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MED112 CODE/BILL

MED112 CH 05 PROCEDURAL CODING: CPT & HCPCS SB

QuestionAnswer
MED112 CHH 05 SB
____ codes have three categories. CPT
The CPT ____ makes the process of selecting the correct procedure code more efficient. index
An indented code uses a ____ to separate the common descriptor from the unique descriptor. semicolon
Where are codes for items that are used in medical practices but are not listed in CPT (such as supplies and equipment) found? A. Healthcare Common Procedure Coding System B. Clinical Procedure Coding C. Common Procedure Coding Practices D. Procedure Coding Healthcare Common Procedure Coding System
Identify the correct statements related to CPT. A. CPT is non-proprietary and is available free to the public. B. CPT code is available only in print from the AMA. C. CPT is a proprietary code set and is not available free to the public. D. CPT code is available only in digital format. CPT is a proprietary code set and is not available free to the public.
How many sections are listed in the main text? A. 2 B. 4 C. 3 D. 6 6
CMS has designated CPT codes as the standard for physician procedures that are paid by which of the following? A. Medicaid B. American Medical Association C. Medicare D. Government insurance program A. Medicaid C. Medicare D. Government insurance program
Which of the following are categories of CPT codes? A. Category I codes B. Category IV codes C. Category III codes D. Category II codes E. Category V codes A. Category I codes C. Category III codes D. Category II codes
Which of the following are appendixes in CPT? A. Appendix B - Summary of Additions, Deletions, and Revisions B. Appendix A - Modifiers C. Appendix D - Summary of CPT Add-on Codes D. Appendix C - Vascular Families A. Appendix B - Summary of Additions, Deletions, and Revisions B. Appendix A - Modifiers C. Appendix D - Summary of CPT Add-on Codes
Which of the following send their suggestions for revisions to the CPT code to the AMA each year? (More than one answer may be correct.) A. Physicians B. Insurance companies C. Medical specialty societies D. State medical associations A. Physicians C. Medical specialty societies D. State medical associations
Which of the following is used to determine the CPT code? A. Treatment B. Procedure C. Appointment date D. Service A. Treatment B. Procedure D. Service
After the index is used to point to a possible code, the main text is read for which purpose? A. To give additional information B. To verify the selection of the code C. To give a cross-reference D. To give similar codes To verify the selection of the code
Which of the following statements are correct in regards to CPT symbols? A. Facing triangles (two triangles that face each other) enclose new or revised text other than the code's descriptor. B. A bullet indicates an existing procedure that was performed twice. C. A triangle indicates that the code's descriptor has changed. D. A bullet indicates a new procedure. A. Facing triangles (two triangles that face each other) enclose new or revised text other than the code's descriptor. C. A triangle indicates that the code's descriptor has changed. D. A bullet indicates a new procedure.
What does the CPT book list? A. Commonly performed medical procedures and services B. Codes for durable medical equipment C. Commonly prescribed medications D. Commonly used diagnostic codes Commonly performed medical procedures and services
Which of the following is the symbol for an add on code? A. < B. + C. * D. ; +
Which appendix includes a Summary of Additions, Deletions, and Revisions in the CPT? A. O B. B C. A D. H B
In order to report Telemedicine codes, the provider must exchange enough information in order to meet the ______ components required as with a face to face encounter. A. procedural B. primary C. key D. minimum key
Why does CPT use semicolons and indentations? A. To link the procedures together B. To separate the main entry from what follows C. When a common part of a main entry applies to entries that follow D. To reference to another section When a common part of a main entry applies to entries that follow
Which of the following is the symbol for an FDA approval pending code? A. A bull's eye B. A lightning bolt C. A diamond D. A facing triangle A lightning bolt
The CPT index contains which of the following information? A. Numeric terms that are listed in the CPT code sections B. Descriptive treatment methods C. Descriptive terms that are listed in the sections of the codes D. Page numbers for the correct codes Descriptive terms that are listed in the sections of the codes
Identify the two places resequenced codes are listed in CPT. A. The code and its descriptor appear in a group of codes to which it is related. B. They are listed at the back of the CPT. C. The code is listed in a supplemental pamphlet. D. They are listed in their original numeric position. A. The code and its descriptor appear in a group of codes to which it is related. D. They are listed in their original numeric position.
A ____ symbol indicates that the code's descriptor has changed. triangle
The practice of displaying CPT codes outside of numerical order in favor of grouping them according to the relationships between code descriptors is known as ____. resequencing
____ are used to communicate special circumstances involved with procedures or services that were performed. Modifiers
The modifiers are listed in which appendix of CPT? A. Appendix C B. Appendix A C. Appendix B D. Appendix D Appendix A
What is the correct definition of add-on codes? A. Add-on codes describe a primary procedure. B. Add-on codes describe secondary procedures commonly carried out in addition to primary procedures. C. Add-on codes are optional codes that can be used to describe the patients' diagnoses. D. Add-on codes reference experimental codes. Add-on codes describe secondary procedures commonly carried out in addition to primary procedures.
During which of the following situations are modifiers used? (More than one answer may be correct.) A. When only part of a procedure has been done B. When a regular procedure has been done C. When a procedure has two parts: a technical and a professional component D. When unusual difficulties occurred during the procedure A. When only part of a procedure has been done C. When a procedure has two parts: a technical and a professional component D. When unusual difficulties occurred during the procedure
Select the symbol used to indicate the code is approved for Telemedicine? A. Triangle B. Star C. Circle D. Bullet Star
How are modifiers shown in CPT? A. Adding a five-digit code to the CPT code B. Adding a space and the two-digit code to the CPT code C. Adding a dash between the modifier and the CPT code D. Adding a space and a five-digit code to the CPT code Adding a space and the two-digit code to the CPT code
Identify when the lightning bolt symbol is used in CPT. A. The lightning bolt symbol remains after the code is approved. B. The lightning bolt symbol indicates the codes cannot be used until approved. C. The lightning bolt symbol is used with vaccine codes that have been submitted to the FDA and are expected to be approved for use soon. D. The lightning bolt symbol indicates the codes can be used and billed to payer. B. The lightning bolt symbol indicates the codes cannot be used until approved. C. The lightning bolt symbol is used with vaccine codes that have been submitted to the FDA and are expected to be approved for use soon.
What is step 4 in the process of assigning CPT codes? A. Abstract the medical procedures from the visit documentation B. Locate the main terms C. Identify the main term for the procedure D. Identify where the service took place Locate the main terms
The practice of displaying CPT codes outside of numerical order in favor of grouping them according to the relationships between code descriptors is known as __________. resequencing or resequenced
Which of the following apply to step 1 of the six steps of assigning CPT codes? A. Decide which procedures were performed. B. Verify codes in the CPT main index. C. Review the documentation. D. Determine the place of service. E. Identify the main term for each procedure. A. Decide which procedures were performed. C. Review the documentation. D. Determine the place of service.
Which of the following is a consideration when abstracting documentation to select services to be reported? A. Payer's policies B. Date of procedure C. Number of procedures D. Modifiers Payer's policies
The use of a modifier means that the procedure ________. A. is different from the description without changing the definition B. changes the definition of the procedure C. has a secondary diagnosis that needs to be used D. is routine and considered normal is different from the description without changing the definition
Which of the following apply to step 3 of the six steps of assigning CPT codes? A. Main terms may be based on organ or body part. B. Main terms may be based on procedure or service. C. Review visit documentation. D. Identify the main term for each procedure. E. Modified main terms may be used. A. Main terms may be based on organ or body part. B. Main terms may be based on procedure or service. D. Identify the main term for each procedure.
Using two or more modifiers with one code will ________. A. provide the best description possible B. be considered fraud C. reduce the chances for claim payment D. not provide enough information about the procedure provide the best description possible
Identify step 4 in the process of assigning CPT codes. A. Locate the main terms in the CPT Index. B. Locate subterms in the CPT index. C. Identify the main terms. D. Determine the need for modifiers. Locate the main terms in the CPT Index.
Which of the following apply to step 5 of the six steps of assigning CPT codes? A. Review the possible codes in the CPT section that the index entries point to. B. The codes to be reported for each day's services are ranked in order of highest to lowest reimbursement. C. Do not eliminate items that are billed separately because they are covered under another broader code. D. Check section guidelines and any notes directly under the code, within the code descriptor, or after the code descriptor. A. Review the possible codes in the CPT section that the index entries point to. B. The codes to be reported for each day's services are ranked in order of highest to lowest reimbursement. D. Check section guidelines and any notes directly under the code, within the code descriptor, or after the code descriptor.
What is step 1 in the process of assigning CPT codes? A. Identify the main term for each procedure. B. Abstract the medical procedures from the visit documentation. C. Review complete medical documentation. D. Verify the code in the CPT main text. Review complete medical documentation.
Which of the following apply to step 6 of the six steps of assigning CPT codes? A. The circumstances involved with the procedure or service may require the use of modifiers. B. The patient's diagnosis does not affect whether a modifier is required. C. The modifier should always be used. D. The patient's diagnosis may affect whether a modifier is required. A. The circumstances involved with the procedure or service may require the use of modifiers. D. The patient's diagnosis may affect whether a modifier is required.
What is step 2 in the process of assigning CPT codes? A. Determine the need for modifiers. B. Identify the main terms. C. Abstract the medical procedures. D. Locate the main terms in the CPT Index. Abstract the medical procedures.
Identify all the correct statements related to the evaluation and management codes (E/M codes). A. E/M codes are rarely used. B. E/M codes determine a patient's diagnosis and the medications necessary to treat the condition. C. E/M codes cover the complex process a physician uses to gather and analyze information about a patient's illness. D. E/M codes are often called the cognitive codes. E. E/M codes are listed first in CPT. C. E/M codes cover the complex process a physician uses to gather and analyze information about a patient's illness. D. E/M codes are often called the cognitive codes. E. E/M codes are listed first in CPT.
What is step 3 in the process of assigning CPT codes? A. Identify the main term for each procedure. B. Review medical documentation. C. Identify the subterm for each procedure. D. Verify the code in the CPT main text. Identify the main term for each procedure.
Which of the following apply to step 4 of the six steps of assigning CPT codes? A. Locate the procedures in the index at the back of the CPT. B. When a code range is listed, read the code descriptors for all codes within the range indicated in the index. C. If the main term cannot be located in the index, the insurance specialist reviews the main term with the physician for clarification. D. If the main term cannot be located in the index, find the closest term. A. Locate the procedures in the index at the back of the CPT. B. When a code range is listed, read the code descriptors for all codes within the range indicated in the index. C. If the main term cannot be located in the index, the insurance specialist reviews the main term with the physician for clarification.
What are most codes in the E/M section organized by? A. Type of service B. Place of service C. Diagnosis D. Date of service Place of service
What is step 5 in the process of assigning CPT codes? A. Review complete medical documentation. B. Abstract the medical procedures. C. Verify the code in the CPT main text. D. Locate the main terms in the CPT Index. Verify the code in the CPT main text.
Which of the following would be considered an established patient? (More than one answer may be correct.) A. Consultation B. Referral provider C. Sees another physician of the same specialty in the new practice within the past three years D. Received any professional services from the provider within the past three years C. Sees another physician of the same specialty in the new practice within the past three years D. Received any professional services from the provider within the past three years
What is step 6 in the process of assigning CPT codes? A. Verify the code in the CPT main text. B. Determine the need for modifiers. C. Determine the need for additional digits. D. Locate the main terms in the CPT Index. Determine the need for modifiers.
Which of the following apply to physician's consultations? A. The physician providing a consultation takes over the care from the treating physician and starts a full course of treatment. B. A consultation occurs when a second physician, at the request of the patient's physician, examines the patient. C. A consultation occurs when the patient's existing physician consults with the patient. A consultation occurs when a second physician, at the request of the patient's physician, examines the patient.
What is the purpose of the codes in the Evaluation and Management section? A. To cover pediatric care to determine if the patient is meeting wellness initiatives B. To cover geriatric care to determine if the patient is eligible for assisted living C. To cover managed care to determine if referrals are needed D. To cover physicians' services that are performed to determine the best course for patient care To cover physicians' services that are performed to determine the best course for patient care
Which of following is the definition for HPI? A. History of Patient Incident B. Hospital Patient Illness C. History of Procedural Incident D. History of Present Illness History of Present Illness
Identify the correct use for preventive medicine services codes. A. Preventive medicine services codes are used to report routine physical examinations in the absence of a patient complaint. B. Preventive medicine services codes are used to report repeated visits. C. Preventive medicine services codes are used when there is a patient complaint. D. Preventive medicine services codes are used to report unusual physical examinations. Preventive medicine services codes are used to report routine physical examinations in the absence of a patient complaint.
Which of the following apply to the place and type of service in E/M codes? A. Most codes in the E/M section are organized by the place of service, such as Identify all the services included under the Anesthesia section. A. Supplementation of local anesthesia B. Regional anesthesia C. General anesthesia D. Experimental anesthesia A. Most codes in the E/M section are organized by the place of service, such as the office, the hospital, or a patient's home. C. A few codes in the E/M section are grouped by type of service.
Identify all the services included under the Anesthesia section. A. Supplementation of local anesthesia B. Regional anesthesia C. General anesthesia D. Experimental anesthesia A. Supplementation of local anesthesia B. Regional anesthesia C. General anesthesia
According to E/M coding, who is considered a "new patient"? A. One who has not received any professional services from the provider within three years B. One who has received professional services from the provider within three years C. One who has not received any professional services from the provider within one year D. One who has only had recent treatment from the provider for issues and has not a physical One who has not received any professional services from the provider within three years
Which of the following apply to the reporting of consultation requests? A. Consultation requests are not formal or written but are informal discussions with the physician. B. The consultation reports should be reviewed and initialed by the primary physician with documentation of follow-up plans. C. Consultation requests and reports must be written documents that are placed in the medical records. D. The consultation reports are kept with the consulting physician. B. The consultation reports should be reviewed and initialed by the primary physician with documentation of follow-up plans. C. Consultation requests and reports must be written documents that are placed in the medical records.
Which of the following apply to anesthesia coding? A. The American Society of Anesthesiologists assigns a base unit value to each code. B. Difficulties, such as a patient with severe systemic disease, add to the value of the anesthesiologist's services. C. The anesthesiologist records the amount of time spent with the patient during the procedure and adds this to the base value. D. The anesthesiologist records level of difficulty and not time during a procedure. A. The American Society of Anesthesiologists assigns a base unit value to each code. B. Difficulties, such as a patient with severe systemic disease, add to the value of the anesthesiologist's services. C. The anesthesiologist records the amount of time spent with the patient during the procedure and adds this to the base value.
Identify all the points about an illness that may be documented for the patient's HPI. A. Quality (type of pain or symptom, such as sudden or dull) B. Modifying factors (any factors that alter the pain or symptom) C. Past surgical information (any surgical history) D. Location (body area of the pain or symptom) A. Quality (type of pain or symptom, such as sudden or dull) B. Modifying factors (any factors that alter the pain or symptom) D. Location (body area of the pain or symptom)
The body-site subsections are followed by which other two subsections? A. Other or unlisted procedures B. Radiological procedures C. Vascular procedures D. Systemic procedures A. Other or unlisted procedures B. Radiological procedures
When coding a routine physical examination under preventive medicine services, lab tests, immunizations, and other services that are part of the annual physical are reported using the appropriate codes from which sections? A. Medicine and the Pathology and Laboratory sections B. Hospital Services and Observation section C. Outpatient Services section D. Counseling section Medicine and the Pathology and Laboratory sections
Identify the use for the codes in the Anesthesia section. A. The codes in the Anesthesia section are used to report anesthesia services performed but not supervised by a physician. B. The codes in the Anesthesia section are used to report anesthesia services supervised only by a physician. C. The codes in the Anesthesia section are used to report anesthesia services performed or supervised by a physician. The codes in the Anesthesia section are used to report anesthesia services performed or supervised by a physician.
Identify three status level codes for the patient's physical status when coding anesthesia services. A. P6 - Moribund patient who is expected to survive the operation B. P4 - Patient with severe systemic disease that is a constant threat to life C. P1 - Normal healthy patient D. P5 - Moribund patient who is not expected to survive without the operation B. P4 - Patient with severe systemic disease that is a constant threat to life C. P1 - Normal healthy patient D. P5 - Moribund patient who is not expected to survive without the operation
Which of the following are among the four add-on codes used for qualifying circumstances in anesthesia services? A. Anesthesia for patient of extreme age (under one year or over age seventy) B. Anesthesia complicated by uncontrolled hypertension C. Anesthesia complicated by utilization of total body hypothermia D. Anesthesia complicated by specified emergency conditions A. Anesthesia for patient of extreme age (under one year or over age seventy) C. Anesthesia complicated by utilization of total body hypothermia D. Anesthesia complicated by specified emergency conditions
Anesthesia codes are reimbursed according to ________. A. time B. level of difficulty C. type of anesthesia D. recovery time time
The Anesthesia section's subsections are organized by ________. A. procedures B. terms C. diagnoses D. body sites body sites
Medical insurance specialists should be aware that some private payers require anesthesia services to be reported by procedure codes from the ________ section rather than from the Anesthesia section. A. Surgery B. Medicine C. Anesthesia D. Medicare Surgery
Which of the following statements apply to surgery codes? (More than one answer may be correct.) A. The surgery code section is the largest procedure code section in CPT. B. The surgery code section is the smallest section in CPT. C. The codes in the surgery section are used for the many hundreds of surgical procedures performed by physicians. A. The surgery code section is the largest procedure code section in CPT. C. The codes in the surgery section are used for the many hundreds of surgical procedures performed by physicians.
Which of the following is NOT an exception to the usual subsection structure? A. Maternity Care subsection B. Digestive System subsection C. Laparoscopy/Hysteroscopy subsection Digestive System subsection
Anesthesia services for Medicare patients and most other patients are reported using codes from the ________ section. A. Medicare B. Outpatient C. Surgery D. Anesthesia Anesthesia
Which of the following is the modifier for Anesthesia by surgeon? A. 26 B. 50 C. 22 D. 47 47
What is the largest code section within the CPT? A. Surgery B. E/M C. Medicine D. Anesthesia Surgery
Which of the following are true of bundled services? A. The episode may take place in multiple settings. B. The episode may not take place over a period of time. C. All components of the episode must always take place at the same location. D. All components of the episode must always occur on the same day. The episode may take place in multiple settings.
As defined by CPT, surgical package codes include all the usual services in addition to the operation itself and which of the following? A. Typical postoperative follow-up care B. E/M services subsequent to the decision for surgery on the day before and/or day of surgery C. Writing orders D. Review of radiology reports after surgery A. Typical postoperative follow-up care B. E/M services subsequent to the decision for surgery on the day before and/or day of surgery C. Writing orders
Which of the following are true of the two parts of radiology procedures? A. The second part of a radiology procedure is the professional component. B. The first part of a radiology procedure is the technical component. C. The second part of a radiology procedure is the follow-up. D. The first part of a radiology procedure is the history taken. A. The second part of a radiology procedure is the professional component. B. The first part of a radiology procedure is the technical component.
Some procedural code descriptors in the Surgery section are followed by the words ________ procedure. A. additional B. combined C. isolated D. separate separate
When unlisted codes are reported, a special report must be attached that defines which of the following? A. Nature of the procedure B. Extent of the procedure C. Need for the procedure D. History of patient A. Nature of the procedure B. Extent of the procedure C. Need for the procedure
Which of the following procedures often use contrast material? A. Heart bypass B. Electromagnetic radiation C. Hysterectomy D. Magnetic resonance imaging (MRI) Magnetic resonance imaging (MRI)
Modifier ____ defines bilateral services. 50
Which of the following is an example of a type of radiologic procedure? A. Chest x-ray B. Echocardiography C. Electrocardiogram D. Diagnostic ultrasound Diagnostic ultrasound
Which of the following statements apply to how payers bundle codes for payment? A. Bundled payments are also known as episode payments. B. Bundled codes are not ethical and should not be used for surgical procedures. C. Bundled payments are single payments to multiple providers involved in one episode of care with accountability shared among providers. D. Bundled payments are also known as multiple payments. E. Bundled payments are multiple payments to single providers. A. Bundled payments are also known as episode payments. C. Bundled payments are single payments to multiple providers involved in one episode of care with accountability shared among providers.
The codes in the Radiology section are used to report which of the following? A. Radiological services performed by or supervised by a physician B. Hospital services C. Radiological services performed by or supervised by a technician D. Outpatient services Radiological services performed by or supervised by a physician
Which of the following statements apply to radiology code reporting? A. The radiologist serves as a consultant only B. The radiologist performs only the technical component C. Most radiology services are performed and billed by radiologists in a private office D. Most radiology services are performed and billed by radiologists working in hospital or clinic settings Most radiology services are performed and billed by radiologists working in hospital or clinic settings
Which of the following apply to radiology procedures? A. There are codes for nearly one hundred unlisted code areas B. Not special report is required for radiology services C. New procedures are common in the area of radiology services D. New procedures are uncommon in the area of radiology services New procedures are common in the area of radiology services
Codes in the Pathology and Laboratory section cover services provided by which of the following? A. Nurse practitioners and physician assistants B. Technicians only C. Physicians only D. Physicians or by technicians under the supervision of physicians Physicians or by technicians under the supervision of physicians
Which of the following apply to coding contrast materials in radiological procedures? A. Without contrast means contrast materials are administered orally or rectally. B. With contrast means only contrast materials given are given in the patient's veins or arteries. C. With contrast means administered orally. D. Without contrast means administered in veins or arteries. A. Without contrast means contrast materials are administered orally or rectally. B. With contrast means only contrast materials given are given in the patient's veins or arteries.
Which of the following apply to grouping labs together? A. Related tests are grouped under laboratory panels for reporting convenience B. Related tests are never grouped C. When a panel code is reported, all the listed tests must have been performed D. When a panel code is reported, none of the listed tests should be completed A. Related tests are grouped under laboratory panels for reporting convenience C. When a panel code is reported, all the listed tests must have been performed
Which subsections of the Radiology section are structured by type of procedure, followed by body sites, and then procedures? A. Diagnostic ultrasound B. Nuclear medicine C. Diagnostic radiology D. Fluoroscopic nuclear ultrasound A. Diagnostic ultrasound B. Nuclear medicine C. Diagnostic radiology
What is bundling in terms of coding? A. Using multiple payments for one procedure code B. Using multiple modifiers for one procedure C. Using multiple providers D. Using a single payment for two or more related procedure codes Using a single payment for two or more related procedure codes
Which of the following apply to reporting unlisted codes for pathology and laboratory services? A. There are codes for twelve unlisted code areas. B. New developments are frequent in pathology and laboratory services. C. There are codes for one hundred unlisted code areas. D. Any unlisted code must be submitted with a special report. A. There are codes for twelve unlisted code areas. B. New developments are frequent in pathology and laboratory services. D. Any unlisted code must be submitted with a special report.
Radiology codes are selected based on which of the following? (More than one answer may be correct.) A. Age of patient B. Body part C. Type of views D. Number of views B. Body part C. Type of views D. Number of views
Procedures and services for laboratory codes are listed in the index under which of the following types of main terms? A. Results B. Name of test C. Procedure D. Abbreviation E. Abnormal reporting B. Name of test C. Procedure D. Abbreviation
Identify all the elements of a complete procedure for reporting pathology and laboratory codes. A. Retesting the sample for accuracy B. Taking and handling the sample C. Performing the actual test D. Ordering the test B. Taking and handling the sample C. Performing the actual test D. Ordering the test
Identify one of the two levels the CLIA certification program awards. A. Mild complexity testing B. Waived tests and provider-performed microscopy procedures C. The Occupational Safety and Health Level 1 D. Mandatory tests Waived tests and provider-performed microscopy procedures
Why are certain pathology and laboratory tests customarily ordered together? A. To get more results B. To reduce the cost of the tests C. For convenience of administering the tests D. To detect particular diseases or malfunctioning organs To detect particular diseases or malfunctioning organs
The Medicine section of the CPT contains codes for which of the following procedures? A. Demographic B. Diagnostic C. Therapeutic D. Evaluation B. Diagnostic C. Therapeutic D. Evaluation
The subsections in the Medicine section have notes containing which of the following? A. Definitions B. Usage guidelines C. Body areas D. Medications A. Definitions B. Usage guidelines
For the services in the Medicine section that are considered Evaluation and Management services, which modifier may not be used? 51
Identify the correct statement related to pathology and laboratory services. A. New developments are unusual in pathology and laboratory services. B. New developments are frequent in pathology and laboratory services. C. New developments seldom happen in pathology and laboratory services. D. There are never new developments in pathology and laboratory services. New developments are frequent in pathology and laboratory services.
Which of the following apply to E/M codes not listed in the Medicine section? A. Codes not listed in the E/M section cannot use the 51 modifier for multiple procedures. B. Some are considered Evaluation and Management services though they are not listed in the E/M section. C. The 51 modifier should be used. D. All services in the Medicine section are considered E/M services. A. Codes not listed in the E/M section cannot use the 51 modifier for multiple procedures. B. Some are considered Evaluation and Management services though they are not listed in the E/M section.
Which of the following apply to Category II codes in regards to tracking? A. The use of these codes is optional and does not affect reimbursement. B. The codes are required for correct coding and are a substitute for Category I codes. C. The use of these codes is mandatory. The use of these codes is optional and does not affect reimbursement.
Which of the following statements are related to certification and how that determines the relationship between tests performed and reported? A. The tests that can be performed are regulated by CLIA. B. Some medical practices have laboratory equipment and perform their own testing. C. CLIA-waived tests are not allowed to be performed in an office. D. In-office labs are guided by federal safety regulations from OSHA. E. In-office labs are not regulated. A. The tests that can be performed are regulated by CLIA. B. Some medical practices have laboratory equipment and perform their own testing. D. In-office labs are guided by federal safety regulations from OSHA.
Which of the following apply to HCPCS codes? A. They refer only to surgical and invasive procedures that are done in a hospital setting. B. They enable the collection of statistical data on medical procedures, products, and services. C. They were set up to give healthcare providers a coding system that describes specific products, supplies, and services. D. They do not provide statistical data. E. They provide uniformity in medical services. B. They enable the collection of statistical data on medical procedures, products, and services. C. They were set up to give healthcare providers a coding system that describes specific products, supplies, and services. E. They provide uniformity in medical services.
Identify the correct statement related to types of codes used in the Medicine section of the CPT manual. A. Codes for the E/M section fall numerically at the end of the section but appear first in CPT. B. Codes for the E/M section fall numerically at the beginning of the section but appear at the end in CPT. C. Codes for the E/M section are not listed numerically. D. Codes for the E/M section are not listed in CPT. Codes for the E/M section fall numerically at the end of the section but appear first in CPT.
Which of the following statements are true of the Tabular List of HCPCS codes? A. A Level II code is made up of five characters. B. The HCPCS Tabular List of codes has more than twenty sections. C. A Level II code begins with a number followed by four letters. D. A Level II code begins with a letter followed by four numbers. A. A Level II code is made up of five characters. B. The HCPCS Tabular List of codes has more than twenty sections. D. A Level II code begins with a letter followed by four numbers.
Subsections in the Medicine section are organized by ________ of service. A. type B. length C. level D. time type
Identify all the correct statements related to categorizing codes that do not have permanent national codes. A. All payers use these miscellaneous codes to bill for items or services that do not have permanent national codes. B. Some codes are miscellaneous or not elsewhere classified. C. Many of the miscellaneous codes are given permanent national status in the updating process. D. No codes are classified as miscellaneous. A. All payers use these miscellaneous codes to bill for items or services that do not have permanent national codes. B. Some codes are miscellaneous or not elsewhere classified. C. Many of the miscellaneous codes are given permanent national status in the updating process.
Which of the following apply to updating HCPCS Level II codes? A. HCPCS Level II is a private code set. B. HCPCS Level II permanent national codes are released on January 1 of each year. C. Information about the codes and updates is located on the CMS HCPCS website. D. HCPCS Level II is a public code set. B. HCPCS Level II permanent national codes are released on January 1 of each year. C. Information about the codes and updates is located on the CMS HCPCS website. D. HCPCS Level II is a public code set.
Identify all the correct information related to Category II codes and tracking data. A. The Category II code set does not contain tracking codes. B. Codes increase the amount of administrative time needed to gather data from documentation. C. Codes reduce the amount of administrative time needed to gather data from documentation. D. The Category II code set contains supplemental tracking codes to help collect data regarding services. C. Codes reduce the amount of administrative time needed to gather data from documentation. D. The Category II code set contains supplemental tracking codes to help collect data regarding services.
With the implementation of the Health Insurance Portability and Accountability Act (HIPAA) of 1996, HCPCS has become ________ for coding and billing. A. not recommended B. optional C. recommended D. mandatory mandatory
In the HCPCS code book, what can be used to make assigning drug codes easier? A. Table of Medicine B. Medicine Index C. Drug Index D. Table of Drugs Table of Drugs
The E section of Level II coding covers ________ equipment. A. disposable B. durable medical C. surgical D. transportable durable medical
Which of the following codes must be used to bill for items or services that do not have permanent national codes? A. Unknown status B. Not elsewhere classified C. Miscellaneous D. Tagged B. Not elsewhere classified C. Miscellaneous
To look up HCPCS codes, where should the coder begin to locate the appropriate diagnosis? A. Main Term Index B. Tabular List C. Alphabetical Index D. Conversion Chart Alphabetical Index
Correctly identify the three HCPCS Level II modifiers for reporting erroneous surgeries. A. PA - Surgical or other invasive procedure on wrong body part B. PB - Surgical or other invasive procedure on wrong patient C. PC - Wrong surgery or other invasive procedure on patient D. PD - Surgical procedure on different person A. PA - Surgical or other invasive procedure on wrong body part B. PB - Surgical or other invasive procedure on wrong patient C. PC - Wrong surgery or other invasive procedure on patient
Identify how the index is arranged in assigning HCPCS Level II codes. A. The index presents drugs in reverse alphabetical order. B. The index is arranged alphabetically with the main term in bold print. C. To assign HCPCS Level II codes, first look up the name of the supply or item in the index. D. The Table of Drugs presents drugs in alphabetical order, followed by dosage. B. The index is arranged alphabetically with the main term in bold print. C. To assign HCPCS Level II codes, first look up the name of the supply or item in the index. D. The Table of Drugs presents drugs in alphabetical order, followed by dosage.
Identify the correct structure of Category II codes in CPT. A. three digits followed by an alphabetical character B. an alphabetical character followed by three digits C. an alphabetical character followed by four digits D. four digits followed by an alphabetical character four digits followed by an alphabetical character
When a physician asks a patient questions to obtain an inventory of constitutional symptoms and of the various body systems, the results are documented as the A. A. family history. B. comprehensive examination. C. past medical history. D. review of systems. review of systems.
Temporary codes for drugs and medical equipment are what type of HCPCS codes? A. D codes B. Q codes C. T codes D. V codes Q codes
The three key factors in selecting an Evaluation and Management code are A. past history, history of present illness, and chief complaint. B. time, severity of presenting problem, and history. C. history, examination, and medical decision making. D. history, examination, and time. history, examination, and medical decision making.
CPT code 99382 is an example of A. a consultation service code. B. an emergency department service code. C. a preventive medicine service code. D. a hospital observation code. a preventive medicine service code.
Anesthesia codes generally include A. all procedures that are ordered by the surgeon. B. preoperative evaluation and planning, routine postoperative care, but not the administration of the anesthetic itself. C. preparing the patient for the anesthetic, care during the procedure, postoperative care, and pain management as required by the surgeon. D. preoperative evaluation and planning, normal care during the procedure, and routine care after the procedure. preoperative evaluation and planning, normal care during the procedure, and routine care after the procedure.
Surgery codes generally include A. preoperative evaluation and planning, the operation and normal additional procedures, and routine care after the procedure. B. all aspects of the operation, including preparing the patient for the surgery, performing the operation and normal additional procedures, as well as normal, uncomplicated follow-up. C. all procedures done during the global period that comes before the surgery. all aspects of the operation, including preparing the patient for the surgery, performing the operation and normal additional procedures, as well as normal, uncomplicated follow-up.
When a Surgery section code has a plus sign next to it, A. it includes preoperative evaluation and planning, routine postoperative care, but not the surgical procedure. B. it includes all procedures done during the global period that follows the surgery. C. it covers preoperative evaluation and planning, the operation and normal additional procedures, and routine care after the procedure. D. it cannot be reported as a stand-alone code. it cannot be reported as a stand-alone code.
When a panel code from the Pathology and Laboratory section is reported A. 90 percent of the listed tests must have been performed. B. all the listed tests must have been performed. C. all the listed tests must have been performed on the same day. D. 50 percent of the listed tests must have been performed. all the listed tests must have been performed.
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