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5 Written questions

5 Matching questions

  1. Suturing coding tips
  2. Coding of underlying diseases
  3. HCPCS
  4. Modifier 22, Unusual procedural services
  5. Preventive Medical Services
  1. a both the manifestation of the condition and its underlying cause need to be listed. ITALICIZED codes are never to be reported w/o an additional code and they are never to be reported as the patients primary diagnosis.
  2. b Pronounced "hick picks"
    Health Care Financing Administration's Common Procedural Coding System

    HCFA (Health Care Financing Administration) Now CMS (Centers for Medicare and Medicaid Services) was/is the governing agency of Medicare and Medicaid

    Three levels:
    CPT (Common Procedural Terminology)
    National Codes or alpha-numeric codes
    Local codes (phased out in 2003)
  3. c When the service provided is > that usually required for the listed procedure (E/M - 21)

    A provider excises a lesion from the crease of the neck of a very obese person. The obesity makes the excision more difficult. The provider indicates the complexity of the removal by adding 22 modifier to code. It may be helpful to include copy of operative report.
  4. d 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. e length of wound is always documented and measured in (cm). When there's more than one wound in the same classification add teh length of the wounds and code it as one repair. repairs involving nerves/tendons/vessels are coded differently (see NS/muscsktl/cv-surgury)
    *Code Length and severity

5 Multiple choice questions

  1. • A Medicare billing provision that enables services provided by NNPs (non-physician providers) in an office or clinic setting to be reimbursed at 100% of the physician fee schedule by billing using the physician's NPI (otherwise reimbursed 85%)
  2. Example:
    Q0113 Pinworm examinations (kit given= supply billed)
    A0100 Non-emergency transportation; taxi
    D0270 Bitewing-single film
    H0030 Behavioral health hotline service
    J0120 Injection, tetracycline, up to 250 mg
    P9019 Platelets, each unit
    K0005 Ultralightweight wheelchair
  3. 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.
  4. a physician is prohibited from making any referral to a provider of designated health services if the physician has a "financial relationship" with the provider. a healthcare provider is prohibited from submitting for services rendered to patients referred in violation of the statute
  5. Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service.
    Pt is seen for fever, h/a, vomiting, and stiff neck. A spinal tap is performed as well as the E&M services consistent with 99214.
    62270 Spinal puncture, lumbar, diagnostic
    Indicates that same provider did both procedures at the same visit.

5 True/False questions

  1. Braces { }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. HEATMedicare/medicaid program that aims at catching fraud


  3. Starred proceduresProcedures in which the follow-up is generally non-existent or varies with the patient's underlying condition
    When billing for a starred procedure, the charge does not include any pre or post-operative care


  4. Kickbacksa bribe or financial incentive


  5. "V" Codesmost commonly used for reporting diagnostic services. Often times additional diagnoses will be reported secondary to the "v" code.

    Radiology and pathology/lab services are usually listed with a "V" code as the primary diagnosis and the pt complaints, symptoms and signs or other diagnoses secondarily.