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5)An 11-month old patient presented for emergency surgery to repair a severely broken arm after falling from a third story window. What qualifying circumstance code(s) may be reported in addition to the anesthesia code?

User Hillin
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27 votes
27 votes

Step-by-step explanation:

What physical status modifier best describes a patient who has a severe systemic disease that is a constant threat to life?

P4

Response Feedback:

Rationale: Review the Anesthesia Guidelines in the CPT® codebook to determine that the Physical Status modifier P4 is the correct choice. Note: Medicare does not recognize physical status modifiers for additional payment.

What modifier is used for medically-directed CRNA services?

QX

Response Feedback:

Rationale: In the HCPCS Level II codebook look for where the modifiers are listed and refer to modifier QX. QX is the correct modifier for CRNA services when medically directed by a physician.

What is the anesthesia code for a cast application to the wrist?

01860

Response Feedback:

Rationale: In the CPT® Index for Anesthesia/Cast Application/Forearm, Wrist and Hand which directs you to 01860. Verify code selection in the numeric section.

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What physical status modifier best describes a patient who has a severe systemic disease that is a constant threat to life?

Tap card to see definition

P4

Response Feedback:

Rationale: Review the Anesthesia Guidelines in the CPT® codebook to determine that the Physical Status modifier P4 is the correct choice. Note: Medicare does not recognize physical status modifiers for additional payment.

Tap again to see term

What modifier is used for medically-directed CRNA services?

Tap card to see definition

QX

Response Feedback:

Rationale: In the HCPCS Level II codebook look for where the modifiers are listed and refer to modifier QX. QX is the correct modifier for CRNA services when medically directed by a physician.

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What physical status modifier best describes a patient who has a severe systemic disease that is a constant threat to life?

P4

Response Feedback:

Rationale: Review the Anesthesia Guidelines in the CPT® codebook to determine that the Physical Status modifier P4 is the correct choice. Note: Medicare does not recognize physical status modifiers for additional payment.

What modifier is used for medically-directed CRNA services?

QX

Response Feedback:

Rationale: In the HCPCS Level II codebook look for where the modifiers are listed and refer to modifier QX. QX is the correct modifier for CRNA services when medically directed by a physician.

What is the anesthesia code for a cast application to the wrist?

01860

Response Feedback:

Rationale: In the CPT® Index for Anesthesia/Cast Application/Forearm, Wrist and Hand which directs you to 01860. Verify code selection in the numeric section.

A 22 year-old patient who has severe medical problems is placed under general anesthesia by an anesthetist for a service not usually requiring anesthesia. What modifier would be appended to the service?

23

Response Feedback:

Rationale: In the CPT® codebook go to Appendix A - Modifiers. Review the modifiers to determine that modifier 23 is reported to indicate a procedure not usually requiring anesthesia (either none or local) but due to unusual circumstances general anesthesia is necessary.

User Abhishek Balani
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