Billing / Coding 5 Flashcards
What was set up to give health care providers a coding system that describes specific products, supplies, and services that patients receive?
HCPCS
CPT is a publication of the
American Medical Association.
Durable medical equipment (DME), such as wheelchairs, is reported using
HCPCS codes.
What is a procedure that is usually part of a surgical package but may also be performed separately.
separate procedure
What is a procedure that is usually part of a surgical package but may also be performed separately.
separate procedure
Unbundling is
separately reporting anything that is included in the bundled code.
When listing multiple procedures, the coder should
list the most complex code first.
refers to using a single payment for two or more related procedure codes.
bundling
In what order should these codes be reported? 11100 for a skin biopsy and +11101 for the biopsy of an additional lesion.
11100, +11101
When selecting an Evaluation and Management code, three components are considered: the type of history, the physical examination, and the
medical decision making.
What kinds of services support treatment, like rehabilitation, occupational therapy, and nutrition therapy?
ancillary services
Anesthesia section have what two types of modifiers?
standard modifiers and physical status modifiers
Anesthesia section have what two types of modifiers?
standard modifiers and physical status modifiers
The E/M coding method came from the
joint effort of CMS and AMA.
How many parts do radiological procedures have?
two
Which of the following is the HIPAA Mandated code set for physician’s procedures and services?
CPT
Level I codes in the Health Care Common Procedure Coding System (HCPCS) are
Current Procedural Terminology (CPT) codes.
Of the four types of examinations that a physician can perform, which level is the most complete?
comprehensive
In CPT, what do Category III codes report?
emerging technology, services, and procedures
facing triangles that appear in front of a code indicate?
new/revised text other than a code descriptor
Which of the following regulates which tests can be completed in an in-office laboratory setting?
CLIA
The last step in the coding process is
determine the need for modifiers.
Which symbol is used to designate a code’s descriptor has changed
a triangle
Which of the following is the best process to correctly select CPT codes?
Determine the procedures and services to report, identify the correct codes, and determine the need for modifiers.
Under CPT guidelines, all services related to a surgical procedure are not additionally reimbursed
during the global period.
Which of the following is used with an anesthesia code to indicate a patient’s health status?
physical status modifiers
CPT Level I modifiers are made up of how many digits?
two digits
Which of the following is not a main term in the CPT index?
all of these are main terms
How many CPT codes are required to report an immunization?
two
Place the steps in the coding process in the correct order.
- Review the documentation of the patient’s visit.
- Determine which procedures may be reported and charged to the patient’s account.
- Identify the main term for each procedure reported on the claim.
- Locate the procedures in the index of CPT
- Review the possible code assignments and verify the correct assignment for the claim.
- Append a modifier to the code as necessary.
How many digits are in Category I codes?
five
In CPT, what do Category II codes report?
services to track performance measurement
