This is another example of CPT system:
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Dr. Experience: Board Certified Specialist with 10 years of experience in practic |
PA Rookie (Physician Assistant): Recently graduated from PA school (not a medical school) one year ago. |
A patient visits Dr.Experience for a follow-up blood pressure treatment. Dr. Experience performs a detail examination and gives his recommendations. ‘By the way Dr.Experience, I have a hang toenail that has been bothering me for a few days’ the patient says. Dr.Experience inspects the nail and correctly decides that the nail will come off in a few days without any surgical intervention, so he assures the patient and gives him instructions on how to take care of it. |
| Dr.Experience’s Medicare Charge for this visit: CPT code 99213 - $57.89. |
http://www.wpsmedicare.com/part_b/fees/physician_fee_schedule/_files/2011-il-12.pdf |
A similar patient comes for a follow-up to Rookie Clinic for blood pressure treatment and also mentions a hang toenail. PA Rookie is a kind and caring provider and performs a detail exam for which Medicare allows a visit charge 99213. However, PA Rookie in not sure about the diagnosis and what the treatment plan should be. He decides to orders an X-ray of the foot and, then, determines that the nail needs to be removed. He then performs a mini surgery for the toenail excision. |
Medicare allows CPT 99213 for visit -$57.89, CPT 73620 for X-ray -$23.10,
CPT 11750 for Excision - $177.95. Total Cost: $258.95!!!!! |
| http://www.wpsmedicare.com/part_b/fees/physician_fee_schedule/_files/2011-il-12.pdf |
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