Chp 12

Question 1

codes used for procedures or services that are always performed in addition to the primary procedure.

Answer 1

Add-on code

Question 2

a comprehensive list of codes used by physicians to bill for procedures and services.

Answer 2

Current Procedural Terminology
(CPT)

Question 3

description of a service listed with its code number.

Answer 3

Descriptor

Question 3

letters or numbers added to a code to clarify the service or procedure.

Answer 3

Modifiers

Question 4

assigning a CPT code, usually an E/M code, at a lower level by a provider or by an insurance company.

Answer 4

Downcoding

Question 5

medical association’s coding system based on CPT-4. Assigns alphabetic and numeric codes to items such as ambulance service, wheelchairs, and injections.

Answer 5

Healthcare Common Procedure Coding System (HCPCS)

Question 6

the criteria or factors on which the selection of a CPT-4 evaluation and management is based.

Answer 6

Key component

Question 7

codes that represent the most resource-intense procedure or service performed at an encounter.

Answer 7

Primary code

Question 8

billing more for a patient care service than it is worth by selecting a code that is higher on the coding scale; this is an illegal practice.

Answer 8

Upcoding

Question 9

a series of steps required to perform a given task; a medical service or test that is coded for reimbursement.

Answer 9

Procedure