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A three-year-old patient is in the operative suite for stage 2 of treatment for double right outlet syndrome. The patient previously had the pulmonary artery banded and is returning for removal of
the pulmonary band and transposition repair of the great vessels via aortic pulmonary reconstruction.
The surgeon performs a time-out and pre-incision review of respiration and BP then the previous sternal incision site is inspected and lightly painted with povidone. Next, reopens the sternal
cavity and inserts central cannulae in the IVC, SVC and ascending aorta for extra corporeal membrane oxygenation (ECMO) bypass, chemical cardioplegia is initiated, stopping the heart and
ECMO is initiated. A physician assistant monitors vitals and oxygenation until heart function resumes. The surgeon carefully incised and removes the Dacron band encircling the pulmonary
artery, with nominal need for dilation. A section of coronary ostia is removed and sutured to the root of the pulmonary trunk. The pulmonary trunk and aortic root are then transected and
transposed to allow for ideal cardiac circulation. Once structural integrity is visually confirmed, the physician assistant is permitted to administer the cardioplegia reversal solution and the
surgeon removes the central cannulae after heart function safely resumes. The sternotomy is closed and the patient is transported to the NICU.
What CPT® codes are reported for the surgery today?
An 8-year-old patient is placed under general anesthesia for treatment of a right orbital fracture due to a traumatic fall to the nose and face from a swing set. An on-call otolaryngologist is
asked to perform a general otolaryngologic examination to evaluate the patient. A mild nasal fracture is the diagnosis given by the otolaryngologist.
What is the CPT® and ICD-10-CM coding for the otolaryngologist's services?
A 60-year-old male suffering from degenerative disc disease at the L3-L4 and L5-S1 levels was placed under general anesthesia. Using an anterior approach, the L3-L4 disc space was exposed. Using blunt dissection, the disc space was cleaned. The disc space was then sized and trialed. Excellent placement and insertion of the artificial disc at L3-L4 was noted. The area was inspected and there was no compression of any nerve roots. Same procedure was performed on L5-S1 level. Peritoneum was then allowed to return to normal anatomic position and entire area was copiously irrigated. The wound was closed in a layered fashion. The patient tolerated the discectomy and arthroplasty well and was returned to recovery in good condition. What CPT® coding is reported for this procedure?
An MRI guided cisternal puncture with diagnostic contrast injection is performed at the C2 level for cervical discography, with imaging supervision and interpretation.
What CPT® coding is reported?
The gastroenterologist performs a simple excision of three external hemorrhoids and one internal hemorrhoid, each lying along the left lateral column. The operative report indicates that the internal hemorrhoid is not prolapsed and is outside of the anal canal.
What CPT® and ICD-10CM codes are reported?