-58, is used to indicate..

Subsequent surgery was planned at the time of the first surgery

What is the function of an add on code?

Identify a code that is never used alone

The way payment is made by a third party payer

Modifier-59 is used to indicate that..

Services that are usually bundled together in one payment, are separate

Modifier -32 is used to indicate a service is mandated. What is an example of mandated service?

Insurance requires 2nd opinion prior to surgery

These are the methods that qualify as “with contrast”.

Intravascularly, infra-articularly, intrathecally

Definition of low birth weight can be found in the notes for subheading..

Initial & Continuing intensive care service

Provides additional information to the third party payer

Provides additional info to the third party payer

HCPCS is a collection of codes that represent the following

Procedures, supplies, products, and services

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Chapters 8-11 CPT

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Questions 87

Answers

1
CPT stands for:
Current Physician’s Terminology
Current Procedural Terminology
Current Procedural Terms
Current Procedure Terminology
2
Which mark between codes in the index of the CPT means 2 codes are available?
Ampersand
Semi-colon
Period
Comma
3
Cpt code assigned to an ED service that has a detailed history/exam with moderate MDM
99291
99283
99284
99220
4
The level of E/M service is based on
All of the above
Key components
Contributing factors
Documentation
5
Request for advice of opinion from one physician to another is this type of service..
Concurrent
Coordination of care
Consultation
Counseling
6
Which code is an example of an add on code?
15201
11000
15100
11301
7
How often are category III codes released?
Every 3 years
Annually
Twice a year
As often as needed
8
The modifier-AA is an example of what type of modifier
HCPCS
None of the above
ICD-10-CM
CPT
9
Range of codes 10004-69990 would be found in this section of the CPT..
Medicine
Pathology
Radiology
Surgery
10
Items billed before a signed/dated order has been received by the supplier
ET
EY
EJ
EP
11
-58, is used to indicate..
Service was repeated
Services usually bundled together into one payment, are separate
Subsequent surgery was planned at the time of the first surgery
A PT is taken back to the OR for a surgical treatment
12
The physician performs an extended exam of the affected body area and organ system.. select the level of exam.
Expanded
Comprehensive
Detailed
Problem focused
13
What is the function of an add on code?
Serves as a primary code under certain conditions
Additional 10%
Indentify those services that are provided with a more major service
Identify a code that is never used alone
14
In which CPT appendix would additions, deletions, & revisions be found?
Appendix A
Appendix C
Appendix B
Appendix D
15
K codes are used to identify..
Durable medical equipment
Drugs administered
Vision/Hearing
Diagnostic radiology service
16
How many main sections are in the CPT manual?
6
9
10
7
17
Which of the following is NOT a reason for the CPT coding system?
Increased reimbursement
Comparative analysis
Improved communication
Data for research
18
The extent of an exam is determined by the..
Gender
Gender and age
Age
Length of time
19
How often are Category III codes released?
Twice a year
Every 3 years
As often as necessary
Annually
20
HCPCS Codes that are used to indentify services that would not be reported with a CPT code.
G
J
Q
K
21
What year was CPT first developed and published?
1966
None of the above
1970
1983
22
What year did CMS develop and publish HCPCS?
1970
1966
1983
None of the above
23
Modifier -51 is used on what type of surgery?
Surgery
E/M
All of the above
Anesthesia
24
This modifier indicates required Waiver of Liability statement issued
GL
GA
GX
GY
25
Modifiers May affect
Type of treatment provided
Health care premiums
The way payment is made by a third party payer
Code selection
26
Eyes
OS
BA
27
Which term reflects the technologic advances made in medicine that are inc into the CPT manual?
Special reports
Revisions
Guidelines
Modifiers
28
This act mandated the adoption of National Uniform Standards
HIAPA
HPIAA
HIPAA
HAPIA
29
Modifier-59 is used to indicate that..
A PT was taken back to the OR for a surgical treatment
Services that are usually bundled together in one payment, are separate
A service was repeated
A subsequent surgery was planned or staged
30
Multiple modifiers are indicated as..
-47
-22
-99
-50
31
These elements would be part of the __history: employment, education, use of drugs.
Social
Any of the above
Past
Family
32
Who publishes CPT?
HHS
WHO
AMA
CMS
33
Modifier that indicates Professional Component..
-26
-50
-22
-51
34
HCPCS codes have how many digits?
5
4
3
6
35
Skin
OS
BA
36
Nursing facility services are used to report services provided in nursing facilities known as..
All of the above
Intermediate
Long term care
Skilled nursing
37
A code that has all of the words that describe the code that follows us what type of code?
Stand alone
Isolated
Developed
Complete
38
Category I CPT does have__digits.
7
5
6
4
39
CPT modifier -91 is not to be used when test are__to confirm initial results.
Directed
Rerun
Selected
Ordered
40
Modifier -32 is used to indicate a service is mandated. What is an example of mandated service?
Another physician request 2nd opinion
Patient requests a 2nd opinion
Insurance requires 2nd opinion prior to surgery
All of the above
41
These are the methods that qualify as “with contrast”.
Intravascularly, infra-articularly, intrathecally
Other route, intravenously, interarticarly
Intra-articularly, intravenously, interarticularly
Oral, rectal, intramuscular
42
Definition of low birth weight can be found in the notes for subheading..
Initial & Continuing intensive care service
Pediatric critical care patient transport
Complex chronic care management service
Inpatient neonatal & pediatric critical care
43
A modifier
Provides additional information to the third party payer
Adds to the HCPCS code number
Increases third party payer reimbursement
Subtracts from the definition of the code
44
Level II National modifiers are found in the introduction sectional of HCPCS and what Appendix?
Appendix B
Appendix D
Appendix A
Appendix C
45
The HPI must be documented in the medical record by..
Any office staff member
Any of the above
The patient
The physician
46
A modifier..
Subtracts from the definition of the code
Provides additional info to the third party payer
Adds to the CPT code number
Increases third party payer reimbursement
47
HCPCS is a collection of codes that represent the following
Providers, payers, & patient advocates
Process, purpose, and service
Procedures, supplies, products, and services
Procedures, surgeries, radiology, & lab services
48
Bruising would be an element of review of this organ system
Integumentary
Hematologic
Immunologic
Neurologic
49
Respiratory
BA
OS
50
An unlisted procedure code:
Procedure/service not found in the CPT
All of the above
Located at the end of a subsection
Located in the section guidelines
51
The examination is the __portion of the EM service
Plan
Subjective
Objective
Assessment
52
According to information 99468, what is the age of neonate?
Less than 20 days
Less than 7 days
28 days or younger
None of the above
53
Modifiers are used to indicate what type of information?
Service greater than usually required
Multiple procedure
All of the above
Bilateral procedure
54
G codes are used to indentify..
Durable medical equipment
Drugs administered and the dosage
Drugs, biologicals, & types of medical equipment
Professional procedures and services
55
Which section Guidelines contain the definition of the chief complaint.
Pathology & Laboratory
Surgery
E/M
Medicine
56
Modifier -79 is used on what type of service?
E/M
All of the above
Anesthesia
Surgery
57
The hospital inpatient service subsection is used for patients admitted to..
Skilled nursing facility
Acute care facility
Hospital observation unit
Temporary care unit
58
Temporary national codes..
E,K,Q
P,L,J
J,S,T
E,D,A
59
Who requires a special report with the use of unlisted codes?
Third party payers
National Center for Health Care
AMA
CPT manual
60
Healthcare providers are __based on the codes submitted on a claim form for procedures & service rendered.
Judged
Taxed
Reimbursed
Rated
61
Modifier -25 is used to report and E/M service that was..
Performed in post op period
Provided on the same day as a MAJOR procedure
Provided on the same day as a MINOR procedure
All of the above
62
Sunset HCPCS modifier indicating denial expected as not reasonable or necessary.
GW
GZ
GS
GV
63
The universal health insurance paper form for submission of outpatient services is the..
HCFA-1500
CMS-1400
CMS-1500
CMS-1450 (UB-04)
64
Indentify this: Back
BA (body area)
OS (organ system)
65
MDM is based on the __the physician must consider about the management of a PT’s condition
# of dx
Risk of morbidity
Amount of data
All of the above
66
Time is not a descriptive component for the __department levels of E/M service.
Emergency
None of the above
Inpatient
Outpatient
67
The rules that govern coding in various health care settings are..
Static
Variable
Nationally established
Unchanging
68
Subset HCPCS modifier indicating an OPT OUT physician providing Emergency service.
GP
GB
GH
GJ
69
Modifier-80 is used when
All of the above
Two surgeons perform a distinct part of surgery
Surgery is complex & requires server AP physicians
Second surgeon provides assistance to primary surgeon
70
HCPCS modifier indicating the service was provided by a resident under a teaching physician.
TE
TH
GE
GC
71
A___exam encompasses a complete single specialty exam or a complete multi system exam..
Problem focused
Comprehensive
Expanded problem focused
Detailed
72
Which punctuation mark between codes in the index of the CPT means a range of codes are available?
Period
Semi-colon
Comma
Hyphen
73
In which CPT appendix would ALL modifiers be found?
Appendix A
Appendix D
Appendix C
Appendix B
74
Critical care codes are reported based on..
Procedures
Time
Amount of documentation
History, exam, mdm
75
An est. PT is someone that’s been seen within the last__years.
5
2
3
4
76
The words that follow a code number in the CPT manual are called?
Identified descriptor
Procedure/service descriptor
Format descriptor
Listing order
77
Procedures that are experimental, newly approved, or seldom used are reported with what code?
Unlisted/category III
Technical
Variable
Modified
78
The rules that govern coding in various health care settings are:
Nationally established
Static
Unchanging
Variable
79
Appendix C of the CPT contains examples of ___codes.
E/M
Add on
Resequenced
Renumbered
80
A list of the unlisted procedures for use in a specific section in the CPT is contained in:
Appendix A
Appendix B
Guidelines
Introduction
81
Modifier that indicates multiple procedures..
-51
-22
-32
-26
82
-52, is used to indicate..
A service was discontinued
Procedure was terminated
Service reduced w/out changing the definition of code
Changes to the description of the code
83
Modifier -57, decision for surgery, is used on what service?
All of the above
Surgery
E/M
Anesthesia
84
Which of the following represents 3 of the 6 elements that a special report must contain?
Service, extent, procedure
Nature, extent, need
Condition, service, description
Anatomic site,, service, extent
85
What types of codes are not recognized by Medicare & other federal payers?
J codes
L codes
S codes
G codes
86
Neck
BA
OS
87
HCPCS stands for
Healthcare common procedure coding system
Health coding procedures creating standards
Healthcare current procedure coding system
Healthcare coding procedure charging system

Chapters 8-11 CPT Flashcards | StudBud