Questions and CORRECT Answers
Who created the first comprehensive disease classification system in the United States in 1869? -
CORRECT ANSWER - American Medical Association (AMA)
What are the main reasons to use procedure coding? - CORRECT ANSWER - To justify
medical services to insurance companies by correlating procedures to diagnosis
To collect statistics about the outcome and effectiveness of treatments
To help physicians and hospitals set fees based on the amount of time and skill required to
provide a specific service
How often are level I codes updated? - CORRECT ANSWER - annually
Who updates and publishes the CPT manual? - CORRECT ANSWER - American Medical
Association(AMA)
HCPCS level II codes include what services that are not in the CPT system and may not be
covered by insurance? - CORRECT ANSWER - procedures, injections, and durable
medical equipment covered by Medicare
How often should updated code books be purchased? - CORRECT ANSWER - every year
CPT manual contains codes which are usually how many digits long? - CORRECT
ANSWER - five-digit code
What is a modifier and how many digits are they? - CORRECT ANSWER - An addition to
a Current Procedural Terminology code that indicates unusual circumstances related to the
procedure, such as a more extensive procedure or two procedures performed in the same session.
, two-digit
What pieces of information may be significant when choosing the correct code for a procedure? -
CORRECT ANSWER - - Location
- Size of lesion or repair
- Method of performing the procedure, test, or surgery
- Number of minutes allotted for a treatment (e.g., acupuncture)
- Complexity of the procedure or service
What are the two types of CPT codes? - CORRECT ANSWER - stand-alone codes and
indented codes
If a patient comes in for an exam and has an electrocardiogram done, per the physician's orders,
is this billed under the examination or separately, under its own code? - CORRECT
ANSWER - Separately
What type of services and providers would find their appropriate codes in the E/M section? -
CORRECT ANSWER - office visits provided by primary care practitioners and
specialists.
Define established patient. - CORRECT ANSWER - A patient who has been seen by one
of the physicians in the practice within the past 3 years.
Define new patient. - CORRECT ANSWER - one who has not had services performed by
any provider in the medical office in the previous 3 years
Define inpatient. - CORRECT ANSWER - a patient who has been formally admitted to a
healthcare facility