MOA Chapter 7 Flashcards
Category 1 codes
procedures/services identified by a five-digit CPT code and descriptor nomenclature; codes traditionally associated with CPT and organized w/in 6 sections
Category 2 codes
contain “performance measurements” traking codes that are assigned an alphanumeric identifier w/a letter in the last field; located after the Medicine section, use is optional
Category 3 codes
contain “emerging technology” temporary codes assigned an alphanumeric identifier w/ a letter in the last field; located after Medicine section, will be archived after five years unless accepted for placement w/in category 1 sections of CPT
CPT
Current Procedural Terminology (codes for medical services and procedures
CPT category 1’s 6 sections
evaluation and management; anesthesia; surgery; radiology; pathology and laboratory; medicine
Stand-alone codes
a complete description of the procedure or service
Indented code
appears below a stand-alone code, requiring the coder to refer back to the common portion of the code description that is located before the semicolon
A bullet point located to the left of a code number
new procedures and services added to CPT
A triangle located to the left of a code number
a code description that has been revised
Horizontal triangles
surround revised guidelines and notes (not used for revised code descriptions)
Semicolon
used to save space in CPT, and some code descriptions are not printed in their entirety next to a code number.
Plus symbol
identifies add-on codes for procedures that are commonly, but not always, performed at the same time and by the same surgeon as the primary procedure
forbidden symbol (circle with / through it)
codes that are not to be used w/ modifier -51. these codes are reported in additions to other codes, but they are not classified as add-on codes.
bull’s-eye symbol
a procedure that includes moderate (conscious) sedation
Moderate (conscious) sedation
administration of moderate sedation or analgesia, which results in a drug-induced depression of consciousness
flash symbol (lightning bolt)
codes that classify products that are pending FDA approval but have been assigned a CPT code
the hollow circle
indicates a reinstated or recycled CPT code
number symbol (pound sign)
precedes CPT resequenced codes, which appear out of numerical order
guidelines
define terms and explain the assignment of codes for procedures and services located in a particular section.
unlisted procedure/unlisted service
assigned when the provider performs a procedure or service for which there is no CPT code.
Special report
copy of procedure report, must accompany the claim to describe the nature, extent, and need for procedure or service along w/ time, effort and equipment necessary- when unlisted procedure or service
instructional notes
appear throughout CPT sections to clarify the assignment of codes
a blocked unintended note
located below a subsection titl and contains instructions that apply to all codes in the subsection
indented parenthetical note
located below a subsection title, code description, or code description that contains an example
descriptive qualifiers
terms that clarify that assignment of a CPT code. can occur in middle of a main clause or after the semicolon and may or may not be enclosed in parentheses.
modifiers
clarify services and procedures performed by providers (-77)
Evaluation and management (E/M) section
[codes 99201-99499] located at the beginning of CPT cause codes describe services most frequently provided by physicians
level of service
relects the amount of work involved in providing health care to a patient, and correct coding requires determinging the extent of history and examination performed as well as the complexity fo medical decision making
place of service POS
physical location where health care is provided to patients
Type of service TOS
kind of healthcare services provided to patients
