CPB Chatper 5 Flashcards
CPT codes
describe services generally provided by healthcare professionals to individual patients
codes that describe services generally acceptable in the current healthcare system and are performed by many providers at multiple clinic locations
Category I codes
used primarily as performance measures
Category 2 codes
set of temporary codes used to designate emerging technologies, services, and procedures
Category 3 codes
five digit numeric code
category 1 codes
four digit numeric code followed by F (1234F)
category 2 codes
four digit numeric code followed by T (1234T)
category 3 codes
semicolon
used to describe a code that is divided into two parts
words before the semi-colon
the common procedure in the code descriptor
after the semi-colon
dependent on the preceding common procedure code
|
appears for only one year after a code is added to the CPT
p
shows code descriptors that have been altered
+
Add-on codes that are listed in appendix D, always accompany a parent code
what modifier is never appended to an add-on code
modifier 51
(x)
codes that are exempt from the use of modifier 51 but are not add-on codes, appendix E
#
the code has been sequenced out of order, appears next to the out of sequence code
*
codes that can be reported when using telemedecine
Appendix A
modifiers
list of modifiers
appendix A
Appendix B
actual changes and additions to the CPT codes from the previous year
Summary of additions, deletions, and revisions
Appendix B
Appendix C
limited to E/M services, examples of different specialties
Clinical Examples
Appendix C
Appendix D
codes not reported as a single or stand-alone code
Add-on codes
Appendix D
the three categories of EM codes
place of service, type of service, and subcategories
what CPT modifiers are specific to anesthesia
P1-P6
When two surgical procedures are performed during a single anesthetic
only use the anesthesia code that describes the most complex procedure or highest unit value
what modifiers are reported first
always list functional or pricing modifiers first, then informational modifiers
modifier 22
increased procedure services
when the service provided is greater than that usually requires for the listed procedure
modifier 22
modifier 24
unrelated EM by the same provider during a postoperative period
unrelated EM by the same provider during a postoperative period
modifier 24
modifier 25
significant, separately identifiable evaluation and management service by the same provider on the same day of procedure or other services
used when documentation supports an EM visit separate from the surgical procedure performed at the same time
modifier 25
modifier 26
professional component
when the professional component of a procedure is reported separately from the technical component
modifier 26
an imaging study is performed in a hospital and interpreted by a physician - what modifier
the physician appends modifier 26 to the code separate from the hospital
modifier 50
bilateral procedure
bilateral procedures performed at the same operative session code
modifier 50
