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When a physician performs a preventive care service, the extent of the exam is determined by the: Age
According to information in 99466, what is the age of a neonate: 24 months or younger
According to E/M guidelines, a(n) comprehensive exam encompasses a complete single-specialty exam or a complete multi-system exam: Comprehensive
Multiple modifiers are indicated with which modifier: -99
According to the CPT manual, modifier -91: is not to be used when tests are rerun to confirm initial results.
According to the notes preceding the Category III codes in the CPT manual, the digits of the Category III codes are not intended to reflect the placement of the code in the Category I section of the CPT: Nomenclature
A modifier: Provides additional information to the third-party payer.
The examination is the objective portion of the: E/M service
Level II (HCPCS) codes are not used in which setting: Inpatient
Who requires a special report with the use of unlisted codes: (TPP) Third party payers
How often are Category III codes released: Twice a year
The hospital inpatient services subsection is used for patients admitted to: An acute care facility
The modifier that indicates multiple procedures is: -51
According to the E/M Guidelines, time is not a descriptive component for: the emergency department levels of E/M services
Modifier -58, staged or related procedure or service by the same physician during the postoperative period, is used to indicate: that a subsequent surgery was planned at the time of the first surgery.
Modifier -52, reduced services, us used to indicate: A service was reduced without changing the definition of the code.
These elements would be part of the social history: employment, education, use of drugs.
The level of E/M Service is based on: Documentation, Key components, and contributing factors.
Critical care codes are: reported based on time.
Which of the following is not a reason for the CPT coding system: Increased reimbursement.
Category I CPT codes have: 5 digits
Healthcare providers care: Reimbursed based on the codes submitted on a claim form for procedures and services rendered.
What is the function of add on code: Identifies a code that is never used alone.
The words that follow a code number in the CPT manual are called: Procedure/Service descriptor.
Procedures that are experimental, newly approved, or seldom used are reported with what type of code: Unlisted/Category III
Which punctuation mark between codes in the index of the CPT manual indicates a range of codes is available: Hyphen
A list of the unlisted procedures for use in a specific section of the CPT manual is contained in: Guidelines
In which CPT Appendix would additions, deletions, and revisions be found: Appendix B
In which CPT appendix would all modifiers be found: Appendix A
What CPT code is assigned to an ED service that has a detailed history and exam with a moderate level of MDM: 99284
Which code is an example of an add on code: 15787
Modifiers may affect: The way payment is made by a third party payer.
Modifiers are used to indicate what type of information: Bilateral procedure, multiple procedures, and service greater than usually required.
Modifier -51, Multiple Procedure, is used on what type of services: Surgery
Which term reflects the technologic advances made in medicine that are incorporated into the CPT manual? Revisions
Where is specific coding information about each section located: Guidelines
Modifier -25 significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service is used to report an E/M service that was: Provided on the same day as a minor procedure performed by the same physician.
Which punctuation mark between codes in the index of the CPT manual indicates two codes are available: Comma
What year was CPT first developed and published: 1966
How many main sections are in the CPT Manual: 6
Who publishes CPT: (AMA) American Medical Assocation
The Universal health insurance form for submission of outpatient services is: CMS 1500
Codes from the E/M subsection Nursing Facilities Service are: Report services provided such as Skilled Nursing , Intermediate Care Facility and Long Term Care Facility.
This act mandated the adoption of national uniform standards for electronic transmission of financial and administrative health information: HIPAA
Which of the following would be used to code drugs: J codes
The range codes 10021-69990 would be found in the section of the CPT manual: Surgery
The physician must consider multiple Dx and management options. There is a moderate amount of data to be reviewed and the risk of complications or death is moderate. What is the level of MDM: Moderate
The request for advice or opinion from one physician to another physician is this type of service: Consultation
Mr. Smith presents to the ER at the local hospital for chest pain and is seen by the ED physician on duty. The physician obtains and extended HPI, an extended ROS, and a pertinent PFSH. What is the level of Hx: Detailed
CPT stands for: Current Procedural Terminology
Medicaid Requirements: (It's the last resort) Low Income Disable End Stage Renal Share of Cost (Medicaid Secondary) Month to Month (Basics)
EOB Explanation of Benifits
DOS Date of Service
Dx Diagnosis
CPT Current Procedural Terminology
HCPCS Healthcare Common Procedure Coding System (Supplies)
HIPAA Health Insurance Portability Accountability Act
MRI Magnetic Resonance Imaging
What is a UB-04 Form and where is it used: Claim form and in the Hospital
What is a CMS 1500 form and where is it used: Claim form and in the medical office
What is EOB and what details are on it: Explanation of Benefits. DOS: Date of Service, Dx: Diagnosis, CPT: Procedure, Charge, Paid by Insurance, Patient Responsibity, Adjustment/Wright off.
What is a (Dx) Diagnosis & what is charged: After the test are done, the Dr. tells the patient what's wrong. No Charge.
What is a procedure & do we charge: Procedure is any kind of test done. Yes we charge.
First thing you do in the medical office with the patient: Hello, good morning or Afternoon. Then ask for any insurances & ID's
Created by: rochelle1977



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