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ELS/ALS Exam Review > Basic Knowledge > Flashcards

Basic Knowledge Flashcards

1
Q

General knowledge of what four types of technology/instrumentation is needed to operate in a reproductive lab?

A
  1. Centrifuges
  2. Pipettes
  3. Temperature-Regulated Equipment
  4. Microscopes
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2
Q

What are the four types of centrifuges used in a lab?

A
  1. Tabletop
  2. Microcentrifuges
  3. High-speed centrifuges
  4. Ultracentrifuges
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3
Q

What three main types of pipettes are used in a lab?

A
  1. Automated pipettes
  2. Semi-automated micropipettes
  3. Glass pipettes
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4
Q

What four types of temperature-regulated equipment are used in a lab?

A
  1. Heat Blocks/Water Baths
  2. Room Temperature (items)
  3. Refrigerators
  4. Freezers
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5
Q

What six types of microscopes are used in a lab?

A
  1. Bright-field microscopy
  2. Dark-field microscopy
  3. Electron microscopy
  4. Fluorescent microscopy
  5. Phase-contrast microscopy
  6. Polarized microscopy
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6
Q

List the fourteen parts of a compound microscope.

A
  1. Eyepiece lens
  2. Tube
  3. Arm
  4. Base
  5. Light source
  6. Stage
  7. Nosepiece
  8. Condenser lens
  9. Iris diaphragm
  10. Course adjustment
  11. Fine adjustment
  12. Low-power objective
  13. High-power objective
  14. Oil-immersion objective
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7
Q

What ten main types of mathematical calculations are needed in a lab?

A
  1. Temperature Conversions
  2. Ratios
  3. Dilutions
  4. Concentrations
  5. Quality Control Statistics
  6. pH
  7. Anion Gap
  8. LDL
  9. Beer’s Law
  10. Osmolar Gap
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8
Q

What five types of concentrations may need to be calculated in a lab?

A
  1. Percent Solutions
  2. Molarity
  3. Normality
  4. Molality
  5. Concentrated Solutions
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9
Q

What two types of dilutions may need to be calculated in a lab?

A
  1. Dilutions

2. Serial Dilutions

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10
Q

What four types of quality control statistics may need to be calculated in a lab?

A
  1. Mean
  2. Standard Deviation
  3. Coefficient of Variation
  4. Confidence Interval
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11
Q

What are six ways to calculate pH?

A
  1. pH = -log [H+]
  2. pH = pKa + log [A-] / [HA]
  3. pH = pKa + log [base] / [acid]
  4. pH = pKa + log [salt] / [acid]
  5. pH = pKa + log [HCO3-] / [H2CO3]
  6. pH = pKa + log [HCO3-] / (PCO2)(0.03)
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12
Q

Define the “Anion Gap” that may need to be calculated in a lab.

A

The difference between the sum of cations and anions in plasma/serum

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13
Q

Define the “LDL” that may need to be calculated in a lab.

A

LDL = Low-Density Lipoprotein; a type of lipoprotein that transports cholesterol and triglycerides from the liver to peripheral tissues

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14
Q

What is the Friedewald Formula for calculating LDL in a lab?

A

LDL cholesterol = total cholesterol - (HDL cholesterol + TRIG/5)

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15
Q

What are the three levels of CLIA test categorization?

A
  1. Waived Testing
  2. Moderate Complexity, including subcategory of PPM procedures (Provider Performed Microscopy)
  3. High Complexity
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16
Q

What are the three CLIA requirements to classify a test as Waived?

A
  1. Cleared by the FDA for home use
  2. Employs methodologies that are so simple and accurate as to render the likelihood of erroneous results negligible
  3. Poses no reasonable risk of harm to the patient if the test is performed incorrectly
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17
Q

What are nine examples of lab tests that have been granted Certificates of Waiver by CLIA?

A
  1. Dipstick or Tablet Reagent Urinalysis (non-automated)
  2. Fecal occult blood
  3. Ovulation tests - visual color comparison tests for human luteinizing hormone
  4. Urine pregnancy tests - visual color comparison tests
  5. Erythrocyte sedimentation rate - non-automated
  6. Hemoglobin (copper sulfate) - non-automated
  7. Blood glucose by glucose monitoring devices cleared by the FDA specifically for home use
  8. Spun microhematocrit
  9. Hemoglobin by single analyze instruments with self-contained or component features to perform specimen/reagent interaction, providing direct measurement and readout
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18
Q

What agency determines if a laboratory test meets CLIA’s criteria for a Certificate of Waiver, and where are revisions to the list of waived tests approved by this organization published?

A

HHS (US Department of Health and Human Services) and the Federal Register, respectively.

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19
Q

Are laboratories eligible for a Certificate of Waiver from CLIA obligated to follow manufacturer’s instructions for performing the test in question?

A

YES

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20
Q

What are the seven criteria for CLIA categorization as Moderate Complexity?

A
  1. Knowledge
  2. Training and experience
  3. Reagents and materials preparation
  4. Characteristics of operational steps
  5. Calibration, quality control, and proficiency testing materials
  6. Test system troubleshooting and equipment maintenance
  7. Interpretation and judgment
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21
Q

Explain the CLIA scoring system for determining level of complexity.

A
  1. Score of 1 indicates the lowest level of complexity.
  2. Score of 2 will be assigned to a criteria heading when the characteristics for a particular test are intermediate between the descriptions listed for scores of 1 and 3.
  3. Score of 3 indicates the highest level of complexity.

SCORING WILL BE TOTALED: Scoring <12 is categorized as MODERATE whereas >12 is categorized as HIGH complexity.

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22
Q

What does CLIA state regarding the ethical obligations related to the release of laboratory test results?

A

CLIA states that laboratory test results must be released only to authorized persons and, if applicable, the individual responsible for using the test results and the laboratory that initially requested the test.

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23
Q

What does HIPAA stand for?

A

Health Insurance Portability and Accountability Act of 1996

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24
Q

What is the intent of HIPAA?

A
  1. Legislation to enable workers, even those with pre-existing medical conditions, to change jobs without loss or interruption of health insurance protection.
  2. HIPAA required the Department of Health and Human Services to establish national standards for electronic health care transactions.
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25
Q

What are the three areas of applicability for HIPAA?

A
  1. A health plan
  2. A health care clearinghouse
  3. A health care provider who transmits any health information in electronic form
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26
Q

HIPAA requires what three safeguards from whom?

A 
Reasonable and appropriate:
1. Administrative
2. Technical
3. Physical 
from any entity or person who maintains or transmits health information
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27
Q

What are the three reasons why HIPAA requires safeguarding of health information?

A
  1. To ensure the integrity and confidentiality of the information
  2. To protect against any unreasonably anticipated (a) threats or hazards to the security of integrity of the information and (b) unauthorized uses or disclosures of the information; and
  3. Otherwise to ensure compliance with this part by the officers and employees of such person.
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28
Q

What are eight labor laws that every lab employee should be familiar with?

A
  1. Americans with Disabilities Act (ADA)
  2. Equal Employment Opportunity Commission (EEOC)
  3. Fair Labor Standards Act (FLSA)
  4. Civil Rights
  5. Workman’s Compensation
  6. Unemployment Compensation
  7. Family and Medical Leave Act (FMLA)
  8. Consolidated Omnibus Budget Reconciliation Act (COBRA)
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29
Q

Define “omnibus.”

A

A volume containing several items previously published separately

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30
Q

The ADA prohibits discrimination based on what four classifications of disabilities?

A
  1. A person who presently has a disability
  2. A person who has a past history of a disability
  3. A person who is perceived to have a disability
  4. A person who associates with a person who has a disability
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31
Q

What does “ADA” stand for?

A

American with Disabilities Act

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32
Q

What does “FLSA” stand for?

A

Fair Labor Standards Act

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33
Q

What does “COBRA” stand for?

A

Consolidated Omnibus Budget Reconciliation

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34
Q

What does “ADA” stand for?

A

American with Disabilities Act

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35
Q

What does “FLSA” stand for?

A

Fair Labor Standards Act

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36
Q

What does “COBRA” stand for?

A

Consolidated Omnibus Budget Reconciliation

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37
Q

How does the ADA define “disability?”

A

As any physical or mental impairment that substantially limits a major life activity

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38
Q

How does the ADA define a “major life activity?”

A

As walking, talking, and maintaining active employment

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39
Q

What does the ADA require an employer provide to a qualified candidate or employee with a disability?

A

A reasonable accommodation

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40
Q

How does the ADA define a “qualified employee?”

A

As one who can perform the essential functions of the job with or without a reasonable accommodation

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41
Q

What is the EEOC and what does it do?

A

It is a federal agency tasked with enforcing employment discrimination laws

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42
Q

What are ten types of discrimination the EEOC investigates?

A
  1. Age
  2. Disability
  3. Equal Pay
  4. National Origin
  5. Pregnancy
  6. Race
  7. Religion
  8. Retaliation
  9. Sex
  10. Sexual Harassment
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43
Q

What is the FLSA

A

Fair Labor Standards Act is a federal law that defines the minimum wage, overtime, and other requirements related to how certain employees are to be paid.

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44
Q

How does the FLSA classify employees?

A
  1. Nonexempt (hourly)

2. Exempt (salaried)

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45
Q

What civil rights law prohibits discrimination based on race, color, creed, religion, national origin, and sex?

A

Title VII of the Civil Rights Act of 1963

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46
Q

What is the “compensation bargain?”

A

The tradeoff between assured, limited coverage and lack of recourse outside the worker compensation system

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47
Q

What two things are generally not available in worker compensation plans?

A

General damages for pain and suffering or punitive damages for employer negligence

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48
Q

What is Workman’s Comp?

A

A form of insurance that provides compensation medical care for employees who are injured in the course of employment, in exchange for mandatory relinquishment of the employee’s right to sui his or her employer for the tort of negligence

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49
Q

What are table top centrifuges used for in the laboratory?

A

Separating cells from serum/plasma

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50
Q

What are micro centrifuges used for in the laboratory?

A

To centrifuge small, plastic, conical-shaped containers with an integral snap cap

51
Q

What are micro centrifuges used for in the laboratory?

A

To centrifuge small, plastic, conical-shaped containers with an integral snap cap

52
Q

What speeds to high-speed centrifuges reach up to?

A

17,000 to 30,000 rpm

53
Q

What are ultracentrifuges and how high-speed are they?

A

Small, air-driven used to separate chylomicrons from serum; up to 150,000 rpm

54
Q

What is a “chylomicron?”

A

A droplet of fat present in the blood or lymph after absorption from the small intestine

55
Q

What do semi-automated pipettes do?

A

Contain or deliver small volumes of liquid ranging from 1to 1000 microliters

56
Q

What two types of semi-automated pipettes are there?

A
  1. Air displacement (forward and reverse mode)

2. Positive displacement

57
Q

What five types of glass pipettes are there?

A
  1. Transfer/volumetric
  2. Measuring/graduated
  3. To Contain (TC)/Rinse-Out
  4. To Deliver (TD)
  5. To Deliver (TD)/Blow-Out
58
Q

What do transfer/volumetric pipettes look like?

A

Bulb in the middle (?) and tapered delivery tip

59
Q

What do measuring/graduated pipettes look like?

A

Uniform in diameter with a tapered delivery tip

60
Q

What must be done after TC pipettes are used?

A

Rinsed with the appropriate solvent after the initial liquid has been drained

61
Q

How are TD pipettes are used?

A

Filled and allowed to drain by gravity being held vertically and the tip placed against the side of the receiving vessel

62
Q

How are TD/Blow-Out pipettes used and what do they look like?

A

Filled and allowed to drain, after which the remaining fluid in the tip is blown out; easily identified by the two frosted bands near the mouthpiece of the pipette

63
Q

What is the T range of water baths and heating blocks?

A

36 to 38 degrees C

64
Q

What is the T range of lab room temperature?

A

20 to 24 degrees C

65
Q

What is the T range of a lab refrigerator vs. a blood bank refrigerator?

A

2 to 8 degrees C vs. 1 to 6 degrees C, respectively

66
Q

What is an acceptable T of a lab freezer vs. a blood bank freezer?

A

Greater than or equal to -18 degrees C vs. greater than or equal to -65 degrees C, respectively

67
Q

Describe what makes bright-field microscopy defined as such.

A

Sample illumination is via transmitted white light, i.e., illuminated rom below and observed from above.

68
Q

What is the most simple of all six types of microscopes?

A

Bright-field

69
Q

What is the most commonly used microscope?

A

Bright-field

70
Q

What are two limitations of bright-field microscopy?

A
  1. Low apparent resolution due to blur of our-of-focus material
  2. Low contrast of most biological samples
71
Q

What is dark-field microscopy used for?

A

Improving the contrast of unstained, transparent specimens

72
Q

Describe what makes dark-field microscopy defined as such.

A

Dark-field illumination uses a carefully aligned light source to minimize the quantity of directly transmitted (unscattered) light entering the image plane, collecting only the light scattered by the sample.

73
Q

What is one positive aspect of dark-field microscopy?

A

It can dramatically improve image contrast, especially of transparent objects.

74
Q

What are two limitations of dark-field microscopy?

A
  1. Low light intensity in final image of many biological samples
  2. Low apparent resolution
75
Q

Describe what makes electron microscopy defined as such.

A

Uses an electron microscope in which electrons illuminate a specimen and create an enlarged image

76
Q

What are two positive aspects of electron microscopy in comparison to light microscopy?

A
  1. Much greater resolving power

2. Can obtain much higher magnifications

77
Q

What limitation do both electron and light microscopes share and why?

A

Resolution limitations imposed by their (respective) wavelengths

78
Q

Compare the lenses of an electron microscopy vs. a light microscope.

A

The electron microscope uses electrostatic and electromagnetic lenses in forming the image by controlling the electron beam to focus it as a specific plane relative to the specimen in a manner similar to how a light microscope uses glass lenses to focus light on or through a specimen to form an image.

79
Q

Describe what makes fluorescent microscopy described as such.

A

It works like light microscopy except it uses a fluorescence instead of or in addition to reflection and absorption to view the object. When certain compounds are illuminated with high-energy light, they then emit light of a different, lower frequency (fluorescence).

80
Q

Why do fluorescent microscopes only show the object of interest, typically?

A

Because fluorescence emission differs in wavelength (color) from the excitation light, so a fluorescent image only shows the structure of interest that was labeled with the fluorescent dye. However, different dyes can be used to stain different structures, which can then be detected simultaneously while still being specific to the color of the dye.

81
Q

Describe what makes phase-contrast microscopes described as such.

A

Small phase shifts in the light passing through a transparent specimen show differences in refractive index as difference in contrast.

82
Q

What is one benefit of phase-contrast microscopes?

A

Contrast is excellent.

83
Q

What is one downfall of phase-contrast microscopes?

A

Frequently, a halo is formed even around small objects, which obscures detail.

84
Q

What are two special optical properties of phase-contrast microscopes?

A
  1. It reduces the direct light in intensity
  2. It creates an artificial phase difference
    As the physical properties of this direct light have changed, interference with the diffracted light occurs, resulting in the phase-contrast image.
85
Q

Describe why polarized microscopy is defined as such.

A

Produces only transmitted polarized light; light is provided from the bottom and is transmitted through the thin section of birefringent (having two different refraction indexes) specimen on a microscope slide.

86
Q

What is one medical application for the polarized microscope?

A

Viewing microscopic crystals in urine.

87
Q

What is the function of the tube on a microscope?

A

Connects the eyepiece to the objective lenses

88
Q

What is the function of the arm on a microscope?

A

Supports the tube and connects it to the base

89
Q

What happens to the light source on a microscope?

A

Sends light up through the diaphragm and through the slide for viewing

90
Q

What are the two functions of the nosepiece on a microscope?

A
  1. Holds the objective lenses

2. Can be rotated to change power

91
Q

What is the purpose of the condenser on a microscope?

A

Focus light onto the specimen (can be moved up and down)

92
Q

What is the iris diaphragm on a microscope?

A

A rotating disc under the stage

93
Q

What are the two functions of the iris diaphragm on a microscope?

A
  1. Vary the intensity and

2. Vary the size of the cone of light that is projected upward into the slide

94
Q

What is the prefix “femto” for?

A

Ten to the power of -15

95
Q

What is the prefix “pico” for?

A

Ten to the power of -12

96
Q

How do you convert F to C?

A

5/9(F-32)

97
Q

What is the formula for a Simple Dilution?

A

Volume of substance to be diluted: Total volume

98
Q

What are three examples of Serial Dilutions?

A
  1. Twofold: 1:2, 1:4, 1:8, 1:16
  2. Fivefold: 1:5, 1:25, 1:125, 1:625
  3. Tenfold: 1:10, 1:100, 1:1000, 1:10000
99
Q

What is the formula to calculate concentrated solutions?

A

C1V1=C2V2

100
Q

What is the formula for calculating SD?

A

Square foot of the sum of: [the mean - X (each number, respectively)]^2 all divided by n-1

101
Q

Define SD.

A

Standard deviation is the root mean square deviation of the values from their mean, or as the square root of the variance.

102
Q

Define Coefficient of Variation.

A

The ratio of the standard deviation of a distribution to its arithmetic mean

103
Q

What is the formula for CV?

A

CV = SD/Mean multiplied by 100

104
Q

Define the Confidence Interval.

A

Gives an estimated range of values, the estimated range being calculated from a given set of sample data

105
Q

What are confidence limits?

A

The lower and upper values of a confidence interval, that is, the values which define the range of a confidence interval.

106
Q

What is a confidence level?

A

The probability value associated with a confidence interval, often expressed as a percentage

107
Q

What are the three most common Confidence Intervals?

A
  1. Mean plus or minus 1SD = 68%
  2. Mean plus or minus 2SD = 95%
  3. Mean plus or minus 3SD = 99%
108
Q

When should the LDL calculation not be performed?

A

When triglycerides are greater than 400mg/dL

109
Q

Chain of custody refers to the chronological documentation showing what six things?

A
  1. Procurement
  2. Custody
  3. Control
  4. Transfer
  5. Analysis
  6. Disposition
110
Q

What is the scope of the purpose of the chain of custody?

A

A chain of custody form is required for any specimen that will be used in a legal proceeding.

111
Q

What are five examples of times in which a Chain of Custody must be used for a legal proceeding?

A
  1. Legal blood alcohol to prosecute DUI cases
  2. Department of Transportation drug testing
  3. Paternity testing
  4. DNA analysis
  5. Rape cases
112
Q

What are four necessary Personnel Policies/Practices?

A
  1. Orientation
  2. Job Description
  3. Competency Evaluation
  4. Performance Evaluation
113
Q

What is the difference between Competency and Performance evaluation of personnel?

A

Competency focuses on documenting, in measurable terms, technical skills.
Performance evaluation focuses on documenting, in measurable terms, knowledge, skills, attitudes, and beliefs.

114
Q

How often should Competency and Performance evaluations occur?

A

Annually

115
Q

What six Lab Computer Functions should personnel be competent in and/or familiar with?

A
  1. Ordering tests
  2. Accessioning specimens
  3. Reporting results
  4. Canceling tess
  5. Crediting patient accounts
  6. Retrieving previously verified patient results
116
Q

Define Reflex Testing.

A

The performance of a test on a patient specimen only after a particular analyze is abnormal or outside of a predetermined range. It includes follow-up testing automatically initiated when certain test results are observed in the laboratory; it is used to clarify or elaborate on primary test results.

117
Q

What are three examples of Reflex Testing?

A
  1. Positive sickle cell screen reflexes: a hemoglobin electrophoresis
  2. Positive ANA test reflexes: an ANA profile for specific antibodies
  3. Positive Chemistrip leukocyte esterase reflexes: a urin culture
118
Q

What is a CPT code?

A

Current Procedural Terminology is a listing of standardized descriptions and five-character, alpha-numeric codes with a text descriptor that medical coders and billers use to report health care services and procedures to payers for reimbursement.

119
Q

What is the purpose of CPT coding?

A

To provide a uniform language accurately describing medical, surgical, and diagnostic services. It serves as an effective means for reliable nationwide communication within the health care industry.

120
Q

How many categories of CPT codes are there?

A

3

121
Q

What is a CPT Code Modifier?

A

A modifier provides the means by which the medical coder or biller can report that a service or procedure performed by a physician or provider has been altered y some specific circumstance but not changed in its definition or code.

122
Q

What are nine reasons to use a CPT Code Modifier?

A
  1. A service/procedure has both a professional and a technical component
  2. A service or procedure was performed by more than one physician and/or in more than one location
  3. A service or procedure has been increased or reduced
  4. Only part of a service was performed
  5. An adjunctive service was performed
  6. A bilateral procedure was performed
  7. A service or procedure was provided more than once
  8. Unusual events occurred
  9. Specific information, such as on which digit a procedure was performed
123
Q

What are four examples of Services or procedures which need a CPT Code Modifier because they have both a professional as well as a technical component?

A
  1. Serum protein electrophoresis
  2. Platelet aggregation studies
  3. Review of peripheral blood smears
  4. Identification of body fluid crystals

ELS/ALS Exam Review (7 decks)

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