostomy (tube placement) for a more permanent treatment of the condition. David Dolan, a Registered Medical Assistant, needs to code for the procedure."

Should David code and bill for the audiometry screening? Why or why not?
What is the diagnosis related to Sophia's procedure? How can David ensure that the diagnosis is correct?
What procedure code should be assigned for a bilateral tympanostomy with local anesthesia? Is a modifier necessary?

Solutions

Expert Solution

Answer :-( 01 )Yes David code and bill for audiometery screening pure tone audiometery (air only)

The medical billing CPT code 92552 test pure tone audiometery done beacuse it have a ability to change both intensity and frequency .

Answer:-(2) The diagnosis of chronic otitis based on previous 4 episodes of ear infection and pain

01)tempnocentsis

David use is use of otoscope and check typmpanic membrane inflammed and fluid peresent there

also medical billing code pure tone audiometery test done so David is confrim about diagnosis of chronic otitis media

Answer :- 03

The procedure code for assign bilateral tympnostomy is (69433).

Tmypanostomy requires insertion a ventilating tube.

Note :- modifier adds on cod generally not need in thier primary code

Modifications with or without if use modification in first procedure then not use in second procedure
Providers are use the (50) modifier ( bilateral procedure) with appropriate CPT code and place (1) in the units field of the claim form

the site specific modification LT ( left side) an RT right side may be used appropriately CPT codes only when procedure performed on either left or right side.

Nightingale answered 1 year ago

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