Dividing services provided into separate codes when a single code is available
Which of the following is an example of unethical or illegal coding?
a) Dividing services provided into separate codes when a single code is available
b) Inclusion of all relevant complications as documented in the patients medical record
c) Using code numbers for the minimum payment allowed
d) strict adherence to coding for only procedures performed at your facility
The transformation of verbal descriptions of diseases, injuries, and procedures into numbers is called ________?
services and procedures
Two coding systems are used by phsicians offices. One is for diagnoses and the other is for ___________?
b) computer directories
c) services and procedures
Physicians Current Procedural Terminology (CPT) is revised ________?
b) when necessary
c) every 6 months
d) every 2 years
Basic CPT codes use ___________?
a) 3 to 5 digits
b) 5 digits
c) 2 digits
d) 3 digits
Add-on modifier - 26 indicates the _______?
a) service is significant and separately identifiable
b) unusual nature of the service or procedure
c) technical component
d) professional component
emergency department services
Codes 99281 through 99285 refer to _______?
a) counseling services
b) outpatient consultations
c) office surgery
d) emergency department services
give a more accurate description
In some billing cases it is necessary to add a 2 digit modifier in order to __________?
a) indicate usual charges
b) prevent miscoding
c) give a more accurate description
d) meet carrier criteria
American Medical Association
CPT codes, descriptions and two digit modifiers are copyrighted by the _______?
a) American Medical Association
b) Blue Cross and Blue Shield Organization
c) CPT Assistant
d) World Hospital Organizaiton
keep from transposing numbers
When transferring codes to claim forms he careful to __________?
a) include descriptions
b) write out all abbreviations
c) keep from transposing numbers
d) write neatly
Unbundling, exploding, or a la carte coding are __________?
add the sum of lengths and report one code
If multiple lacerations are repaired under the same classification and in the same group of anatomic parts a billing and coding specialist should _______?
a) add the sum of lengths and report one code
b) report a code for each laceration
c) include a printed report
d) report only the longest laceration
Modifier code - 66 indicates ________?
a) procedure performed on infants
b) surgical team
c) assistant physician
d) two surgeons
Modifier code - 99 indicates ________?
a) laboratory work
b) surgical tray
c) universal application
d) multiple modifiers
cause of wound
Which of the following is NOT needed when coding a laceration repair ________?
a) depth of wound
b) size of wound
c) location of wound
d) cause of wound
The modifier for a repeat procedure by the same physician is ______?
convert medical descriptions into 5 digit codes
The purpose of CPT is to ________?
a) revise technologic advances
b) simplify the CMS-1500 form
c) convert medical descriptions into 5 digit codes
d) organize insurance billers work
The CPT coding system is used by all of the following EXCEPT ___________?
a) doctors offices and clinics
b) outpatient departments
c) third party payers
Amerian Medical Association
The CPT coding system was developed by the ______?
a) American Medical Association
b) federal government
c) state government
d) Social Security Administration
In the CPT manual, a round bullet symbol indicates a ________?
a) bundled code
b) new code
c) revised code
d) deleted code
A triangle symbol in the CPT manual indicates a _______?
a) minor surgical procedure
b) decision for surgery
c) new code
d) revised description
In Appendix B
In the CPT manual, where is a complete summary of additions, deletions and revisions located?
a) In Appendix B
b) In Appendix A
c) In the Index
d) In the Table of Contents
Which of the following is NOT one of the sections in the CPT manual?
a) Evalution and management
b) Integumentary system
add on or indented codes
There are two types of CPT codes:
stand-alone and __________?
a) sub codes
b) parent codes
c) stand aside codes
d) add on or indeted codes
lesser important procedures
In CPT coding, the words following the semicolon may indicate all of the following EXCEPT ___________?
a) alternative anatomic site
b) alternative procedure
c) lesser important procedures
d) extent of procedures
third party payers
CPT surgical packages are used only by _________?
a) third party payers
Which of the following is NOT included in the CPT surgery package ___________?
a) The operation
b) the surgery
c) Normal follow-up care
d) General anethesia
Which of the following indicates a co-surgeon?
When using CPT codes to indicate an unlisted procedure, the last digit will usually be a _______?
written medical report
Claims including codes for an unusual,new,seldom performed or unlisted procedure should include a _________?
a) duplicate copy
b) written medical report
c) written description by the code number
d) numerical summary
all answers are correct
In the CPT index, main terms are listed by _____?
a) procedure or service
b) organ or anatomic site
c) condition, synonym, or abbreviation
d) all answers are correct
At the beginning of the CPT index are ________?
d) anatomical listings
must refer to the main text
Even if only one code is listed for the desired procedure in the index of the CPT manual, the user ____________?
a) can select that code
b) must refer to the main text
c) can expect across references
d) notes that code on the claim form
The CPT manual is divided into how mayn sections?
The Evaluation and Management section is organized by type of service, place of service, and __________?
a) nature of presenting problem
c) patient status
d) coordination of care
counseling and coordination of care
The key components of documentation that support levels of E?M codes includes the following EXCEPT __________?
c) counseling and coordination of care
d) medical decision-making
medical decision making
Components of a medical history inlude all of the following except __________?
a) medical decision making
b) chief complaint
c) family history
d) review of systems
level of complexity
A key component in coding medical decision-making is _____________?
a) patient childhood diseases
b) level of complexity
c) the physician's level of education
d) the amount of time the physician spends with the patient
counseling exceeds 50% of the time spent
Physician counseling is considered a key component for selecting the level of code assignment for Evaluation and Management services only when ____________?
a) the physician is a psychiatrist
b) counseling exceeds 50% of the time spent
c) the physician does not take a history or perform a physical examination
d) the physician is a physchologist
in minutes starting with 30-74 minutes
Critical care is coded _____________.
a) in quarter hours units
b) each time the patient is seen in a 24 hours period
c) the minute the patient is determined to have a life threatening emergency
d) in minutes starting with 30-74 minutes
ventilator management is included
In a case requiring critical care coding __________.
a) the coder is expected to unbundle
b) no other services are included
c) ventilator management is not included
d) ventilator management is included
A code indicating a vaginal delivery only, not including obstetric care, is _____________?
not paid by third party payers
Physicians telephone calls are usually __________?
a) coded according to area codes
b) not paid by third party payers
c) paid by third party payers
d) coded using HCPCS Level II codes
require vast documentation and are typically not paid by third party payers
Care Plan Oversight Sevices for hospice and homebound patients _____________?
a) require vast documentation and are typically not paid by third party payers
b) are usually paid by the third party payers
c) are not listed services in CPT
d) are coded once for every 24 hours period the patient is seen
Labor leading to childbirth
Which of the following conditions would not require critical care?
a) Cardiac arrest
b) Labor leading to childbirth
d) Respiratiory failure
Anesthesia codes are divided by ___________?
b) anatomical site
c) drug name
d) number of anethesiologists
patient's status at the time of anesthesia
For anesthesia coding purposes, physical status modifiers are used to indicate ________?
a) age of patients at time of surgery
b) patient's status upon admittance
c) patient's status at the time of anesthesia
d) patient's status at the time of completion of surgery
Both anesthesia guidelines and medicine are correct answers
Where in the CPT manual are codes for anethesia provided under difficult circumtances?
a) Anesthesia guidelines
d) Both anesthesia guidelines and medicine are correct answers
Which section of the CPT manual is the largest?
b) Evaluation and Management
global surgical package
When one fee is used for a surgical procedure and uncomplicated follow-up care, this is called a __________?
a) surgical unit
b) global surgical package
c) general procedure