HCPCS, ICD, CPT, and CMS-
1500 (chapter 8 & 11) Exam
HCPCS codes - answer-generally for products, supplies, and services, things like
ambulance services, durable medical equipment, prosthetics, and orthotics that aren't
represented by CPT codes; ensure uniform reporting of medical products or services on
claims
excludes1 - answer-not coded here
excludes2 - answer-Not included here
modifiers are appended to CPT codes in order to: - answer-clarify the procedure or
service
to go directly to the table of neoplasms, you must know ___ and the ___ of the
neoplasm. - answer-classification, site
reporting lesion excision requires: - answer-knowing the size including the margins or
the lesion, and knowing whether the lesion is benign or malignant
What are the key components of E/M? - answer-1. History
-Chief complaint
-History of Present illness
-Review of Symptoms
-Past, Family and Social History
2. Physical Exam
3.Medical Decision Making Complexity
in what section of CPT are lesion removal codes found? - answer-surgery
HCPCS level II codes are also known as: - answer-permanent national codes
when there is a CPT code and a HCPCS level II code available to report a service,
which code should be reported? - answer-depends on payer policy
when reporting more than one diagnosis on a claim: - answer-guidelines within ICD-10-
CM should be followed
coding directly from the index could result in: - answer-inaccurate coding, rejected
claims, and inappropriate reimbursement
, when the site of a burn is not specified, ______. - answer-code only according to the
extent of body surface involved
when the patient is seen for pain related to a neoplasm _____. - answer-list the pain
diagnosis first
underdosing refers to _____. - answer-patient taking less than prescribed
when assigning an E/M code visit for an established patient, how many key components
must be considered? - answer-2 - physical exam and medical decision making since an
established patient has had their PFSH (past, family, and social history) taken already
once the coder has read through the source document, the next step is to: - answer-
identify the main term and locate it in the index
HCPCS level II modifiers: - answer-can be used with CPT of HCPCS level II codes
Found in Apendix B in the back of the book
the purpose of temporary codes is: - answer-to allow payers to assign codes needed
before the next update
which HCPCS codes are used to report drugs purchased by and administered by a
physician's office? - answer-J codes
the development of an insurance claim begins when the: - answer-patient contacts the
office and makes an appointment
the only form of punctuation allowed on a CMS-1500 is a: - answer-comma
only ___ ICD-10-CM codes are entered on a single claim form. - answer-twelve
when a patient allows the provider to bill their insurance company and collect payment
from the insurer, this is known as: - answer-assignment of benefits
the from and to date field in block 24 of the CMS-1500 should be completed when: -
answer-the same service is provided on consecutive dates
what should be entered in blocks 12 and 13 on the CMS-1500? - answer-the patient's
handwritten signature or signature on file (SOF)
the first-listed diagnosis on a claim should be the: - answer-main reason patient was
seen
what codes are used by physicians to report patient service provided in a hospital
setting? - answer-CPT
1500 (chapter 8 & 11) Exam
HCPCS codes - answer-generally for products, supplies, and services, things like
ambulance services, durable medical equipment, prosthetics, and orthotics that aren't
represented by CPT codes; ensure uniform reporting of medical products or services on
claims
excludes1 - answer-not coded here
excludes2 - answer-Not included here
modifiers are appended to CPT codes in order to: - answer-clarify the procedure or
service
to go directly to the table of neoplasms, you must know ___ and the ___ of the
neoplasm. - answer-classification, site
reporting lesion excision requires: - answer-knowing the size including the margins or
the lesion, and knowing whether the lesion is benign or malignant
What are the key components of E/M? - answer-1. History
-Chief complaint
-History of Present illness
-Review of Symptoms
-Past, Family and Social History
2. Physical Exam
3.Medical Decision Making Complexity
in what section of CPT are lesion removal codes found? - answer-surgery
HCPCS level II codes are also known as: - answer-permanent national codes
when there is a CPT code and a HCPCS level II code available to report a service,
which code should be reported? - answer-depends on payer policy
when reporting more than one diagnosis on a claim: - answer-guidelines within ICD-10-
CM should be followed
coding directly from the index could result in: - answer-inaccurate coding, rejected
claims, and inappropriate reimbursement
, when the site of a burn is not specified, ______. - answer-code only according to the
extent of body surface involved
when the patient is seen for pain related to a neoplasm _____. - answer-list the pain
diagnosis first
underdosing refers to _____. - answer-patient taking less than prescribed
when assigning an E/M code visit for an established patient, how many key components
must be considered? - answer-2 - physical exam and medical decision making since an
established patient has had their PFSH (past, family, and social history) taken already
once the coder has read through the source document, the next step is to: - answer-
identify the main term and locate it in the index
HCPCS level II modifiers: - answer-can be used with CPT of HCPCS level II codes
Found in Apendix B in the back of the book
the purpose of temporary codes is: - answer-to allow payers to assign codes needed
before the next update
which HCPCS codes are used to report drugs purchased by and administered by a
physician's office? - answer-J codes
the development of an insurance claim begins when the: - answer-patient contacts the
office and makes an appointment
the only form of punctuation allowed on a CMS-1500 is a: - answer-comma
only ___ ICD-10-CM codes are entered on a single claim form. - answer-twelve
when a patient allows the provider to bill their insurance company and collect payment
from the insurer, this is known as: - answer-assignment of benefits
the from and to date field in block 24 of the CMS-1500 should be completed when: -
answer-the same service is provided on consecutive dates
what should be entered in blocks 12 and 13 on the CMS-1500? - answer-the patient's
handwritten signature or signature on file (SOF)
the first-listed diagnosis on a claim should be the: - answer-main reason patient was
seen
what codes are used by physicians to report patient service provided in a hospital
setting? - answer-CPT
