Question

Provide the CPT code(s) for the following and include any necessary modifiers:

1. Chiropractic manipulation of the spine, thoracic, and lumbar regions

2. EMG testing of both upper extremities and related paraspinal musculature

3. Ophthalmology Clinic Progress Note

4. Today, I saw a new patient who is a 46-year-old white female who was diagnosed with Grave's toxic diffuse goiter, early last year. She had some swelling of the eyes and was originally told she had an allergy; then the same person, after he found out she had Graves', put her on prednisone. It was unknown what the dose was, but the patient showed me her bottles and it is obvious that she was on 20mg a day, taken at suppertime. She has now come down from this. She was also on prednisone acetate eye drops. The patient denies any history of any problems except that she became quite depressed and her head felt funny on the steriods. The patient had a history of an ulcer problem in the past, which was treated with diet. The patient allegedly had a positive Mantoux test years ago, but her chest x-rays have always been negative. Today when I saw here, she was 20/80 in the right and 20/40 in the left with her refraction. The lids are markedly swollen, and she has marked inferior ptosis from the sagging lids, the water collection, and the redness. There is marked chemosis of the conjunctivase and thickening of the lids. The patient has full extraocular motility, except she cannot converge. There is marked swelling of the globes on the retropulsion exam. The pressures are 21 and 20 in primary gaze and 30 and 2 in up gaze. The discs are flat. The patient has pseudoexfoliation in the right eye and nuclear cleotic cataracts in both eyes, right greater than left. I counseled the patient about the treatment of this and offered her radiation therpay along with the proper dose of steriods of 100mg a day for a week and then taper down from the 100mg. I will send her to see Dr. Zapata for consultation radiation therapy, and I think we would see her weekly as we get this problem under control. I did not feel she needed any topical medication, and she definitely does not need surgery now since there is no proptosis at this time. We will see her again in 1 week. I counseled her about the side effects of the high dose of steriods and how to take them.

5. A 30-year-old established patient receives a tetanus toxoid that is administered intramuscularly by the physician assistant.

6. Nasopharyngoscopy with endoscope. The patient has persistent nosebleds.

7. An established, 70-year-old Medicare patient presents to the nurse for a pneumonia (Polysaccharide 23-Valent) and a trivalent flu immunization, 0.5 mL (2 injections.

8. A 30-year-old with end-stage renal disease receives a full month of dialysis with eight encounters.

9. The patient presents for a bronchospasm evaluation before and after a spirometry that is administered to monitor his lung capacity. The patient has episodes of shortness of breath

10. A patient receives the initial 30-minute training for her prosthetic arm. Patient has a congenital absence of forearm and hand.

11. A DTaP and an oral poliomyelitis vaccine (live) are administered to a new 5-year-old patient. A problem focused history and examination are performed for an acute URI, and the medical decision making is straightforward (separate identifiable service).

12. An 18-month-old established patient receives a DT that is administered intramuscularly by the physician, after the physician counseled the parents on the vaccine.

13. A patient brings his allergy medication into the office, and a single injection service is provided by the nurse. The patient is allergic to primrose.

Answer 1

1)the CPT code for the Chiropractic manipulation of the spine, thoracic, and lumbar regions is 98941( that includes CMT -Chiropractic manipulation therapy of three spinal regions).

2)The CPT code for the  EMG testing of both upper extremities and related paraspinal musculature is 95861.If the thoracic paraspinal musculature is involved then the code is 95869.

3)The CPT code for the Ophthalmology Clinic Progress Note is 92002.