How can we help?

You can also find more resources in our Help Center.

30 terms

CPT CH 13

CPT coding (Step-By-Step Chapter 13)
STUDY
PLAY
Modifier
provides additional information to the third party payer
Special Report
Required when reporting a unusual or variable service. Pertinent information should include adequate definition or description of the NATURE, EXTENT, and NEED for the procedure and the TIME, EFFORT, and EQUIPMENT necessary to provide the service.
Procedures that are experimental, newly approved, or seldom used are reported with what type of code?
Unlisted or Category III
Where is specific coding information about each section located?
Guidelines
Procedure/Service Descriptor
The words that follow a code number in the CPT manual
Nomenclature
According to the notes preceding the Category III codes in the CPT manual, the digits of the Category III codes are not intended to reflect the placement of the code in the Category I section of the CPT
Category I codes in the CPT manual have ___ digits.
5
A code that has all of the words that describe the code that follows is what type of code?
stand alone
Which punctuation mark between codes in the index of the CPT manual indicates two codes are available?
comma
Who publishes the CPT manual?
AMA
(American Medical Association)
Who requires a special report with the use of unlisted codes?
third-party payers
According to the CPT manual, modifier -91 is not to be used when tests are ____ to confirm initial results.
rerun
The universal health insurance form for submission of outpatient services is the?
CMS-1500
According to the E/M Guidelines, time is not a descriptive component for the ____ department levels of E/M service.
emergency
Which punctuation mark between codes in the index of the CPT manual indicates a range of codes is available>
hyphen
In which CPT appendix would all modifiers be found?
Appendix A
The range of codes 10021-69990 would be found in this section of the CPT manual:
Surgery
An unlisted procedure code is
located in the Section Guidelines, at the end of a subsection or subheading, and is a procedure/service not found in the CPT manual.
A list of the unlisted procedures for use in a specific section of the CPT manual is contained in:
Guidelines
What is NOT a reason for the CPT coding system?
increased reimbursement
Two digit modifier for a return to the operating room for an unplanned related procedure during a postoperative period.
-78
The ______ section Guidelines contain the definition of a chief complaint.
E/M
(evaluation and management)
The correct order from largest to smallest division of the CPT hierarchy in the CPT manual is:
Section, Subsection, Subheading, and Category
Appendix C of the CPT manual contains examples of ___________ codes.
clinical
-76
repeat procedure by the same physician
-51
multiple procedures
-50
bilateral procedure
-54
surgical care only
T/F: According to the Surgery guidelines, surgical destruction may be considered part of a surgical procedure.
TRUE
T/F: If a coder is unable to locate a code that describes the exact service provided, it is acceptable to use a code that approximates the services provided.
FALSE