A70-year-old patient with chronic obstructive asthma is brought to the urgent care center with increased wheezing and coughing. the provider initiated an albuterol inhalation treatment, one dose, delivered by nebulizer. after treatment, the patient's exacerbation was somewhat improved but the provider determined a second treatment was necessary. what codes are reported

The codes to be reported in the given case are 94640, 94640 - 76, J7609 * 2, J44.1.  

In the CPT index, when one looks for airway obstruction / Inhalation treatment / Non-pressured or pressured, then one is directed to 94640. Inhalation treatment was instructed therapeutically in treating the acute airway obstruction. Two treatments were given, so code 94640 is reported twice.  

Under code 94640, there is a parenthetical instructing given to use modifier 76, in case if more than one inhalation treatment is done on a similar date. As the treatment is done urgently, that is, in the office, the physician uses albuterol, in the given case, two doses of albuterol is given, so J7609 is reported twice per dose. The diagnosis code for exacerbation is J44.1.  

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he forelimbs below belong to four species that descended in a direct line from the ancestral mammal shown above. of the four descendants shown, which species most likely appeared earliest in evolutionary history?