62 terms

CPT Basics

False, Mod 59
(7-10) True or False: Modifier 91 is used when separate results are reported for different species or strains described by the same code.
(7-7) True or False: The CPT nomenclature lists the generic (nonproprietary) names of drugs whenever possible? (Page ?)
In the subheading title or code descriptor
(6-1) How is the imaging technique delineated in each radiological subsection? (320)
Radiological supervision and interpretation
(6-8) When a surgical procedure involving imaging is performed, the radiological portion of the procedure is designated as _____________. (322)
No, It is a HCPCS code
(6-3) Is the "TC" modifier a CPT coding convention to designate the technical component for a procedure or service? (323)
(6-13) It is appropriate to separately report the supply of radiopharmaceuticals with the appropriate CPT or HCPCS Level II codes. (324)
The highest-order vessel catheterized within each vascular family should be coded.
(6-6) If a first-order and a second-order vessel within the same vascular family are selectively catheretized via the same access, how would the catheterization procedure be reported? (336)
(6-9) If the same vascular access is used for both a diagnostic and a therapeutic service on the same occasion, the access is coded only once. (336)
Mod 59 (Distinct procedural service) and HCPCS RT & LT
(6-5) When interventional radiology procedures are performed, what CPT and HCPCS Level II modifiers are used to indicate catheterization of separate vascular families? (338)
(6-7) If less than the required elements for a complete ultrasound examination are reported, the limited code for that anatomic region should be used once per patient examination session. (339)
Clinical treatment planning
(6-14) The cognitive process carried out by the physician to determine all of the parameters of a given course of radiation therapy is called __________________. (344)
Code Number
Place or type of service
Content or extent of service
Counseling and/or coord of care
Nature of presenting problem
Time typically required
What is the basic format of E/M Codes?
Office visit
Hospital visit
What are the broad categories of E/M Codes?
How many of the key components (History, Exam, Medical Decision Making) must be met for an initial hospital visit?
Office: New Patient
Office: Established Patient
Initial Observation Care: New Or Est
Initial Hospital Care: New or Est
Hospital Inpatient: New or Est
Observation or New Patient Care: New or Est
Hospital Discharge
99238 (or 99239)
Office Consult: New or Est
A visit can be considered a consultation even if treatment has been initiated.
- Physician requests physician
- Request is documented in M/R
- Consultants opinion is documented
-Consultant may initiate treatment
-Written report must be sent
5 point summary of consultation requirement
Office consultation: New or Est
Inpatient Consultations
Emergency Department
ED Dr gets EM service
If multiple Drs are in the ED, how is it documented?
Critical Care Services
Moderate (conscious) sedation
Codes exempt from Moderate (consciuos) sedation, it's included in procedure code.
Appendix G
Modifier 47
Anesthesia provided by surgeon/doctor
P1 Physical Status Modifier
A normal healthy patient
P2 Physical Status Modifier
A patient with mild systemic disease
P3 Physical Status Modifier
A patient with severe system disease
P4 Physical System Modifier
A patient with severe system disease that is a constatnt threat to life
P5 Physical Status Modifier
A moribund patient who is not expected to survive
P6 Physical Status Modifier
A declared brain-dead patient whose organs are being removed for donor purposes
Anesthesia time begins
When the anesthesiologist begins to prepare the patient for the induction of anesthesia
Anesthesia time ends
When the anesthesiologist is no longer in personal attendance, that is, when the patient may be safely placed under postoperative supervision
The anesthesia code representing the most complex procedure is reported along with the combined time for all procedures.
How is the anesthesia code for multiple procedure reported?
Only one qualifying circumstance code may be selected and reported per session.
Basic anesthesia administration services include the placement of invasive monitoring lines.
Current Procedural Terminology
CPT stand for _______________ _______________ _______________.
Category II
_______________ ____ codes support performance measurement.
Category III
_______________ ____ codes are a set of temporary codes for emerging technology.
January 1st????
Healthcare Common Procedure Coding System (HCPCS) codes are updated and revision are available on ______________ ____.
Procedure, Organ, Condition, or Synonyms.
When using the alphabetic index in the back of the CPT book, you can look up information by ______________, _______________, _______________, or _______________.
(CH 1-1) Who developed and maintains the CPT code set? (2)
Level I CPT Code Set and Level II HCPCS National Codes
(CH 1-2) What are the 2 levels of the HCPCS codes? (19-20)
(CH 1-3) Who maintains the HCPCS Level II Codes? (20)
January 1st
(CH 1-4) When are category I codes implemented?
Category I - CPT Code Set
(Ch 1-5) Which CPT codes are five-digit numeric codes?
(Ch 1-6) (True/False) - Inclusion of a procedure descriptor and its associated code number in the CPT code set indicates health insurance coverage. (1)
(Ch 1-7) (True/False) - The first character of HCPCS Level II codes is numeric. (20)
Where is information regarding changes to HCPCS Level II Codes obtained?
(Ch 1-8) HCPCS/Medicare website
A list of codes for reporting medical services and procedures
(ch 1-9) What is the CPT Code Set?
(Ch 1-10) (True/False) Category II codes may be used as a substitute for Category I codes.
(Ch 1-11) (True/False) Alphabetic Listing of Performance Measures lists the Category II codes in alphabetic order to allow a user to easily find each performance measurement code according to the measure being defined.
Composite Measure Codes
(Ch 1-12) _______________ _______________ _______________ combine several measures within a single code descriptor to facilitate reporting for a particular clinical condition when all components are met.
(Ch 1-13) (True/False) Newly added Category II codes are made available via electronic distribution on the AMA website: www.ama-assn.org/go/cpt.