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Patient to Payment Study Guide Chapter 5
Terms in this set (62)
Current Procedural Terminology
CPT is the abbreviation for
Indicates a new procedure code
An indicates that the code's descriptor has changed.
An Add on Code
A plus sign (+) next to a code in the main text indicates
In CPT, a number appended to a code to report particular facts is called an
Category II Codes
Are optional CPT codes that are used to track performance measures for a medical goal, such as reducing tobacco use.
A category III code has an for the fifth digit.
Are temporary codes for emerging technology, services, and procedures.
Evaluation and Managment
E/M is the abbreviation for
Services Not Listed in CPT
Unlisted procedures are
When a Code for an Unlisted Procedure is Used
When must a special report be attached to a health care claim?
Place of Service
An administrative code indicating where medical services are provided is called
The correct process for assigning accurate procedure codes has steps.
An is the five-digit number to which one or two-digit CPT modifiers may be assigned.
A service requested by thr patient's physician that is performed by a second physician is known as an
What is the term for when a physician sends a patient to another physician for either total care or a specific portion of the care?
Level of Service
When determining the correct E/M code, the amount of work, time, and decision-making that was involved us called
The Attending Physician
Which of the following is not a key component that is used to determine level of service for E/M coding?
Are factors that are found in the patient's medical record and used to determine the level of evaluation and management services
History of Present Illness
Is a description of the development of the illness from the first sign or symptom that the patient experienced to the present time.
Review of Systems
The is an inventory of body systems
Codes in the surgery section that represent groups of procedures are called
To break a panel or package of services/procedures into component parts is an incorrect billing practice known as
A procedure code for a surgical package that covers a group of services that should not also be listed individually is called an
The includes the days surrounding a surgical procedure when all services relating to the procedure are considered part of the surgical package.
An is a procedure that is usually part of a surgical package but may aslo be performed separately
An us a single code grouping laboratory test frequently done together.
Health Care Common Procedure Coding System
Are codes for supplies and other items not included in CPT
Level 11 Codes Insured by CMS
The HCPCS coding system has two levels, level I codes from CPT and
Health Care Common Procedure Coding System
HCPCS is the abbreviation for
That in a Referral, the Primary Physician Sends the Patient to Another Physician For Health Care.
The difference between referral and a consultation is
In CPT, which term describes services performed at the request of another provider, after which the patient's care is returned to the requesting provider?
On correct claims,each reported service is connected to what element that supports the medical necessity of the service?
The Requesting Physician
Under CPT guidelines, after a consultation, who takes responsibility for the patient's care?
After the Global Period
Under CPT guidelines, services follow-up care related to a surgical procedure are only reimbursed
In CPT, a plus sign (+) next to a code indicates an
The divisions of CPT. such as Anesthesia and Radiology, are referred to as
In CPT, a triangle next to a code indicates an
In CPT, a bullet (solid circle) next to a code indicates an
New Text Other Than a Code Descriptor
In CPT, facing triangles that appear in front of a code indicate an
In CPT, which term describes the number that is used to report a special circumstances involved with a procedure or service?
In a the care of a patient is transferred from one physician to another physician.
In CPT, grouping laboratory tests into a single code is called a
What is the correct CPT code for routine cataract removal (extracapsular) with insertion of intraocular lens prosthesis (one-stage procedure), manual technique
What is the correct code for arthroplasty performed on the temporomandibular joint without autograph to remove bony ankylosis
What is the correct CPT, code for magnetic resonance imaging (MRI) of a temporomandibular joint?
What is the correct CPT, code for an excision of a small amount of black tissue for sampling?
What is the correct CPT, code for the history and examination of a healthy newborn girl admitted and discharged from the hospital on the same day?
What is the correct CPT code for a diagnostic dilation and curettage?
What is the correct CPT, modifier for minimal surgical assistant services?
What is the correct CPT modifier for a staged or relaxed procedure by the same physician during the postoperative period?
What is the correct CPT, code for the first hour of physician critical care of a patient in a coronary care unit who has gone into cardiac arrest?
What is the correct CPT code for an unlisted procedure on the abdomen
What is the correct CPT code for a repair of a diaphragmatic hernia, transthoracic ?
What is the correct CPT, code for the initial office visit for evaluation of a 13-year-old male with progressive scoliosis 30 minutes, detailed history and, examination, low- complexity of decision making
What is the correct CPT code for a repeat office visit with a 30-year old male patient for a blood pressure check ?
What is the correct CPT code for the initial visit to a psychiatrist's office for a 15-year-old male patient who may be suicidal; the family is consulted; the history and examination are both comprehensive, and the decision-making is highly complex
What is the correct CPT code for a regularly scheduled follow-up gifteen-minute nurisng home visit with a patient who has had a stroke ?
What is the correct CPT code for a gastrostomy with construction of a gastric tube?
What is the correct CPT code for a consultation provided by a rheumatologist for evaluation of a 58-year-old male patient with shoulder arthralgia; detailed history and, examination, and low complexity of medical decision-making
What is the correct CPT code for an initial consutation provided by a surgeon for a 42-year-old female patient who has been admitted to the hospital for rectal bleeding; problem focused history and, examination, and straightforward decision making?
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