Please see below the exact instructions from my professor for this project:
Using the Case Studies at the end of Your Text-Book fill the claims (CMS-1500) for case studies 2-7 and 2-11. You have to complete the encounter forms, find the codes and then fill the claims following the claims instructions given in the corresponding Chapter of the text-book according to the Health Plan. You must use the website given in the Web Links, but you have to download the form first and then fill the claims and send to me be clicking the SUBMITING option at the bottom. Keep in mind that the deadline for this evaluation is as always the WEDNESDAY after posting. Because the 14th edition has not the Case Studies I have attached the Cases for the Project!
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CASE STUDY 2-7
Fp?o9d?rMstFe?t`?’A¥:,h€rt:Nt:2345. (ioi) 111.2222 Case study Npl: 3345678901
PROVIDER(S): HENRY C. CARDIAC, M.D. EIN. 22-1234567 Npl: 3456789012
PATIENT INFORMATION: Name:
Date of Birth:
14 Ridley St
INSURANCE INFORMATION: Patient Number. 2 -7
Place of service: Office
Primary Insurance plan: Medicare
Primary policyholder. Sel f
Po!icyholder Date of Birth`
Relationship to Patient:
Secondary Insurance Plan:
Seconclary Insurance Plan lD #:
Patientstatus I Married I Divorced ill single
I student I other
PROCEDURE INFORMATION Description of Procedure or Service
1. office visit, level IV 2 EKG, routine with interpretation 3.
0 6 -2 0 -Y¥¥Y
Code Charge loo . 00
65 . 00
GOODMEDICINE CLINIC 1 Provider Street . Anywhere, NY 12345 . (101) 111-2222
PROVIDER: HENRY C. CARDIAC, M.D.
OFFICE VISIT 06/20/YYYY
S: Elderly African American male returns, after a two-year hiatus, for follow-up of coronary artery disease and associated problems. Since triple coronary bypass surgery four years ago, he has had no chest discomfort. It should be noted that he had no chest discomfort during a markedly abnormal stress test performed just two weeks before the bypass surgery. He now reports intermittent dyspnea that occurs at rest and spontaneously abates. He does not notice any discomfort c)n exertion, but he does report that his lifestyle is sedentary. He denies orthopnea, paroxysmal nocturnal dyspnea, .or edema. He has continued to follow up with his internist, Dr. Gooddoc, for treatment of his dyslipidemia and hypertension. He is on Cholestin and Tenormin.
0: Patient is a mildly obese, African American male appearing his stated age, in no acute distress. Weight is 210. Height is 5’8″. Pulse 16. BP 162/82, 172/82, and then 188/82 in the office. HEENT grossly unremarkable. Neck reveals normal jugular venous pressure, without hepatojugular reflux. Normal carotid pulses; no bruits present. Lungs are clear to A&P. Heart reveals regular rhythm, Sl and S2 are normal. There is no murmur, rub, click, or gallop. Cardiac apex is not palpable. No heaves or thrills are detected. Abdomen is soft, nontender, with normal bowel sounds, and no bruits. No organomegaly, including abdominal aorta, or masses noted. Extremities reveal a surgical scar in the right leg, presumably from saphenous venectomy. Femoral pulses are normal, without bruits. Dorsalis pedis and posteric)r tibial pulses are also normal. There is no cyanosis, clubbing, or edema. Neurological is grossly within normal limits.
A: 1. Dyspnea.
2. Hypertension. 3. Hypercholesterolemia. 4. Status post aortocoronary bypass surgery four years ago.
Per ERG, an inferior myocardial infarction may have occurred sometime in the past. There is independent suggestion of this on stress-thallium test performed six months ago. Additionally, he still has symptoms of dyspnea .
P: 1. Patient was instructed to follow-up with Dr. Gooddoc for hypertension and dyslipidemia.
2. Schedule treadmill stress test for next week.
J/eape.eaha,M.3>. Henry C. Cardiac, M.D.