Using 100 words:List four types of anesthesia along with an example of the type of procedures for which each are used.ReferenceCarol J. Buck, Saunders (2022). Step-by-Step Medical Coding,  by Carol J. Buck, Saunders

CHAPTER 12
ANESTHESIA

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Anesthesiologist
Doctor of medicine specialized in anesthesia
Usually independent practices
(not hospital employees)
e.g., Anesthesia Associates, Inc. or Pain Clinic, Ltd.
Services reported separately

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The anesthesiologist is a physician whose medical specialty is anesthesia. These specialists are often members of outside practices who report their services separately.
Why would the anesthesiologist’s services be reported separately? (Because it is a separate physician who specializes in this type of medicine)

Uses of Anesthesia
Relieve pain
Manage
Unconscious patients
Life functions
Resuscitation

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Use of anesthesia creates a state of analgesia (the absence of pain) that allows the patient to have surgery or another procedure performed without experiencing pain.
The anesthesiologist’s job is to administer medications that will induce general, regional, local, or conscious sedation in the patient while managing the life functions of the unconscious patient and directing respiratory or cardiac resuscitation efforts.
If a patient suffers cardiac arrest while on the operating table, why is the anesthesiologist the one to manage the problems associated with resuscitation? (He or she is responsible for management of the patient while under anesthesia.)

Methods of Anesthesia (1 of 3)
Figure 12.1A
Endotracheal: Through mouth

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What is anesthesia? (Administration of a drug to obtain loss of sensation.)
Ask students to identify different types of anesthesia. (General, regional, local, or monitored anesthesia care [MAC])
When will endotracheal anesthesia be administered? (When general anesthesia is needed; major procedure)
This figure shows one method of delivering general anesthesia. Endotracheal anesthesia is accomplished by inserting a tube into the nose or mouth and delivering a gaseous drug through the tube.

Methods of Anesthesia (2 of 3)

Figure 12.2
Local: Application to area (injection or topical)

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With local anesthesia, an anesthetic agent such as lidocaine is directly applied to the area involved as a topical anesthesia or is administered by local infiltration through a subcutaneous injection, as shown in Fig. 12.2.
What types of procedures would use local anesthesia? (Relatively minor procedures such as tooth extraction or suturing a wound would be candidates.)
What is a key difference between local and general anesthesia? (There is no loss of consciousness with local anesthesia as there is when a general is administered.)

Methods of Anesthesia (3 of 3)
Epidural: Into epidural space
Regional: Field or nerve
Includes spinal and epidural

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When is an epidural anesthesia us

CHAPTER 13
SURGERY GUIDELINES
AND GENERAL SURGERY

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Surgery Section
Largest CPT Section
Section format:
10004-69990
Divided by subspecialty
Integumentary
Cardiovascular

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How many subsections are included in the Surgery section of the CPT manual? (It has 19 subsections, with codes ranging from 10004 to 69990. Within the Surgery section, the Integumentary and Cardiovascular are among the more complex subsections.)

Notes and Guidelines
Throughout section
Information varied and extensive
“Must” reading

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Guidelines are provided at the start of each section of the CPT. The information they contain allows the coder to appropriately interpret and report on the procedures and services included in that section.
Can subsections have their own notes with special instructions? (In addition to the general guidelines, each subsection, subheading, category, and subcategory of information included in the CPT is likely to have its own set of notes, including special instructions for use of the codes contained in that part of the CPT. These instructions must be followed for coding to be accurate.)

CPT Manual Text Changes

Figure 13.1

►◄ Indicates text changes from previous edition

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Why is it important to note any changes in the CPT guidelines accompanying a revision of the CPT? (Revisions to the CPT are periodically released. New or revised text included in the CPT guidelines is indicated by arrows placed at the start and end of the changed information, as shown here in Fig. 13.1.)

Subsection Notes

Figure 13.2

Subsection notes apply to entire subsection

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As an example, consider the following notes from the Musculoskeletal System subsection shown in Fig. 13.2. Because this note is provided at the start of the subsection, it applies to the entire subsection.
Three critical pieces of information are provided:
Location of cast and strapping procedures—knowing this may speed up the process of locating a code.
If more than one cast or traction device is applied, an additional listing may be required. Failure to follow this note could result in underpayment for services rendered.
Definitions are provided for key terms that will be used throughout the section.

Subheading Notes

Figure 13.3

Subheading notes apply to entire subheading

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On what basis are subheadings clustered within a subsection? (Subsections of the CPT may include subheadings to cluster together a group of related procedures or services. As with notes that appear under subsections, notes placed under a subheading will apply to all procedures and services within that portion of the CPT. The note listed in this example [Fig. 13.3] provide

CHAPTER 15
MUSCULOSKELETAL SYSTEM

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Musculoskeletal System (1 of 2)

Subsection divided: Anatomic site
(Forearm and Wrist), then service
(e.g., excision)
Used extensively by orthopedic
surgeons
Many codes commonly used by
variety of physicians
Extensive notes

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Subsections reflect anatomical sites. Within each anatomical site, subheadings reflect the procedures performed.
Many musculoskeletal codes, such as those used for splinting, casting, and fracture repair procedures, are also used by primary care and family practice physicians.
This section of the CPT includes many notes. Why is it important to carefully review these notes? (Notes tell you how to use the information to identify any qualifying conditions.)

Musculoskeletal System (2 of 2)
Most common:
Fracture and dislocation treatments
“General” subheading
Arthroscopic procedures
Casts and strapping

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What types of procedures are listed under the General subheading? (Miscellaneous procedures not specific to an anatomical site, i.e., incisions of soft tissue abscesses, wound exploration, or biopsies of muscle and bone tissue)

Fractures
Questions to ask:
Site of fracture or dislocation
Type of treatment (open, closed)
Manipulation performed and documented
Was traction used; if so, what type
Was percutaneous fixation used
Was internal fixation applied (make sure this is not included in code description)
Was an external fixation system applied
Did documentation support skin closure
What type of anesthesia was used

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Fracture Treatment (1 of 2)
Open: Surgically opened to view or remotely opened to place nail across fracture
Open reduction with internal fixation (ORIF)
Closed treatment, fracture site is not exposed by surgical incision
Percutaneous, neither open or closed. Fixation devices (such as pins) are placed across the fracture site under imaging
Treatment terms not to be confused with type of fracture
Open fracture: Bone penetrates skin
Closed fracture: Bone does not penetrate skin

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Fractures are coded by treatment, which may be open, closed, or percutaneous.
How do the three types of fracture treatment differ? (Typically, open and percutaneous treatments require surgical intervention, whereas closed treatment many times can be completed without taking the patient to the surgery suite.)

Type of treatment
depends on type
and severity
of fracture
“Complicated”
in a code descriptor may
indicate excessive
hemorrhage, infection,
prolonged physician
work, or difficulty in
reaching the site or
depth of the site.
Fracture Treatment (2 of 2)
Figure 15.1

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Which type of fracture treatment would most likely be used for a greenstick fractu




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