Chapter 13 Procedural Coding
Terms in this set (21)
HCPCS stands for?
Healthcare Common Procedure Coding System
HCPCS is divided into?
Level 1 mannual
is the AMA CPT-4
Level 1 AMA CPT-4 consist of?
A numeric coding system painted by the AMA &
5-digit codes used by physicians to code procedures or services.
How many sections are in the CPT ?
What is the layout of the CPT? 1)
1) Evaluation and management E/M
5) Pathology and Laboratory
Where is the alphabetic Index located?
The back of the book
Alphabetic index is organized by?
When is the Alphabetic index presented?
What is the code for physician office?
11 in Block 24B
What are section guidelines?
Each section begins with guidelines.
Refer to the guidelines to answer questions
When must a special report be submitted with the claim?
When an unlisted procedure, unusual, variable, or new procedure is done.
What codes are used most frequent ?
what are the key components?
2) physical examination
3) medical decision making (the last of the three)
Third Party Payer
An organization that provides payment for specified coverage provided under a health plan
Provided to indicate that a service or procedure has been altered by some specific curcumstance
it contains the full description of the procedure without additional explaination
a critical illness or injury which acutely impairs one or more vital organ systems
medical service & procedures that must be justified by the patient symptoms & diagnosis
Review of Systems
an inventory of body systems obtained through a series of questions asked of patients
loss of limb or of sight
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