CODING REIMBURSE- MENT AND COST PROCEDURE CODING PATIENT SCENARIO HISTORY 1 CARE PATH DIAGRAM PATIENT WORKSHEET 1.1: UTI - Simple Cost Total = $ Urine Culture CBC (CPT 85027) $13.08 Total Cost Oral Antibiotics Cephalexin cap $54 Total Cost Levofloxacin tab $111 Total Cost Augmentin tab $ Total Cost Oral Antibiotics: One of the following is prescribed for days; 1.Cephalexin cap; 2.Levofloxacin tab 3. Augmentin Tab. BACTERIAL INFECTION BACTERIMIA DISCHARGE Ultrasound of Kidneys SURGICAL PATIENT CRITICAL CARE PATIENT MEDICAL PATIENT History Physical Exam IV antibiotics Or Oral antibiotics Oral antibiotics/ Observation Urine Culture Symptomatic Presentation Urine Culture Blood Culture Scenario: A 28-year-old woman with iron deficiency anemia underwent colonoscopy which showed a large polyp not amenable to removal. Biopsy showed fragments of tubulovillous adenoma and low grade dysplasia. Laparoscopic assisted right hemicolectomy was performed. The procedure goes well but during recovery phase, patient presents symptoms of UTI. Evaluation

CODING REIMBURSE- MENT AND COST PROCEDURE CODING PATIENT SCENARIO HISTORY 2 CARE PATH DIAGRAM PATIENT WORKSHEET 1.2: UTI - Moderate Complete Blood Count (85027) once a day for 4days Blood Draw (36415) CBC (CPT 85027) $13.08 Total Cost Blood Draw (CPT 36415) $ Total Cost BACTERIAL INFECTION BACTERIMIA DISCHARGE Ultrasound of Kidneys History Physical Exam IV antibiotics Or Oral antibiotics Urine Culture Symptomatic Presentation Urine Culture Blood Culture Scenario: A 647-year-old man with mild deficiency anemia underwent colonoscopy which showed a large polyp not amenable to removal. Biopsy showed fragments of tubulovillous adenoma and low grade dysplasia. Laparoscopic assisted right hemicolectomy was performed. The procedure goes well but during recovery phase, Patient presents symptoms of UTI. Urine Culture CBC (CPT 85027) $13.08 Total Cost Oral Antibiotics Cephalexin cap $54 Total Cost Levofloxacin tab $111 Total Cost Augmentin tab $ Total Cost Oral Antibiotics: One of the following is prescribed for days; 1.Cephalexin cap; 2.Levofloxacin tab 3. Augmentin Tab. Cost Total = $530 Oral antibiotics/ Observation Evaluation SURGICAL PATIENT CRITICAL CARE PATIENT MEDICAL PATIENT

CODING REIMBURSE- MENT AND COST PROCEDURE CODING PATIENT SCENARIO HISTORY 3 CARE PATH DIAGRAM PATIENT WORKSHEET 1.3: UTI – Moderate Complex BACTERIAL INFECTION BACTERIMIA DISCHARGE Ultrasound of Kidneys History Physical Exam Evaluation IV antibiotics Or Oral antibiotics Oral antibiotics/ Observation Urine Culture Symptomatic Presentation Urine Culture Blood Culture IV antibiotics: One of the following is prescribed X 8 days (changed to oral antibiotics once the patient feels better): Levofloxacin IV; Cefazolin IV. IV Antibiotics Levofloxacin IV $135.28Total Cost Cefazolin IV $ Total Cost Scenario: A 54-year-old woman with iron deficiency anemia underwent colonoscopy which showed a large polyp not amenable to removal. Biopsy showed fragments of tubulovillous adenoma and low grade dysplasia. Laparoscopic assisted right hemicolectomy was performed. The procedure goes well but during recovery phase, Patient present symptoms of UTI. Complete Blood Count (85027) once a day for 4days Blood Draw (36415) CBC (CPT 85027) $13.08 Total Cost Blood Draw (CPT 36415) $ Total Cost Urine Culture CBC (CPT 85027) $13.08 Total Cost Cost Total = $ SURGICAL PATIENT CRITICAL CARE PATIENT MEDICAL PATIENT

CODING REIMBURSE- MENT AND COST PROCEDURE CODING PATIENT SCENARIO HISTORY 4 CARE PATH DIAGRAM PATIENT WORKSHEET 1.4: UTI - Complex BACTERIAL INFECTION BACTERIMIA DISCHARGE Ultrasound of Kidneys History Physical Exam IV antibiotics Or Oral antibiotics Oral antibiotics/ Observation Urine Culture Symptomatic Presentation Urine Culture Blood Culture Scenario: A 62-year-old woman with iron deficiency anemia underwent colonoscopy which showed a large polyp not amenable to removal. Biopsy showed fragments of tubulovillous adenoma and low grade dysplasia. Laparoscopic assisted right hemicolectomy was performed. The procedure goes well but during recovery phase, Patient present symptoms of UTI. Echo of Kidney (CPT $ Total Cost Echo of kidneys (74160) IV antibiotics: One of the following is prescribed X 8 days (changed to oral antibiotics once the patient feels better): Levofloxacin IV; Cefazolin IV. IV Antibiotics Levofloxacin IV $135.28Total Cost Cefazolin IV $ Total Cost CBC (CPT 85027) $13.08 Total Cost Blood Draw (CPT 36415) $ Total Cost Urine Culture CBC (CPT 85027) $13.08 Total Cost Complete Blood Count (85027) once a day for 4days Blood Draw (36415) Cost Total = $ Evaluation SURGICAL PATIENT CRITICAL CARE PATIENT MEDICAL PATIENT