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Transesophageal echocardiogram

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1. LOCATION: Outpatient, Hospital;PATIENT: Tom White;SURGEON: David Barton, MD;RADIOLOGY: Morton Monson, MD;PROCEDURE: Transesophageal echocardiogram;INDICATIONS: Evaluation of the aortic valve considering the stenosis that was not welldocumented angiographically;PROCEDURE: The patient received 2 mg of Versed, and a transesophageal probe was;advanced to the lower part of the esophagus. We had good visualization of the heart. The;mitral valve was thickened with slight prolapse, but there was no significant regurgitation;noted. The LV displayed normal size and normal function. The aortic root is normal in;size. The aortic valve is calcified with diffuse cusp excursions with still adequate;opening. Valve area was variable in different incidents varying from 1 to even above 2.;CONCLUSION: This transesophageal echo shows aortic valve disease but does not;appear to be severe. It appeared to be moderately stenotic, and considering the;angiography and the hemodynamics, this patient does not need valve surgery yet.;Identify the main term to be looked up in the alphabetical index of the CPT;2. LOCATION: Outpatient, Hospital;PATIENT: Tom White;SURGEON: David Barton, MD;RADIOLOGY: Morton Monson, MD;PROCEDURE: Transesophageal echocardiogram;INDICATIONS: Evaluation of the aortic valve considering the stenosis that was not welldocumented angiographically;PROCEDURE: The patient received 2 mg of Versed, and a transesophageal probe was;advanced to the lower part of the esophagus. We had good visualization of the heart. The;mitral valve was thickened with slight prolapse, but there was no significant regurgitation;noted. The LV displayed normal size and normal function. The aortic root is normal in;size. The aortic valve is calcified with diffuse cusp excursions with still adequate;opening. Valve area was variable in different incidents varying from 1 to even above 2.;CONCLUSION: This transesophageal echo shows aortic valve disease but does not;appear to be severe. It appeared to be moderately stenotic, and considering the;angiography and the hemodynamics, this patient does not need valve surgery yet.;Identify the main term to be looked up in the alphabetical index of the ICD-9-CM;manual;3. LOCATION: Outpatient, Hospital;PATIENT: Tom White;SURGEON: David Barton, MD;RADIOLOGY: Morton Monson, MD;PROCEDURE: Transesophageal echocardiogram;INDICATIONS: Evaluation of the aortic valve considering the stenosis that was not welldocumented angiographically;PROCEDURE: The patient received 2 mg of Versed, and a transesophageal probe was;advanced to the lower part of the esophagus. We had good visualization of the heart. The;mitral valve was thickened with slight prolapse, but there was no significant regurgitation;noted. The LV displayed normal size and normal function. The aortic root is normal in;size. The aortic valve is calcified with diffuse cusp excursions with still adequate;opening. Valve area was variable in different incidents varying from 1 to even above 2.;CONCLUSION: This transesophageal echo shows aortic valve disease but does not;appear to be severe. It appeared to be moderately stenotic, and considering the;angiography and the hemodynamics, this patient does not need valve surgery yet.;What modifier will be appended to the CPT code to indicate the physicians portion;of the service?;4. LOCATION: Outpatient, Hospital;PATIENT: Tom White;SURGEON: David Barton, MD;RADIOLOGY: Morton Monson, MD;PROCEDURE: Transesophageal echocardiogram;INDICATIONS: Evaluation of the aortic valve considering the stenosis that was not welldocumented angiographically;PROCEDURE: The patient received 2 mg of Versed, and a transesophageal probe was;advanced to the lower part of the esophagus. We had good visualization of the heart. The;mitral valve was thickened with slight prolapse, but there was no significant regurgitation;noted. The LV displayed normal size and normal function. The aortic root is normal in;size. The aortic valve is calcified with diffuse cusp excursions with still adequate;opening. Valve area was variable in different incidents varying from 1 to even above 2.;CONCLUSION: This transesophageal echo shows aortic valve disease but does not;appear to be severe. It appeared to be moderately stenotic, and considering the;angiography and the hemodynamics, this patient does not need valve surgery yet.;Identify the correct procedure (CPT-4) code(s) for the above scenario;CPT-4: __________ Modifier;5. LOCATION: Outpatient, Hospital;PATIENT: Tom White;SURGEON: David Barton, MD;RADIOLOGY: Morton Monson, MD;PROCEDURE: Transesophageal echocardiogram;INDICATIONS: Evaluation of the aortic valve considering the stenosis that was not welldocumented angiographically;PROCEDURE: The patient received 2 mg of Versed, and a transesophageal probe was;advanced to the lower part of the esophagus. We had good visualization of the heart. The;mitral valve was thickened with slight prolapse, but there was no significant regurgitation;noted. The LV displayed normal size and normal function. The aortic root is normal in;size. The aortic valve is calcified with diffuse cusp excursions with still adequate;opening. Valve area was variable in different incidents varying from 1 to even above 2.;CONCLUSION: This transesophageal echo shows aortic valve disease but does not;appear to be severe. It appeared to be moderately stenotic, and considering the;angiography and the hemodynamics, this patient does not need valve surgery yet.;Identify the correct diagnosis (ICD-9-CM) code(s) for the above scenario;ICD-9-CM;6. The patient presented to Dr. Elhart with complaints of chest pain and SVT. A 2-D;doppler and color-flow doppler was performed at the local hospital in the outpatient;department, and Dr. Elhart monitored the echocardiography. You are reporting the;service before the test results are known.;LOCATION: Outpatient, Hospital;PATIENT: Emily Watts;PHYSICIAN: Marvin Elhart, MD;STUDY: The study is a transthoracic 2-D and color-flow doppler echocardiography;INDICATION: Chest pain and SVT;M-MODE MEASUREMENTS;1. Left Atrium is 3.9, aortic root 2.3;2. RV dimension 1.7;3. LV diastole 5;4. LV systole 2.3;5. Fracture shortening 0.46;6. Interventricular septum 0.7;7. Posterior wall thickness 0.7;DOPPLER;1. Mild mitral regurgitation;2. Mild to moderate tricuspid regurgitation;3. RV systolic pressure 73 mmHg;2-D FINDINGS;1. Left ventricle is normal in size with good LV systolic function noted;2. Normal left atrium, right atrium, and right ventricle;3. No pericardial effusion seen;4. Aortic root is normal in size with normal aortic valve;5. The mitral valve is structurally normal with mild mitral regurgitation;6. Mild tricuspid regurgitation;CONCLUSION;1. Normal LV size with preserved LV systolic function;2. No significant aortic or mitral valve disease;3. No dilation of the chambers noted;Based on the statements in the scenario, which modifier will be assigned to report;the physicians portion of the service?;7. The patient presented to Dr. Elhart with complaints of chest pain and SVT. A 2-D;doppler and color-flow doppler was performed at the local hospital in the outpatient;department, and Dr. Elhart monitored the echocardiography. You are reporting the;service before the test results are known.;LOCATION: Outpatient, Hospital;PATIENT: Emily Watts;PHYSICIAN: Marvin Elhart, MD;STUDY: The study is a transthoracic 2-D and color-flow doppler echocardiography;INDICATION: Chest pain and SVT;M-MODE MEASUREMENTS;1. Left Atrium is 3.9, aortic root 2.3;2. RV dimension 1.7;3. LV diastole 5;4. LV systole 2.3;5. Fracture shortening 0.46;6. Interventricular septum 0.7;7. Posterior wall thickness 0.7;DOPPLER;1. Mild mitral regurgitation;2. Mild to moderate tricuspid regurgitation;3. RV systolic pressure 73 mmHg;2-D FINDINGS;1. Left ventricle is normal in size with good LV systolic function noted;2. Normal left atrium, right atrium, and right ventricle;3. No pericardial effusion seen;4. Aortic root is normal in size with normal aortic valve;5. The mitral valve is structurally normal with mild mitral regurgitation;6. Mild tricuspid regurgitation;CONCLUSION;1. Normal LV size with preserved LV systolic function;2. No significant aortic or mitral valve disease;3. No dilation of the chambers noted;Identify the main term to be researched in the alphabetical index of the CPT-4;manual?;8. The patient presented to Dr. Elhart with complaints of chest pain and SVT. A 2-D;doppler and color-flow doppler was performed at the local hospital in the outpatient;department, and Dr. Elhart monitored the echocardiography. You are reporting the;service before the test results are known.;LOCATION: Outpatient, Hospital;PATIENT: Emily Watts;PHYSICIAN: Marvin Elhart, MD;STUDY: The study is a transthoracic 2-D and color-flow doppler echocardiography;INDICATION: Chest pain and SVT;M-MODE MEASUREMENTS;1. Left Atrium is 3.9, aortic root 2.3;2. RV dimension 1.7;3. LV diastole 5;4. LV systole 2.3;5. Fracture shortening 0.46;6. Interventricular septum 0.7;7. Posterior wall thickness 0.7;DOPPLER;1. Mild mitral regurgitation;2. Mild to moderate tricuspid regurgitation;3. RV systolic pressure 73 mmHg;2-D FINDINGS;1. Left ventricle is normal in size with good LV systolic function noted;2. Normal left atrium, right atrium, and right ventricle;3. No pericardial effusion seen;4. Aortic root is normal in size with normal aortic valve;5. The mitral valve is structurally normal with mild mitral regurgitation;6. Mild tricuspid regurgitation;CONCLUSION;1. Normal LV size with preserved LV systolic function;2. No significant aortic or mitral valve disease;3. No dilation of the chambers noted;In the intro paragraph as well as the indication it references the abbreviation;SVT. What does SVT stand for?;9. The patient presented to Dr. Elhart with complaints of chest pain and SVT. A 2-D;doppler and color-flow doppler was performed at the local hospital in the outpatient;department, and Dr. Elhart monitored the echocardiography. You are reporting the;service before the test results are known.;LOCATION: Outpatient, Hospital;PATIENT: Emily Watts;PHYSICIAN: Marvin Elhart, MD;STUDY: The study is a transthoracic 2-D and color-flow doppler echocardiography;INDICATION: Chest pain and SVT;M-MODE MEASUREMENTS;1. Left Atrium is 3.9, aortic root 2.3;2. RV dimension 1.7;3. LV diastole 5;4. LV systole 2.3;5. Fracture shortening 0.46;6. Interventricular septum 0.7;7. Posterior wall thickness 0.7;DOPPLER;1. Mild mitral regurgitation;2. Mild to moderate tricuspid regurgitation;3. RV systolic pressure 73 mmHg;2-D FINDINGS;1. Left ventricle is normal in size with good LV systolic function noted;2. Normal left atrium, right atrium, and right ventricle;3. No pericardial effusion seen;4. Aortic root is normal in size with normal aortic valve;5. The mitral valve is structurally normal with mild mitral regurgitation;6. Mild tricuspid regurgitation;CONCLUSION;1. Normal LV size with preserved LV systolic function;2. No significant aortic or mitral valve disease;3. No dilation of the chambers noted;Identify the correct procedure (CPT-4) code(s) for the above scenario.;CPT-4: __________ Modifier;10. The patient presented to Dr. Elhart with complaints of chest pain and SVT. A 2-D;doppler and color-flow doppler was performed at the local hospital in the outpatient;department, and Dr. Elhart monitored the echocardiography. You are reporting the;service before the test results are known.;LOCATION: Outpatient, Hospital;PATIENT: Emily Watts;PHYSICIAN: Marvin Elhart, MD;STUDY: The study is a transthoracic 2-D and color-flow doppler echocardiography;INDICATION: Chest pain and SVT;M-MODE MEASUREMENTS;1. Left Atrium is 3.9, aortic root 2.3;2. RV dimension 1.7;3. LV diastole 5;4. LV systole 2.3;5. Fracture shortening 0.46;6. Interventricular septum 0.7;7. Posterior wall thickness 0.7;DOPPLER;1. Mild mitral regurgitation;2. Mild to moderate tricuspid regurgitation;3. RV systolic pressure 73 mmHg;2-D FINDINGS;1. Left ventricle is normal in size with good LV systolic function noted;2. Normal left atrium, right atrium, and right ventricle;3. No pericardial effusion seen;4. Aortic root is normal in size with normal aortic valve;5. The mitral valve is structurally normal with mild mitral regurgitation;6. Mild tricuspid regurgitation;CONCLUSION;1. Normal LV size with preserved LV systolic function;2. No significant aortic or mitral valve disease;3. No dilation of the chambers noted;Identify the correct diagnosis (ICD-9-CM) code(s) for the above scenario;ICD-9-CM;ICD-9-CM;ICD-9-CM;ICD-9-CM

 

Paper#18324 | Written in 18-Jul-2015

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