Answer the following statements true (T) or false (F)

Question

1. An established patient seen in the physician’s office for sore throat and a temperature. The
physician performed a problem-focused history, problem-focused examination and medical
decision making was of low complexity. The final diagnosis was acute pharyngitis.
2. The patient was diagnosed with a suspicious left breast mass. Under ultrasound guidance,
percutaneous, the surgeon inserted a breast marker and performed a biopsy.
3. The patient has been experiencing occasional rectal bleeding. The surgeon performed a
colonoscopy that extended to the cecum. A biopsy was taken of tissue in the ascending
colon, the source of the bleeding was not found.
4. The physician documents the diagnosis as calculus of the ureter. The surgeon performs a
cystoscopy, ureteroscopy for fragmentation of the stone and insertion of double J stent
5. The patient was taken to the outpatient surgical suite with the diagnosis of chronic
hoarseness. The surgeon performed a flexible bronchoscopy with bronchial cell washings
and brushings.

Answer 1

1. False
The documentation supports code 99212.
2. False
Feedback: The correct code is 19083 (ultrasound guidance)
3. False
Feedback: The only code that should be reported is 45380. The surgeon did not perform
any procedure related to the rectal bleeding.
4. True
5. True