Please answer the following scenarios, remember that in the Evaluation and Manag
ID: 136376 • Letter: P
Question
Please answer the following scenarios, remember that in the Evaluation and Management section you will need to assign one code per day. Also there are specific modifiers for this section for example Modifier 25 and 27 to list a few. Add all the modifiers needed for each case.
Separate codes and modifiers by one dash, do not leave any spaces, example:
XXXXX-XX
Question 3 4 pts 35 year old male came to the hospital complaining of chest pain. The patient was admitted to an observation bed on Feb1st, on this day the patient had a comprehensive history a comprehensive examination and a medical decision making of moderate complexity. The patient had a negative stress test, negative cardiac enzymes, and an EGD that showed a large pyloric ulcer. The patient was started on Famotidine and discharged home on Feb 2 in good condition.Explanation / Answer
Question 3
A common medical problem that can be mistaken with heart disease is pyloric ulcer ,it produces symptoms which is very challenging to distinguish between symptoms of pyloric ulcer and angina .
In pyloric ulcer ,ulcer or sores are produced in the lining of stomach and duodenum which is the first part of small intestine these type of ulcers are painful and can be felt in abdomen,but sometimes it can cause chest pain .
PYLORIC ULCER VS CHEST PAIN _EVALUATION
It is not difficult for doctors to distinguish between chest pain or pain of pyloric ulcer.these two types of pain are quite different from one another.
Peptic ulcer are not induced by exercise and relieved by rest and pain occurs along with bloating and nausea which is different from chest pain.
Although it is very important to go for confirmatory test of angina.
Endoscopy is the favourdf diagnosis of pyloric ulcer ,peptic ulcer ,testing of helicobacter pylori may also be useful ,x-ray of upper digestive system is also recommend.
Although stress test of patient is negative .
MANAGEMENT:
Antibiotics to get rid of helicobacter pylori bacteria ,a two week course of oral antibiotics are recommended .
fomidine is a H2 receptor blockes used to care excessive secretion of acid in the stomach , that also includes cimetidine,nizatidine,rantidine etc.
Antacids to neutralise stomach acid.
Patient with pyloric ulcer feels comfortable after administration of H2 receptor like fomitidine.
Question 4
CODE OR TIME RVU BILL
LEVEL
99201 10 minutes 0.45 $43 straight forward
99202 20 minutes 0.88 $68 low complexity
99203 30 minutes 1.34 $95 moderate complexity
99204 45 minutes 1.34 $138 high complexity
99205 60 minutes 2.00 $170 straight forward