CPT 76815 is a limited ultrasound, in which only the fetal heartbeat, position, placental location, and/or volume of amniotic fluid are evaluated. In this scenario, much more was done than a limited study. The ultrasound technician documented age-appropriate fetal measurements, which are supported by CPT 76816. A biophysical profile (BPP) was also done, which monitors the fetus's movements, tone, and breathing as well as evaluates the volume of amniotic fluid. Each of these elements counts as 2 units of grading to evaluate the general well-being ofthe fetus. The desired score of a BPP is 8/8. Because a fetal nonstress test (NST) was completed in conjunction with a BPP, report CPT 76818 instead of CPT 76819. Modifier TC is used to reflect that only a technical component of the procedure was completed. However, because the patient received these services in an obstetrical office that employs the physicians providing prenatal care and owns the ultrasound equipment the code should be submitted without modifiers TC or 26 to receive 100% reimbursement.

The "application of casts and strapping" guidelines located in the surgery section of the CPT book explain that a splint is reported when the physician providing the initial service does not perform, or expects to perform, any other treatment. In this case, because the visit was minimal and directed only at the sprain with no intended follow-up care, only the application of the splint would be reported. The application itself is considered static because the wrist is completely immobilized. HCPC crosswalk for a wrist splint, in addition to knowing the difference bet',veen static and dynamic, would immediately lend itself to the correct HCPC: S8451.

Although CPT code 97530 does describe therapeutic activities, the focus is directed at improving functional performance, whereas the correct CPT code 97110 works to develop range of motion. The CPT code for a soft tissue massage (or manual therapy 97140) is based on 15-minute increments, however, anything over 8 minutes prior to or after can be counted as a unit. Based on this, the 23 minutes spent can be counted as two units. Sequencing is based on highest RVU.
Coding crosswalk for a rotator cuff tear is classified as a muscle strain, so answer B, which specifies
"other injury," can be eliminated. Because the patient is in the recovery period of the injury, the seventh character would not be considered active but subsequent.

The first procedure documented is a bronchoscopy, reported with CPT codes 31622-31654.
Because the procedure was specifically aimed at confirming a diagnosis based off a previously confirmed malignancy, the bronchoscopy would be considered diagnostic (CPT 31622). The second procedure performed is a mediastinotomy with removal of cancerous tissue. An incision made into the parasternal intercostal space is considered transthoracic, making the correct procedure code
39010. Sequencing is based off the highest RVU value, and modifier 51 is appended to the bronchoscopy procedure code to indicate that multiple procedures were performed in the same session.

A "gaping" injury and/or "single-layer closure" is indicative of an intermediate repair and a
"superficial" injury and/or use of a "tissue adhesive" is indicative ofa simple repair. Because the repairs are not in the same classification, each repair is reported in a single code, sequenced from the most to the least severe (eliminating answers B and D), with modifier 59 appended to the less complicated procedure(s). Local anesthesia is included in these procedures, as is debridement unless the provider specifically indicates that it is extensive. In answer A, an HCPC's code for tissue adhesive would be reported only if the patient had Medicare.