CPT Final Exam

CPT Final Exam CPT and HCPCS codes are used in what type of healthcare setting? - Hospital outpatient, physician offices CPT is - current procedural terminology HCPCS is - healthcare common procedure coding system Who publishes CPT (Level I HCPCS)? How often is it updated? When is it updated? - AMA publishes cpt, it is updated annually, on Jan. 1 of each year CPT Category 1 codes consist of: - Anesthesia, Evaluation and management, surgery, radiology, pathology and laboratory, medicine What are Category 2 CPT codes for? What does the Category 2 code consist of? - Performance Measures consist of 4 numbers followed by a capital F, such as 1000F What are Category 3 CPT codes for? What does the Category 3 code consist of? - New & Emerging Technology consist of 4 numbers followed by a capital T, such as 2000T What are modifiers Why are they used? - Supplementary Codes to provide additional information to a code What is a HCPCS level II code used to report? What does the HCPCS level II code consist of? - Are used for supplies, DME, injectable substances, dental and chiropractic as well as orthotics Structure: J1885 - capital letter followed by 4 numbers What are HCPCS level II codes also called? - National codes Who developed the HCPCS level II codes? How often are they updated? When are they updated? - Developed by CMS, they are updated yearly update Jan1 NCCI - National Correct Coding Initiative What does the National Correct Coding Initiative edits do? - Helps CMS to detect inappropriate codes submitted on claims - CPT coding guidelines - Current standards of medical/surgical coding practice - Advice from specialty societies List 3 NCCI edits and the definition of those edits. - 1. Comprehensive/component edit = edit pertains to HCPCS codes that should NOT be used together. 2. Mutually exclusive edit = edit applies to improbable or impossible combinations of codes 3. Medical unlikely edits =