Certified Coding Specialist - Questions And
Accurate Answers (A+)
To assign modifier ______correctly, two physicians of different ________ must
have worked together as co-surgeons and each surgeon dictated his/her own
operative report. Correct Answer - -62
specialties
When more than two physicians work together to complete a complicated
procedure and each physician has a specific portion of the surgery to
complete, they are called.... Correct Answer - co-surgeons
This modifier indicates an increased service and is overused and results in an
increase in payment of 20% to 30%. As such, the assignment of this modifier
comes under particularly close scrutiny by third-party payers. What is this
modifier? Correct Answer - -22
When adding multiple CPT modifiers to a code, you would list the modifiers
from:
When adding multiple HCPCS modifiers, list in:
If CPT modifiers and HCPCS modifiers are both used, list: Correct Answer
- CPT- highest to lowest
HCPS-ascending alphabetical order
both- CPT (highest to lowest) then HCPS (ascend. alpha.)
What part of the CPT manual lists a full description for all modifiers?
Correct Answer - appendix A
When a CPT codes does not fully explain an unusual procedure,what should
be added to the code? Correct Answer - modifier
Third-Party payers require this modifier for a mandated service. Correct
Answer - -32
(like a rape test required by police, or phyiscal exam needed for workers
comp; third-party payer will pay 100% for mandated services)
,Modifier -47, anesthesia by the surgeon, is never added to what CPT code?
Correct Answer - Anesthesia Code
How many units of service may be billed when reporting the -50 modifier
(bilateral) to Medicare? Correct Answer - one unit
(For medicare, just submit 27447-50 for procedure done left and right;
whereas other payers want two lines 27447 and 27447-50.)
When reporting -51 modifier to indicate multiple procedure performed, which
procedure should be reported first on the claim? Correct Answer -
Primary Procedure
Medicare considers what service to be part of the surgery and bundled
payment not allowing the -56 modifier? Correct Answer - preoperative
E&M services provided the day before or the day of a major surgery are
included in what package? Correct Answer - Global Day
Modifier -63 indicates procedure provided to a neonate or infant up to what
weight? Correct Answer - 4 kg or 8.8 lbs
A surgical team consists of how many physicians? Correct Answer -
More than two
What is defined as a place of service specifically equipped and staffed for the
sole purpose of performing procedures? Correct Answer - Operating
Room
How many modifier area are available on a CMS-1500 insurance claim form
for one-line item charge? Correct Answer - four
Describing a physician's services in radiology or pathology. Correct
Answer - Professional component
Describing the services provided by the facility. Correct Answer -
Technical Component
, Bundling together of time effort and services for a specific procedure into one
code instead of reporting each component separately Correct Answer -
Surgical Package
Code assignments in the E/M section varies according to three factors:
Correct Answer - 1. place of service
2. type of service
3. patient status
Type of service (for E/M) examples Correct Answer - consultation,
admission, newborn care, office visit
Six sections of the CPT manual Correct Answer - Evaluation and
Management
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Medicine
Patient status (for E/M) Correct Answer - new, established, outpatient,
inpatient
A new patient is one who has not received a face-to-face professional service
from that physician or another physician in the same practice of the same
specialty for _____ years. Correct Answer - 3 years
Another name for the HCPCS Level II is: Correct Answer - national codes
The face-to-face encounter between a physician and a patient for primary
management of the patient's health status is a/an _____. Correct Answer -
office visit
The key component of E/M service is _____. Correct Answer - medical
decision-making
The four levels of medical decision-making complexity are: Correct
Answer - 1.straightforward
2.low
Accurate Answers (A+)
To assign modifier ______correctly, two physicians of different ________ must
have worked together as co-surgeons and each surgeon dictated his/her own
operative report. Correct Answer - -62
specialties
When more than two physicians work together to complete a complicated
procedure and each physician has a specific portion of the surgery to
complete, they are called.... Correct Answer - co-surgeons
This modifier indicates an increased service and is overused and results in an
increase in payment of 20% to 30%. As such, the assignment of this modifier
comes under particularly close scrutiny by third-party payers. What is this
modifier? Correct Answer - -22
When adding multiple CPT modifiers to a code, you would list the modifiers
from:
When adding multiple HCPCS modifiers, list in:
If CPT modifiers and HCPCS modifiers are both used, list: Correct Answer
- CPT- highest to lowest
HCPS-ascending alphabetical order
both- CPT (highest to lowest) then HCPS (ascend. alpha.)
What part of the CPT manual lists a full description for all modifiers?
Correct Answer - appendix A
When a CPT codes does not fully explain an unusual procedure,what should
be added to the code? Correct Answer - modifier
Third-Party payers require this modifier for a mandated service. Correct
Answer - -32
(like a rape test required by police, or phyiscal exam needed for workers
comp; third-party payer will pay 100% for mandated services)
,Modifier -47, anesthesia by the surgeon, is never added to what CPT code?
Correct Answer - Anesthesia Code
How many units of service may be billed when reporting the -50 modifier
(bilateral) to Medicare? Correct Answer - one unit
(For medicare, just submit 27447-50 for procedure done left and right;
whereas other payers want two lines 27447 and 27447-50.)
When reporting -51 modifier to indicate multiple procedure performed, which
procedure should be reported first on the claim? Correct Answer -
Primary Procedure
Medicare considers what service to be part of the surgery and bundled
payment not allowing the -56 modifier? Correct Answer - preoperative
E&M services provided the day before or the day of a major surgery are
included in what package? Correct Answer - Global Day
Modifier -63 indicates procedure provided to a neonate or infant up to what
weight? Correct Answer - 4 kg or 8.8 lbs
A surgical team consists of how many physicians? Correct Answer -
More than two
What is defined as a place of service specifically equipped and staffed for the
sole purpose of performing procedures? Correct Answer - Operating
Room
How many modifier area are available on a CMS-1500 insurance claim form
for one-line item charge? Correct Answer - four
Describing a physician's services in radiology or pathology. Correct
Answer - Professional component
Describing the services provided by the facility. Correct Answer -
Technical Component
, Bundling together of time effort and services for a specific procedure into one
code instead of reporting each component separately Correct Answer -
Surgical Package
Code assignments in the E/M section varies according to three factors:
Correct Answer - 1. place of service
2. type of service
3. patient status
Type of service (for E/M) examples Correct Answer - consultation,
admission, newborn care, office visit
Six sections of the CPT manual Correct Answer - Evaluation and
Management
Anesthesia
Surgery
Radiology
Pathology and Laboratory
Medicine
Patient status (for E/M) Correct Answer - new, established, outpatient,
inpatient
A new patient is one who has not received a face-to-face professional service
from that physician or another physician in the same practice of the same
specialty for _____ years. Correct Answer - 3 years
Another name for the HCPCS Level II is: Correct Answer - national codes
The face-to-face encounter between a physician and a patient for primary
management of the patient's health status is a/an _____. Correct Answer -
office visit
The key component of E/M service is _____. Correct Answer - medical
decision-making
The four levels of medical decision-making complexity are: Correct
Answer - 1.straightforward
2.low
