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What is the time frame defining when pain becomes chronic?

A 59-year-old male experienced left arm pain while cleaning the garage. There was no injury. His provider scheduled a 30-minute stress test using the Bruce Protocol at the hospital. There was no arm pain while on the treadmill; he did have a slight heart rhythm abnormality. The patient rested for 2 minutes. He had no further symptoms or pain. The cardiologist supervised the study, interpreted the test and dictated a report. What is the correct reporting for the stress test?

A patient is seen in the ED for nausea and vomiting that has persisted for 4 days. The ED physician treats the patient for dehydration which is documented in the patient’s record as the final diagnosis. What ICD-10-CM code(s) is/are reported for this encounter?

A 40-year-old presents with vaginal bleeding for several weeks. The gynecologist orders an ultrasound to obtain more information for a diagnosis. What diagnosis code is appropriate for this encounter?

A 37-year-old female is seen in the clinic for follow-up of lower extremity swelling. She has had this issue for the past six months. HPI: Patient is here today for follow-up of bilateral lower extremity swelling. The swelling responded to hydrochlorothiazide.DATA REVIEW: I reviewed her CBC lab. EXAM: Patient is in no acute distress. ASSESSMENT: 1. Bilateral lower extremity swelling. This has resolved with diuretics.PLAN: Will order an echocardiogram and kidney function lab test. Refill prescription. Return in 2 months.

A patient with McCune-Albright syndrome has a fibrous tissue neoplasm of the frontal bone (skull of cranium) extending into the orbit on the left. The surgeon excises the fibrous tissue neoplasm off the bone and down through the dura mater. Prophylactic decompression of the optic nerve was also performed. What CPT® and ICD-10-CM codes are reported?

A patient presents with a healed fracture of the left ankle. The patient was placed on the OR table in the supine position. After satisfactory induction of general anesthesia, the patient’s left ankle was prepped and draped. A small incision about 1 cm long was made in the previous incision. The lower screws were removed. Another small incision was made just lateral about 1 cm long. The upper screws were removed from the plate. Both wounds were thoroughly irrigated with copious amounts of antibiotic- saline solution. Skin was closed in a layered fashion and sterile dressing applied. What CPT® code(s) should be reported?

___________ fixation with pins, screws, plates, or wires is placed directly on or in the bone to immobilize a fractured bone and to maintain alignment while it heals.

Patient has TAH-BSO. What CPT® code is reported?

What is the correct CPT® code for a percutaneous pyelolithotomy with extraction measuring 1 cm?