CPT/HCPCS coding 3 chapter 1

__________ must accompany claims when an unusual, new, seldom used, or Category I unlisted code or Category III code is usubmitted? - answer-Special report - used to describe the nature, extent, and need for the procedure or service & the time, effort and equipment necessary to provide the service. ___________ provide specific information about coding in a given section of the CPT and contain valuable information for the coder. They are found at the beginning of each section and may contain definitions of terms, applicable modifiers, subsection information, unlisted services, special reports information, or clinical examples. - answer-CPT guidelines and notes ____________ provide additional information or "adds to the story" regarding services provided to a patient when the regular five digit CPT code does not completely reflect the service or procedure provided? - answer-Modifiers, (2 digits, 2 letters, letter & number) 1.) Codes that contain a full description? 2.) Codes that are listed & indented under stand alone codes? 3.) In CPT it is understood that descriptions for indented codes include the____________? - answer-1.) Stand-alone codes 2.) Indented codes 3.) portion of the associated stand-alone code description that precedes the semicolon. 1.) HCPCS stands for_______? 2.) It is divided into________? - answer-1.) Healthcare Common Procedural Coding System 2.) Level I = CPT codes & Level II = National Codes A procedure or service not found in the CPT manual can be coded as an _______ procedure only if________? - answer-unlisted procedure, only if no Category I CPT or Category III code is available. According to the CPT manual, modifier 91 is not to be used when tests are _____to confirm initial results? - answer-Rerun. According to the E/M guidelines, time is not a component for the...? - answer-Emergency dept. of E/M Services. (E/M - Evaluation and Management pg. 7) According to the surgery guidelines, destruction can be considered part of - answer-integral to a procedure. Acode that has all of the words in the code that follows is ______? - answer-stand-alone Category I CPT codes have how many digits? - answer-5 CPT are incorporated as Level ________codes? - answer-Level I codes CPT codes are referred to as Category ____codes? - answer-Category I CPT stands for_________? - answer-Current Procedural Terminology Ending in F, optional performance measures (e.g. 3014F, Screening Mammography) are _____________codes? - answer-Category II Ending in T, temporary codes that identify emerging technologies, services, and procedures are _______codes?. - answer-Category III Experimental, newly approved or seldom used procedures? - answer-unlisted/Category III Healthcare providers' are________based on the code submitted on a claim for procedure and services? Reimbursed. - answer-The CMS-1500. (Used to be called the HCFA - name does not exist anymore changed to CMS). How are add-on codes reported? - answer-An add-on code can not be used alone. The code that the add-on is associated with must be sequenced first. How many main sections are in the CPT manual? - answer-6. How often are Category III codes released? - answer-Twice a year. In which CPT Appendix would additions, deletions, and revisions be found? - answer-Appendix B. In which CPT Appendix would all modifiers be found? - answer-Appendix A. Level ______ codes/National Codes are alphanumeric codes used by providers to report services, supplies, and equipment provided to Medicare and Medicaid patients for which no CPT codes exist. - answer-Level II codes Level II codes are not used in what type of setting? - answer-Inpatient setting (Use the procedures in the back of ICD-9-CM) National Codes are used by health care facilities in - answer-outpatient settings. (Volume 3 is used for these inpatient procedures.) Symbol for modifier -51 (indicating multiple procedures) exempt codes? - answer-Null symbol aka. circle with a line through it (think "no smoking" symbol) Symbols with definitions are located - answer-at the bottom of the page in the CPT manual. The CPT coding system was first developed by the______ in ________ ? - answer-AMA, 1966 The CPT Index contains four primary classes of entries. They are:_______? - answer-1.) Procedure or service 2.) Organ or other anatomic site 3.) Condition 4.) Synonyms, Eponyms, and Abbreviations The CPT was incorporated as LEVEL I codes into the HCPCS system by the _________ - answer-CMS in 1983