Chapter 7
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| The bull's eye symbol means | a procedure includes moderate conscious sedation
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| guidelines define terms and explain the assignment of codes for | procedures/services located in a particular section of the CPT manual
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| procedures/services listed on a claim must be linked to | the ICD-9-Cm (diagnostic) code that justifies the need for the service or procedure
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| modifier -57 would be assigned when | the reported E/M service resulted in the initial decision to perform surgery
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| appendix E contains | a complete list codes that are modifier -51 exempt
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| physician services rendered in office, home, hospital, consultations and other medical services are | listed in the E/M section of the manual
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| category l codes are procedures/services that are identified by | a 5 digit CPT code and descriptor nomenclature (these are codes traditionally associated with the CPT and organized within six sections).
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| pertinent information relates to... | nature, extent, and need
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| you will not find a star as a symbol in the CPT manual. However you will find the following: | triangle, gullet, and horizontal triangles
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| descriptive qualifier clarifies the assignment of a | CPT code
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| category lll codes contain | "emergency technology" temporary codes assigned for data collection
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| Modifiers are two digit | numeric codes
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| The following are some of the sections found in the CPT manual: | Medicine, Pathology and Laboratory, Radiology
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| E/M codes represent services most often provided by | physicians
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| Modifier -25 would be assigned when | a documented E/M services was performed on the same day as another significant, separately identifiable E/M service.
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| Medicine codes describe | specialty services
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| An established patient | has been seen by the physician in the last three years
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| Concurrent care - | services provided by more than one physician on the same day
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| Anesthesia time unit - | 15min. increments
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| Preventative medicine = | routine exams or risk management
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| Unlisted service - | E/M service with no CPT code
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| Key Components = | history, exam and medical decision-making
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| Special report is used with an | unlisted service
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| CPT -4 stands for | Current Procedural Terminology, 4th edition
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| AMA complies the information in the | CPT -4 manual
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| The CPT manual has three distinct categories: | Category l codes
Category ll codes
Category lll codes
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| Category l codes - | made up of six sections; codes contain five numbers; each section has its own set of guidelines
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| Category ll codes - | contain a set of codes used for performance measurement; made up of four numbers followed by the letter "F"; they are optional and cannot be substituted for category l codes
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| Category lll codes - | temporary codes used for emerging technology; made up of four numbers followed by the letter "T"; if Category lll codes is available, you must use it rather than Category l "unlisted"
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| CPT 4 manual has 14 | appendices
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| Physical Status (P1-P6) is use by | anesthesia providers
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| POS = | place of service codes
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| The six sections in Category l are: | 1. E/M - called the "99" codes for short
2. Anesthesiology
3. Surgery
4. Radiology
5. Pathology & Laboratory
6. Medicine (except anesthesiology)
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