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5 Written questions

5 Matching questions

  1. ICD-9 volumes
  2. Consultation
  3. Colon :
  4. When can you NOT bill "incident to"?
  5. importance of documentation
  1. a are placed after an incomplete term which requires one or more of the modifying terms that follow it in order to make the code assignable to a given category.
  2. b • If a physician is not on the premises at the time the NPP sees the patient.

    • If the patient is new to the clinic and has not been previously seen by the physician.

    • If the NPP makes a new diagnosis.

    • In a hospital.
  3. c "A consultation is a type of service provided by a physician whose opinion or advice regarding evaluation and/or management of a specific problem is requested by another physician or other appropriate source."
  4. d required for payment. It provides the justification & support for the procedures and services you render by making the medical necessity of your service clear to the 3rd party
  5. e Vol 1= "Diseases- Tabular List"
    Vol 2= "Diseases- Alphabetical Index"
    Vol 3= Listing of procedure codes and an index to the procedures.

5 Multiple choice questions

  1. repairs requiring more than layered closure (ie: scar revision, debridement, etc.)
  2. Pretty straightforward
    Certain "panels" have one code for related blood tests (liver function, lipids, thyroid functions)
    Everything in the panel will be listed with the code
  3. "Medical necessity of a service is the overarching criterion for payment in addition to the individual requirements of a CPT code. It would not be medically necessary to bill a higher level of evaluation and management service when a lower level of service is warranted. The volume of documentation should not be the primary influence upon which a specific level of service is billed."
  4. Codes 99381-99397
    The "Comprehensive" nature of the Preventive Medicine Services reflects an age and gender appropriate history/exam.
    (anticipitory guidence, risk factor reduction, etc)
  5. International Classification Of Disease, 9th Revision, Clinical Modifications

    Initially developed by the World Health Organization as a way to report morbidity and mortality statistics worldwide
    Not initially meant to be used for billing purposes

    Maintained and updated yearly by the National Center for Health Statistics

5 True/False questions

  1. CPT, Category IInflating the seriousness of the patient's condition or the level of E/M needed to help the patient to obtain a higher reimbursement the one is entitled


  2. Kickbacksa bribe or financial incentive


  3. Stark LawA superbill is a form used by medical practitioners that can be quickly completed and submitted to an insurance company or employer for reimbursement.
    It generally has both CPT codes and ICD-9 codes that are frequently used in your practice in a check-box format.


  4. Up Codingusing tow codes when a combined code exists


    CPT codes account for the majority of the HCPCS coding system
    Maintained/Updated by the AMA
    Codes for >7,000 procedures and services
    5-digit code 00100-99199
    Followed by a verbal description
    Three Categories:
    I= Evaluation & Management
    II= Performance Measurement
    III= New/emerging technology