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CPT & HCPCS Coding True or False

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TRUE
Anesthesia services are reimbursed based in part on the amount of time anesthesia is administered.
TRUE
The anesthesia code for the most complex procedure is assigned when multiple procedures are performed during the same operative session under the same type of anesthesia.
FALSE
Preoperative and postoperative visits by the anesthesiologist can be reported in addition to the administration of the anesthesia.
FALSE
When a second physician provides moderate conscious sedation in a nonfacility setting then this physician can report a moderate conscious sedation code.
TRUE
When a physician performs the surgery and administers the anesthesia the modifier 47 (Anesthesia by surgeon) needs to be appended to the procedure code.
TRUE
Physical Status Modifiers are used to indicate the condition of the patient at the time the anesthesia was administered.
FALSE
The ASA Relative Value is a list of the charges for the anesthesia services performed.
FALSE
Only one Qualifying Circumstances Code can be reported during the same operative session.
FALSE
The appropriate Physical Status Modifier is decided by the medical coder and does not need to be documented by the anesthesiologist.
TRUE
The procedure with the highest basic unit value is reported when multiple surgical procedures are performed during the same operative session.
FALSE
Hospital Observation Services codes may only be assigned if the patient is in an area designated by the hospital as an observation area.
TRUE
When a patient is admitted to a hospital directly from a physician's office report a code from the Initial Hospital Care Subcategory.
FALSE
The anticoagulant management codes can be reported in the outpatient and inpatient setting.
FALSE
When a patient and/or the family initiates a consultation (instead of a physician initiating it), a consultation code is reported.
FALSE
HCPCS: When a physician orders that a patient be placed under observation, the patient's status is that of an inpatient.
FALSE
HCPCS: The codes listed in the Chemotherapy Drugs category cover the cost of the chemotherapy and the administration.
TRUE
Modifier 50 (Bilateral procedure) should be appended if a patient has bunionectomy procedures performed on both the right foot and the left foot during the same operative session (code 28292).
TRUE
If a patient had multiple procedures performed during the same operative session, modifier 51 (Multiple procedures) would be added to the additional procedure codes.
TRUE
When the description of a code includes the word bilateral you do not add the modifier 50 (Bilateral procedure) to the CPT® code.
FALSE
There are no exceptions to adding the modifier 51 (Multiple procedures) to a CPT code when more than one procedure is performed during the same operative session.
FALSE
For spine examinations using magnetic resonance angiography with contrast administered by intravascular injection, an additional code is reported for the intravascular injection.
FALSE
A code designated as a separate procedure can never be reported by itself or in addition to other procedures or services.
TRUE
The modifier 26 is reported when the physician provides only the professional component of the procedure.
TRUE
When a physician both performs the procedure and provides imaging supervision and interpretation, a combination of procedure codes is reported.
TRUE
The modifier TC is reported when the provider provides only the technical component of the procedure.
FALSE
Debridement must be coded separately when debridement is carried out in conjunction with an intermediate or complex wound repair.
TRUE
Code range 15002-15005 (Surgical preparation) is used for the initial wound recipient site preparation.
TRUE
Destruction means the ablation of benign, premalignant, or malignant tissues by any method.
TRUE
The initial cast application and removal are included in the open or closed treatment code.
FALSE
Coding separately for external fixation may be done even when external fixation is part of the main code description.
TRUE
All surgical endoscopies under the Surgery/Respiratory System include the diagnostic endoscopy.
FALSE
Lung allotransplantations involve four distinct physician work components.
TRUE
Backbench work in lung allograft includes work on the cadaver, single or double lung allograft, and preparation of pulmonary artery and bronchus.
TRUE
A physician performing two procedures on the same date of service during the same operative session would append modifier-51 to the second procedure code.
FALSE
It is not important to read special "notes" located under subheadings or subsections. Only notes that are part of the code description apply.
TRUE
Routine postoperative follow-up care is covered under the surgical global package.
TRUE
If follow-up care after a therapeutic surgical procedure is for a complication or other disease process the physician may code and report additional services separately.
FALSE
When a code description includes the note "separate procedure," it should never be reported separately.
FALSE
When destruction is carried out as part of a procedure, it is always coded separately.
FALSE
Category III codes cannot be used in the place of Category I unlisted codes.
FALSE
Category II codes are used to report emerging technologies.
TRUE
Qualifying Circumstances Codes are considered Add-on Codes which means they cannot be reported without an anesthesia code.
FALSE
The anesthesia formula is basic units + time units + conversion factor = total units. Total units X conversion factor = reimbursement rate.
TRUE
The insertion of a central venous catheter is an example of an unusual form of monitoring and can be coded and billed separately from the anesthesia service code.
TRUE
The cost of practicing medicine varies from one location to another. Therefore, the conversion factor is based on geographic location where the anesthesia service was performed.
FALSE
Physical Status Modifiers are represented by the initial letter P followed by a single digit from 1 to 5.
TRUE
The conversion factor is multiplied by the number of units to determine the reimbursement for the anesthesia services provided.
TRUE
The basic unit value for each anesthesia code is listed in the Relative Value Guide (RVG) which is published by The American Society of Anesthesiologists (ASA).
FALSE
When multiple procedures are performed during the same operative session under the same type of anesthesia each code is reported separately.
FALSE
When you cannot find a code that accurately describes a service or procedure you should report the code that most closely matches the service or procedure.
TRUE
Modifiers provide additional information about the services provided to a patient.
TRUE
Add-on codes are only reported when a procedure or service is performed by the same physician.
FALSE
Evaluation and Management codes are used to report facility charges.
TRUE
The guidelines for each section are listed at the beginning of each section.
FALSE
The indented codes include the full code descriptions.
TRUE
The guidelines contained within each section only apply to the codes that the guideline precedes.
TRUE
The four types of main terms are procedure or service, organ or other anatomic site, condition, and synonyms, eponyms and abbreviations.
FALSE
CPT® codes are organized by specialty and the use of them are restricted by specialty.
TRUE
Instructional notes contain information about additional codes, modifiers, alternative code assignments, and deleted codes.
FALSE
HCPCS: The Red Color Bar indicates contractor discretion.
FALSE
HCPCS: The HCPCS code should be assigned when the CPT® and HCPCS code descriptions are identical.
TRUE
HCPCS: A special report is used when a HCPCS modifier is reported.
FALSE
HCPCS: The Yellow Color Bar indicates a service not covered by or invalid for patients covered by Medicare.
TRUE
HCPCS: The route of administration column in the Table of Drugs lists the most common methods of delivering the referenced generic drug.
TRUE
HCPCS: The use of HCPCS codes is mandatory on all Medicare and Medicaid claims submitted for payment of services provided by healthcare providers.
TRUE
HCPCS: The Blue Color Bar instructs the coder there are special instructions associated with the assignment of the code.
FALSE
HCPCS: The place of service codes listed in Appendix 6 are reported on hospital claims to describe the location where the services were provided.
FALSE
HCPCS: The codes located in the Table of Drugs are provided only for the brand name of a drug.
TRUE
HCPCS: The modifiers in the HCPCS codebook have the same purpose as the modifiers in the CPT codebook.
TRUE
When a code does not exist that accurately describes the procedure/treatement, the coder should report an unlisted code.
FALSE
Modifiers are used to identify when no procedure is done.
TRUE
Appendix C contains coding examples to assist in the selection of the Evaluation and Management codes.
TRUE
In Appendix A, modifier 22, applies to codes in the Surgical Section, as opposed to Evaluation and Management codes, because typical procedure times are not listed.
FALSE
All procedures performed by physicians are found in the CPT codebook.
TRUE
Evaluation and management visits represent the most common patient-physician interactions.
FALSE
The chief complaint must be located under the heading CHIEF COMPLAINT.
TRUE
The number of minutes a physician spends face-to-face with a patient can be a factor in selecting the correct E/M code.
TRUE
Physician visits to hospital inpatients are coded and billed by an outpatient coder.
TRUE
Medical coding specialists working for a healthcare facility such as a surgery center, hospital, or nursing home would bill facility charges, not E/M services.
FALSE
Every E/M code category requires the medical coder to distinguish between new and established patients.
TRUE
When selecting an E/M code, the chief complaint must always be identified.
TRUE
Information in the physical examination should be objective information reported by the provider.
FALSE
Surgery is defined as what takes place when the surgeon scrubs up to the moment the last stitch is placed.