Procedural Coding
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| evaluation & management (E/M services) | services physician provides to evaluate patients
🗑
|
||||
| key components need to be present to assign a code | ~ 3 of 3 for a new patient ~ 2 of 3 for an established patient (subsequent means the same as established)
🗑
|
||||
| key components used to ID the correct level of service | ~history ~examination ~MDM (medical decision making)
🗑
|
||||
| what are the contributory factors | ~counseling ~coordination of care ~time ~nature of presenting problem
🗑
|
||||
| new patient | have not received any professional services w/ in 3 years
🗑
|
||||
| established patient | have received professional services in the last 3 years
🗑
|
||||
| inpatient | formally admitted into the hospital
🗑
|
||||
| consult | when services are rendered by a doctor whose opinion is requested by another doctor to evaluate or treat a patients illness
🗑
|
||||
| follow-up | when the patient comes back after the consult
🗑
|
||||
| how to code consult & follow-up | under consultation section in CPT book
🗑
|
||||
| initial hospital new patient consult | 1st visit by consulting doctor
🗑
|
||||
| follow-up inpatient consult | when doctor is asked to follow up while the patient is admitted
🗑
|
||||
| confirmatory consult | consulting doctor offers an opinion about the treatment plan after dx has been made
🗑
|
||||
| office/outpatient consult | patient seen in office by a specialist
🗑
|
||||
| referral | total transfer of care of a patient from physician to another & when requesting an authorization for the patient to receive services
🗑
|
||||
| relative value unit | doctors are paid based on these
🗑
|
||||
| criteria needed to bill 99211 | ~face to face time, ~a physician must be in the office, ~seperate service must be provided, ~proper documentation
🗑
|
||||
| what is bundled services? | services grouped together related to a procedure (ex. panels)
🗑
|
||||
| preventative medicine | services provided to prevent, occurance of illness, injury, and disease
🗑
|
||||
| preventative medicine is catergorized | by the patients age
🗑
|
||||
| inpatient status | formally admitted into hospial or other health care facility for an overnight stay
🗑
|
||||
| outpatient status | service received in an office, clinic, urgent care center, ER, or surgery center
🗑
|
||||
| observation status | not formally admitted (on hold) while a decision is made to admit or discharge based on patients condition observed, Not considered INPATIENT at this point
🗑
|
||||
| how many digits are there in the CPT code? | 5
🗑
|
||||
| what does CPT stand for? | current procedural terminology
🗑
|
||||
| how many levels of the HCPCS are there? | 3
🗑
|
||||
| how often are CPT codes revised? | annually
🗑
|
||||
| who developed HCPCS codes? | CMS (Centers for Medicare and Medicaid Services)
🗑
|
||||
| emergency care | care for an unexpected medical condition or worsening of a condition that poses a threat to life, limb, or sight
🗑
|
||||
| critical care | intensive care provided in a variety of acute life threatening conditions requiring constant bed side attention by the physician
🗑
|
||||
| relative value unit formula | RVU x GAF x CF = medicare $ per service
🗑
|
||||
| counseling | discussion between physician and patient, family or both, regarding health concerns
🗑
|
||||
| modifier | gives a more accurate description of services rendered (2 digit code)
🗑
|
||||
| inpatient consultation 4 R's | ~request, ~render, ~report, and ~reason
🗑
|
||||
| observation status time length | 24 hours
🗑
|
||||
| T/F ~ could take up to 8 months for insurance companies to reimburse new codes? | T
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
maxphia32
Popular Medical sets