Coding Corner Questions: A Drug Administration Quiz

1. A 70–year-old female patient with rheumatoid arthritis affecting multiple joints who is rheumatoid-factor positive but without organ or system failure returns for her third infliximab infusion. She is scheduled to receive 500 mg of the drug. How should this encounter be coded?
   1. 96413, 96415, J1745 x 50; ICD 10: M05.79
   2. 96413, 96415, J1745 x 50; ICD 10: M05.69
   3. This encounter cannot be coded without querying the provider
   4. None of the above
2. A 75-year-old female patient with a diagnosis of postmenopausal osteoporosis without current pathological fracture returns to the practice for her scheduled denosumab injection. She was last seen for an office visit four weeks ago and previously received denosumab six months ago. She is given 60 mg of the drug. How should this encounter be coded?
   1. 96401, J0897 x 60; ICD: M81.0
   2. 99212, 96401, J0897 x 60; ICD 10: M81.1
   3. 96372, J0897 x 60; ICD 10: M81.0
   4. 99212, 96372, J0897 x 60; ICD 10: M8.1
3. A 66-year-old Medicare patient has a diagnosis of rheumatoid factor-positive rheumatoid arthritis. His disease affects multiple joints, but is associated with no organ involvement, and he returns for his follow-up visit. The history is expanded focused, the exam is problem focused, and the medical decision making is of low complexity. The patient is given an adalimumab injection of 40 mg, because the patient does not like to inject himself. How should this encounter be coded?
   1. 99213-25, 96401, J0135 x 2; ICD 10: M05.79
   2. 99213-25, 96372, J0135 x 2; ICD 10: M05.69
   3. 99213; ICD 10: M05.79
   4. None of the above
4. A 65-year-old female patient with age-related osteoporosis returns to the practice for her fourth dose of ibandronate sodium, which she receives every 3 months. The dosage is 3 mg. The nurse starts the IV and administers the drug as a bolus over 30 seconds. How should this encounter be coded?
   1. 96401, J1740 x 3; ICD 10: M81.0
   2. 96374, J1740 x 3; ICD 10: M81.0
   3. 96375, J1740 x 3; ICD 10: M81.0
   4. 99211-25, 96374, J1740 x 3; ICD 10: M81.0

Editor’s note: Case vignettes presented in the Coding Corner are created to illustrate questions about coding. They are not intended to represent the full medical record of a case.

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