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A newborn baby is delivered at the hospital. Immediately after birth, the pediatrician is present in the delivery room to monitor the baby’s condition due to cardiac distress. The pediatrician performs cardiopulmonary resuscitation to stabilize the baby’s condition. What E/M coding is reported?

The term episiotomy is what type of procedure?

A 72-year-old female sustained a left radius fracture, resulting in volar angulation, radial shortening and loss of radioulnar inclination. A general anesthetic was administered. A standard dorsal central approach to the wrist was made. The capsule was opened in a T fashion and the malunion site was identified. A series of osteotomes was utilized to open the fracture site and the normal distal radial architecture was restored. The pie-plate was placed on the distal radius utilizing a combination of 2.0 and 1.8 screws and threaded pins for the distal segment and 2.7 screws proximally. Fragments were secured, and Norian SRS was packed into the defect and allowed to harden. With this completed, the wounds were copiously irrigated with normal saline. Soft tissue was closed over the plate and distal radius and secured with 2-0 Vicryl. What CPT® code is reported?

A 55-year-old man presents with uncontrolled tremors that have become quite severe and are now disabling. A trial of a deep brain stimulator electrode is recommended. The patient is placed in the head holder adapter for the frame. The scalp is incised exposing the skull using a perforator to make a single burr hole 2.5 cm from the midline at the level of the coronal suture exposing the dura and is punctured for access. Microelectrode recording (MER) and stimulation is done to target and reposition the electrodes to determine the best placement for the neurostimulator electrode. The neurostimulator electrode array is placed in the thalamus and fastened into position with radiographic image monitoring placement. The lead is coiled in a pocket under the galea, which is sutured closed, followed by skin closure. What CPT® code is reported?

A 42-year-old patient was admitted to an ASC and began having complications in the OR after the induction of anesthesia. The surgeon immediately discontinued the planned surgery. If the insurance company requires a reported modifier, what modifier best describes the extenuating circumstances for the anesthesiologist?

A 37-year-old male is diagnosed with cholelithiasis, choledocholithiasis and acute and chronic cholecystitis. What ICD-10-CM code(s) is/are reported?

In what year was HITECH enacted as part of the American Recovery and Reinvestment Act?

The provider makes an incision in the patient’s left tympanic membrane in order to inflate eustachian tubes and aspirate fluid in a patient with acute eustachian salpingitis. The procedure is completed without anesthesia. What CPT® and ICD-10-CM codes are reported?

A patient is diagnosed with an injury to the right side facial nerve. In the OR suite the surgeon performs a neurorrhaphy with nerve graft to restore innervation to the face using microscopic repair. The surgeon created a 2 cm incision over the damaged nerve, dissected the tissues and located the nerve. The damaged nerve was resected and removed. The 3.0 cm graft taken from the sural nerve was sutured to the proximal and distal ends of the damaged nerve. What CPT® and ICD-10-CM codes are reported?

A male patient with convulsions is sent for a computerized axial tomogram (CT scan) of the brain with contrast. What diagnosis code is reported as the reason for the CT Scan?