Correct Answers
What organization is responsible for updating CPT codes - answer-American Medical
Association
What organization is responsible for maintaining HCPCS level II Codes - answer-
Centers for Medical Services
What code set describels medical necessity - answer-ICD-10-CM
Dr Smith saw a medicare pt. w/ a dx of rectal abscess in Certral Hospital. She
performed an incision and drainage in the outpatient surgery department.
Which coding system describes the rectal abscess?
Which would hospital use to bill for surgical services?
Which would Dr. Smity use to report surgical services? - answer-ICD
CPT
CPT
Place a mark in front of all dx. that would support medical necessity for CPT code
92550- tympanometry and reflex threshold measurement - answer-All but paralysis
Which of the following CPT codes would be linked to the diagnosis E80 Enterobiasis? -
answer-Pinworm Exam
What Coding system is used for Physician offices - answer-ICD 10 cm for DX
CPT, HCPCS for procedure
What Coding system is used for Hospital Outpatient Services - answer-ICD 10 cm for
DX
CPT, HCPCS for procedure
What Coding system is used for Hospital Inpatient - answer-ICD 10 cm for DX
ICD 10 PCS for procedure
Category 1 codes - answer-Supplementary tracking codes, for use in performance
assessment and quality improvemetn activities
Category II codes - answer-Optional, some payers may require
monitor internal performance for key measures, no charge
Category III codes - answer-temporary codes: emerging technology, document the
unconventional methods so that their efficacy and outcomes can be documented.
, Purpose of coding - answer-transform information into a code for payment purposes
serves as a method of communication between professions
compare reimbursement rates
speed claim process
provide data on trending and planning
∙ Bullet symbol signifies - answer-New code
triangle symbol signifies - answer-changes
appendix B - answer-revisions, deletions, additions
appendix D - answer-lists all add on codes
Facing triangle symbol signifies - answer-indicates new or revised text
Plus sign symbol signifies - answer-designed as an add-on code
Null symbol signifies - answer-Exemption to modifier 51
lightning bolt type symbol signifies - answer-Pending FDA approval
# symbol signifies - answer-resequenced code
STAR symbol signifies - answer-telemedicine. this in new in 2017
Patient visits physician office for a sore throat. The services for this patient would be
submitted on what claim form? - answer-CMS1500
Billing form for physician office and outpatient services - answer-CMS1500
In what CPT appendix would all modifiers be found - answer-Appendix A
CPT manual is updated for USE in - answer-January every year. (October is when it's
done, January starts USE)
What are category II CPT codes used for? - answer-Supplemental tracking codes for
performance assessment
HCPCS was developed by - answer-CMS
Pt seen in clinic for laceration of knee- Wound requires sutureing- which of the following
types of codes would be assigned to represent the repair (suture) on a claim form? -
answer-CPT