CPMA Exam Chapter 3 Questions And
Answers
When the list of associated add-on codes is too extensive, there will not be a list of
applicable primary codes in a parenthetical note following the add-on code
All add-on codes are exempt from the multiple procedure concepts (modifier 51) See
Appendix A
Multiple surgical procedure reduction is applied when multiple procedures are performed
during the same operative session.
The highest valued code is paid at 100%
The 2nd highest valued code is paid at 50%.
And each additional procedure is paid at 25%
If a claim exceeds five line items, payers may evaluate for special pricing
, CPMA Exam Chapter 3 Questions And
Answers
The fee schedule for add-on codes already accounts for the reduction, and the payment is
made at 100%
The Medicare National Physician Fee Schedule (MPS) Relative Value File is useful for
determining if procedures are subject to the multiple procedure payment reduction.
If there is a "0" in the Multiple Procedure column, the procedure is not subject to the multiple
procedure payment reduction
If there is a "2" in the multiple procedure column, the procedure is subjected to the multiple
procedure payment reduction.
The Medicare National Physician Fee Schedule (MPS) Relative Value File contains information
for global days, RVUs, assist surgeon appropriate, etc
ALL AUDITORS should use this during the audit process.
A triangle symbol located to the left of a code indicates that the description of the code
has been revised.
Answers
When the list of associated add-on codes is too extensive, there will not be a list of
applicable primary codes in a parenthetical note following the add-on code
All add-on codes are exempt from the multiple procedure concepts (modifier 51) See
Appendix A
Multiple surgical procedure reduction is applied when multiple procedures are performed
during the same operative session.
The highest valued code is paid at 100%
The 2nd highest valued code is paid at 50%.
And each additional procedure is paid at 25%
If a claim exceeds five line items, payers may evaluate for special pricing
, CPMA Exam Chapter 3 Questions And
Answers
The fee schedule for add-on codes already accounts for the reduction, and the payment is
made at 100%
The Medicare National Physician Fee Schedule (MPS) Relative Value File is useful for
determining if procedures are subject to the multiple procedure payment reduction.
If there is a "0" in the Multiple Procedure column, the procedure is not subject to the multiple
procedure payment reduction
If there is a "2" in the multiple procedure column, the procedure is subjected to the multiple
procedure payment reduction.
The Medicare National Physician Fee Schedule (MPS) Relative Value File contains information
for global days, RVUs, assist surgeon appropriate, etc
ALL AUDITORS should use this during the audit process.
A triangle symbol located to the left of a code indicates that the description of the code
has been revised.
