Answer the questions following each of the exercises. PROCEDURE: Tracheostomy PRE-PROCEDURE DIAGNOSIS: Traumatic brain injury; pneumonia ANESTHESIA: Lidocaine 1% with epinephrine injected subcutaneously over the neck at the level of the second tracheal ring. PROCEDURE: The patient's neck was prepped as above. Lidocaine with epinephrine was injected into the subcutaneous tissue after identification of the tracheal rings. A small horizontal incision was then made until reaching the trachea. The bronchoscope was passed and the light was then identified passing the incision site and the endotracheal tube was pulled back until away from the trach site. A needle was then passed into the trachea. A guidewire and sequential dilators were then passed into the trachea until an 8.0 Shiley tracheostomy tube was placed. This was assessed by passing the bronchoscope into the trach with visualization of the airways. The ventilator was then moved to the tracheostomy with adequate return of tidal volumes. The endotracheal tube was then removed and the trach was sutured in place. The patient tolerated the procedure well. Questions: 1.1. What is the objective of this procedure? 1.2. A bronchoscope was used in performing this procedure. Does the use of the bronchoscope affect the assignment of the approach value? 1.3. Which approach value is assigned? 1.4. What code(s) should be assigned?