For the questions below, note which specialty each scenario belongs to and what the main term is, and assign the appropriate CPT codes.
Tips:
In the physician office setting, the first-listed procedure (or service) is usually assigned a code from the CPT Evaluation and Management (E/M) section. The only except to this rule is when the patient undergoes office surgery (e.g., excision of benign lesion), in which case a code is assigned from the CPT Surgery section (instead of the CPT E/M Section).
NOTE: If the patient receives E/M services during the same encounter as office surgery, and the E/M services resulted in performing the office surgery add modifier -25 to the E/M code. Report the CPT Surgery code as the first-listed code and the CPT E/M code as the secondary code (adding modifier -25).
Secondary Procedure(s) or Service(s)
Secondary procedures (or services) are usually less complex than the first-listed procedure.
Secondary procedures are assigned CPT and HCPCS Level II codes, and they may require the addition of a modifier. Refer to the appendix of modifiers, located at the back of your CPT and HCPCS level II coding manuals. Third-party payers typically discount payment of secondary procedures by 50%.
Assign the specialty, main term and CPT code(s) to the following:
1. Anesthesia for bilateral vasectomy
Specialty:
Main term:
CPT Code:
2. Breath test for alcohol
Specialty:
Main term:
CPT Code:
3. Intradermal tuberculosis TB test
Specialty:
Main term:
CPT Code:
4. Anesthesia for repair of cleft palate
Specialty:
Main term:
CPT Code:
5. Definitive drug Screening for amphetamine
Specialty:
Main term:
CPT Code:
6. Thyroid stimulating hormone (TSH) test
Specialty:
Main term:
CPT Code:
7. Suction lipectomy, lower right leg
Specialty:
Main term:
CPT Code:
8. Excision of benign lesions on chest, 0.4 cm with simple closure
Specialty:
Main term:
CPT Code: