110 terms

Billing & Coding: Chapter 4: CPT Coding

Dividing services provided into separate codes when a single code is available
Which of the following is an example of unethical or illegal coding?
The transformation of verbal descriptions of diseases, injuries, and procedures into numbers is called
services and procedures
Two coding systems are used by physicians' offices. One is for diagnoses and the other is for
Physicians' Current Procedural Terminology (CPT) is revised
5 digits
Basic CPT codes use
professional component
Add-on modifier -26 indicates the
emergency department services
Codes 99281 through 99285 refer to
give a more accurate description
In some billing cases it is necessary to add a 2 digit modifier in order to
American Medical Association
CPT codes, descriptions and two digit modifiers are copyrighted by the
keep from transposing numbers
When transferring codes to claim forms be careful to
Unbundling, exploding, or a la carte coding are
add the sum of lengths and report one code
If multiple lacerations are repaired under the same classification and in the same group of anatomic parts a billing and coding specialist should
surgical team
Modifier code -66 indicates
multiple modifiers
Modifier code -99 indicates
Cause of the wound
Which of the following is NOT needed when coding a laceration repair?
the modifier for a repeat procedure by the same physician is
convert medical descriptions into 5 digit codes
The purpose of CPT is to
The CPT coding system is used by all of the following EXCEPT
American Medical Association
The CPT coding system was developed by the
new code
In the CPT manual, a round bullet symbol indicates a
revised description
A triangle symbol in the CPT manual indicates a
In Appendix B
In the CPT manual, where is a complete summary of additions, deletions and revisions located?
Integumentary system
Which of the following is NOT one of the sections in the CPT manual?
add on or indented codes
There are two types of CPT codes: stand-alone and
lesser important procedures
In CPT coding, the words following the semicolon may indicate all of the following EXCEPT
third party payers
CPT surgical packages are used only by
General anesthesia
Which of the following is NOT included in the CPT surgery package?
Which of the following indicates a co-surgeon?
When using CPT codes to indicate an unlisted procedure, the last digit will usually be a
written medical report
Claims including codes for an unusual, new, seldom performed or unlisted procedure should include a
procedure or services
organ or anatomic site
condition, synonyms, eponym, or abbreviation
In the CPT index, main terms are listed by
At the beginning of the CPT index are
must refer to the main text
Even if only one code is listed for the desired procedure in the index of the CPT manual, the user
The CPT manual is divided into how many sections?
patient status
The Evaluation and Management section is organized by type of service, place of service, and
counseling and coordination of care
The key components of documentation that support level of E/M codes include the following EXCEPT
medical decision making
Components of a medical history include all of the following EXCEPT
level of complexity
A key component in coding medical decision-making is
counseling exceeds 50% of the time spent
Physician counseling is considered a key component for selecting the level of code assignment for Evaluation and Management services only when
in minutes starting with 30-74 minutes
Critical care is coded
ventilator management is included
In a case requiring critical care coding,
A code indicating a vaginal delivery only, not including obstetric care, is
not paid by third party payers
Physician telephone calls are usually
require vast documentation and are typically not paid by third party payers
Care Plan Oversight Services for hospice and homebound patients
Labor leading to childbirth
Which of the following conditions would not require critical care?
anatomical site
Anesthesia codes are divided by
patient's status at the time of anesthesia
For anesthesia coding purposes, physical status modifiers are used to indicate
Both anesthesia guidelines and medicine
Where in the CPT manual are codes for anesthesia provided under difficult circumstances?
Which section of the CPT manual is the largest?
global surgical package
When one fee is used for a surgical procedure and uncomplicated follow-up care, this is called a(n)
Surgeries which are prolonged or extremely difficult are coded with the modifier
A code used to indicate that a physician assisted the primary surgeon in a major procedure is
The following are subsections of the surgery section of the CPT manual EXCEPT
the physician report
For coding purposes, information about the size of a lesion should come from
recipient site and defect
Free skin grafts are coded by
coded separately
For a breast biopsy, the placement of a wire marker is
site and treatment
Fractures are coded by
select the code that reflects the farthest extent of the procedure
To code diagnostic endoscopy procedures
Code groupings for arteries and veins vary according to
Codes for the digestive system are arranged by site, beginning with the mouth and ending with the
a diagnostic endoscopy
A surgical endoscopy always includes
identify the site from which it originated
When coding ostomies, it is critical to
not coded separately
When an exploratory laparotomy is used to surgical approach for another procedure, it is
by anatomic site of hernia
In the CPT index, hernia codes are listed
fallopian tubes
The code for a total hysterectomy includes removal of the
by anatomic site and type of procedure
Codes for the nervous system subsection of the CPT manual are divided
unilateral or bilateral orientation
When coding spinal procedures, consider all of the following EXCEPT
use a modifier to indicate the professional component
If a radiologist is reading films taken at another facility
surgery section
When contrast material is injected by a radiologist, the injection procedure code is taken from the
by anatomic site
Codes in the Diagnostic Radiology subsection are arranged
age of the patient
When coding radiation oncology, consider all of the following EXCEPT
brand names for lab equipment
Considerations when coding urinalysis and chemistry laboratory procedures include all of the following EXCEPT
a tooth
Level I pathology code 88300 identifies specimens that normally do not need to be viewed under a microscope such as
separate from initial care
If a physician spends 50 minutes with a patient after he or she has been admitted for a suicide attempt in connection with depression, the psychotherapy coding would be
The major factor for coding psychiatry is
The Physical Medicine codes are indications of types of modalities and
coded first
When coding trauma cases, the most severe injury is
The code for a simple drainage of a finger abscess is
the appropriate code for an indirect laryngoscopy with removal of foreign body is
The code for the complicated removal of a subcutaneous foreign body of the foot is
The code for a percutaneous needle core breast biopsy (without imaging) is
The appropriate code for a gastro code for a gastrojejunostomy without vagotomy is
The code for a complex arthrotomy of the knee (lateral) with meniscectomy is
The range of codes for newborn care is
The code for Subsequent Hospital Care which indicates physician visits for a patient in stable condition is
Which Emergency Department Services code indicates a need for immediate attention without the presence of a life-threatening condition?
The code for harvesting a small boat graft when the graft is not already listed as a part of the procedure is
The code for a simple repair of a superficial scalp wound not exceeding 2.5 cm in length is
The code for repair of a flexor tendon of the leg is
The preoperative placement of a needle localization wire in the breast is coded
If an arthroplasty is performed for reasons of a fractured ankle, it is coded
Which code describes a surgical thoracoscopy with excision-plication of bullae as well as pleural procedures?
The code for a coronary artery bypass graft using three arterial grafts is
The code for a partial colectomy with anastomosis is
Which code describes a laparoscopic vaginal hysterectomy with the removal of the ovaries?
The CPT that appropriately describes a set of obstetric laboratory tests for the first obstetric visit is
The highest level of pathology coding which would include examination of neoplastic tissue or very involved specimen is
Which code indicates an immunization for tetanus toxoid?
If a therapeutic infusion is introduced for up to 1 hour, which code is used?
A hemodialysis procedure requiring repeated evaluations would be coded as
ophthalmological services
Codes 92002 to 92014 deal with
Prosthetic training for the initial session of 15 minutes would be coded as
97750 X 2
A physical performance test or measurement that lasts 30 minutes and includes a written report is coded as
The proper code for a radiological exam of the eye for detection of a foreign body is
An x-ray of the gastrointestinal tract with a small bowel follow-through is coded
A bone density study by computerized tomography is coded as
Testicular imaging for vascular flow is coded as
An antibody test (nonspecific type) for herpes simplex virus is coded as
A cholera vaccination for the product only is coded as
The code for ordinary replacement of contact lens is