PTP 2 Unit 1

Question 1

What are the 3 components of the CPT Code Values?

Answer 1

1. Professional work - Time, technical skill, physical effort required to perform the service or procedure, mental effort and judgement involved, and amount of stress associated with the level of risk to the patient
2. Practice Expence - Costs associated with labor, equipement and supplies
3. Professional liability insurance relative value - A fixed figure established and updated by CMS

Question 2

Healthcare Common Procedural Coding System (HCPCS)

What is the Difference between Time-based codes and Event/Serviced-based codes?

Answer 2

• Time-based codes: Are reimbursed based on time
• Event/Service-based codes: Are reimbursments for the service or event. No matter how long they take they are only 1 unit.

Question 3

What CPT code is 97110?

Answer 3

Therapeutic Exercise (e.g., routine exercise)

Question 4

What CPT code is 97112?

Answer 4

Neuromuscular Re-education (e.g., balance training)

Question 5

What CPT code is 97116?

Answer 5

Gait Training (e.g., Ambulation training)

Question 6

What CPT code is 97530?

Answer 6

Therapeutic Activities (e.g., Bed Mobility Training, Transfer Training)

Question 7

What CPT code is 97161?

Answer 7

PT Evaluation Low Complexity

This is an event/service-based code

Question 8

What CPT code is 97162?

Answer 8

PT Evaluation Moderate Complexity

This is an event/service-based code

Question 9

What CPT code is 97163?

Answer 9

PT Evaluation High Complexity

This is an event/service-based code

Question 10

What is the CPT code for Gait Training?

Answer 10

97116

Question 11

What is the CPT code for Therapeutic Exercise?

Answer 11

97110

Question 12

What is the CPT code for PT Evaluation Moderate Complexity?

Answer 12

97162

Question 13

What is the CPT code for Therapeutic Activities?

Answer 13

97530

Question 14

What is the CPT code for PT Evaluation High Complexity?

Answer 14

97163

Question 15

What is the CPT code for PT Evaluation Low Complexity?

Answer 15

97161

Question 16

What is the CPT code for Neuromuscular Re-education?

Answer 16

97112

Question 17

8 Minute Rule

With this rule, how many units do you bill for 8-22 minutes of treatment?

Answer 17

1 unit

Question 18

8 Minute Rule

With this rule, how many units do you bill for 23-37 minutes of treatment?

Answer 18

2 unit

Question 19

8 Minute Rule

With this rule, how many units do you bill for 38-52 minutes of treatment?

Answer 19

3 unit

Question 20

8 Minute Rule

With this rule, how many units do you bill for 53-67 minutes of treatment?

Answer 20

4 unit

Question 21

8 Minute Rule

With this rule, how many units do you bill for 68-82 minutes of treatment?

Answer 21

5 unit

Question 22

If you bill 3 units, what was the range of time of the treatment session?

Answer 22

38-52 minutes

Question 23

If you bill 1 units, what was the range of time of the treatment session?

Answer 23

8-22 minutes

Question 24

If you bill 4 units, what was the range of time of the treatment session?

Answer 24

53-67 minutes

Question 25

If you bill 5 units, what was the range of time of the treatment session?

Answer 25

68-82 minutes

Question 26

If you bill 2 units, what was the range of time of the treatment session?

Answer 26

23-37 minutes