Reference no: EM133207860
Review the following 10 scenarios and pick out the key terms of the items that would need to be submitted for reimbursement. Do NOT need to code the procedures, just list out the elements that would be billed for each scenario. Remember that an office visit is reported as an Evaluation and Management (E/M) service.
1. Patient Roberta Anderson had an office visit for fatigue, weight gain, heart palpitations, and loss of hair. The physician performed an EKG and then checked her blood pressure. Roberta then had her blood drawn in the office to test her thyroid function. What items are billable to insurance for reimbursement?
2. Jonathon Banks saw Dr. Block for knee pain and swelling. The physician performed a steroid injection and gave the patient an order for an MRI. What items are billable to insurance for reimbursement?
3. Ian Jacobson was seen in the urgent care center after an accident, he is unable to put weight on his left leg to walk. An x-ray was performed and it was confirmed Mr. Jacobson had a hairline fracture of his tibia. He was fitted for a cast and given a boot to help him walk with his cast. He was given an order for a prescription of an NSAID for the pain. He is to follow up with an orthopedic physician upon cast removal for treatment and possible physical therapy. What items are billable to insurance for reimbursement?
4. Veronica Smith had a benign lesion removed from her right upper arm on 5/1/18. After the removal, stitches were used to close the wound and it was dressed with a sterile dressing. Four days later on 5/5/18, Ms. Smith had a return visit as the wound and surrounding skin were red and infected. What items are billable to insurance for reimbursement for the 5/5/18 follow-up visit?
5. Roberto Martinez had a malignant lesion removed from his left lower leg on 4/8/18. After the removal, stitches were used to close the wound and it was dressed with a sterile dressing. Five days later on 4/13/18, Mr. Martinez returned to the office for the treatment of a keratosis pilaris (KP) lesion on his right upper arm. What items are billable to insurance for reimbursement for the 4/13/18 follow-up visit?
6. Patient was seen in the pediatrician's office for a sore throat and earache. The physician performed a rapid strep test throat swab. The patient was positive for strep bacteria and prescribed antibiotics. What items are billable to insurance for reimbursement?
7. Patient is seen in urgent care for a cough and fever. The physician orders a chest x-ray and diagnosis the patient with acute bronchitis. The patient is given a nebulizer breathing treatment and prescribed an inhaler and antibiotics. What items are billable to insurance for reimbursement?
8. Natalie Johnson is seen in the Emergency Department (ED) for severe pain in her right lower quadrant. She does not have a fever or any other symptoms. Blood work shows no elevated WBC levels indicating no infection. The ED physician orders an ultrasound to check her appendix. The ultrasound shows access fluid from a burst ovarian cyst. What items are billable to insurance for reimbursement?
9. George Lima was seen for a routine yearly exam. His blood pressure is elevated and is complaining of fatigue and pain in his left arm. The physician performs an EKG which is normal. The physician refers Mr. Lima for an echocardiogram. What items are billable to insurance for reimbursement?
10. Monica Polanski was seen for her yearly gynecology examination. The physician performed a pap smear and HPV smear tests. The physician orders a follow-up ultrasound of Ms. Polanski's uterine fibroids. They discuss birth control and set up an appointment for implanting an IUD next month. What items are billable to insurance for reimbursement?