I am stuck on this one coding scenario I'm hoping you can help me. I have gotten CPT code 90947 or 90945 but I am unsure which is the right one? I need a CPT code for an inpatient hospital scenario, Dialysis Progress Note. The patient was seen during CAPD while using 1.5% 2-liter fill volumes. She's on IV fluids, appears dry, only slight edema, some pain and tenderness on examination, but otherwise is eating better and feeling much better. Her cultures so far are negative. The patient is on vancomycin and gentamicin for peritonitis, which she'll continue to get through her pharmacy. Her current hospital dialysis prescription will continue and she'll remain in the hospital a few more days. Patient agrees with this plan. (I've been trying hard to code this online-study exam question myself but I'm just not sure. Are either of the two codes I mentioned correct? If not, where should I be looking?) Thank you for your help!
90945 is the correct code
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Please use your text, study materials, and a good search engine or two to find your answers.
1. Go to http://www.google.com or http://www.bing.com
2. Type in cpt codes (or whatever search terms you need). Press Enter.
3. Read different search results until you find what you need.
4. Re-search with different search terms if you don't find all you need.
90947
90945
To determine the correct CPT code for the given scenario, we need to analyze the information provided. CPT code 90947 and 90945 are both related to dialysis services, but we need more specific details to identify the appropriate code.
In the scenario, the patient is an inpatient in a hospital receiving dialysis treatment. The documentation includes information about the patient's condition, examination findings, and ongoing treatment.
To find the correct CPT code, we can use the following steps:
Step 1: Identify the main service being provided
Based on the information provided, the main service is the "Dialysis Progress Note" for an inpatient hospital scenario.
Step 2: Review the description of potential CPT codes
To determine the appropriate codes, we need to review the descriptions of the CPT codes related to dialysis. Specifically, we should look for codes that involve the documentation elements mentioned in the scenario, such as progress note, inpatient, and hospital dialysis prescription.
Step 3: Analyze the documentation details
Now let's review the documentation details to see which code is the best match:
- CPT code 90947: This code refers to "Dialysis services requiring repeated evaluations over time, for maintenance of a chronic condition." While this code mentions the need for ongoing evaluations, it does not specifically involve progress notes or inpatient hospital scenarios.
- CPT code 90945: This code is for "Dialysis services other than hemodialysis (e.g. peritoneal dialysis, hemofiltration, or other continuous renal replacement therapies)." Since the scenario mentions Continuous Ambulatory Peritoneal Dialysis (CAPD), this code seems more relevant.
Step 4: Verify code selection with official coding resources
To ensure accuracy, it is always recommended to consult official coding resources like the American Medical Association's (AMA) CPT codebook or online coding databases. These resources contain comprehensive code descriptions, guidelines, and instructions that help in accurate code selection.
Based on the information in the scenario, CPT code 90945 appears to be the more appropriate choice for the inpatient hospital scenario involving CAPD. However, it is essential to double-check with official coding resources for the final confirmation.