CDEO Study Guide UPDATED ACTUAL
Exam Questions and CORRECT Answers
Congestive Heart Failure - CORRECT ANSWER - A chronic condition in which the heart
doesn't pump blood as well as it should.
Hypertension - CORRECT ANSWER - A condition in which the force of the blood
against the artery walls is too high.
HEDIS - CORRECT ANSWER - Healthcare Effectiveness Data and Information Set
HIPAA - CORRECT ANSWER - Health Insurance Portability and Accountability Act
MPFS - CORRECT ANSWER - Medicare National Physician Fee Schedule
Multiple procedure rule - CORRECT ANSWER - The highest value code is paid at 100%.
The second highest value code is paid at 50%. Each additional code is paid at 25%. Add on
codes are exempt from the multiple procedure rule. They are paid at 100%.
Bullet symbol - CORRECT ANSWER - Indicates new procedures and services added to
the CPT book.
Triangle symbol - CORRECT ANSWER - Indicates that the description of the code has
been revised
Opposing horizontal triangles - CORRECT ANSWER - Indicates new and revised text,
other than in procedure descriptors
Forbidden symbol - CORRECT ANSWER - Identifies codes that are modifier 51 exempt
and exempt from the multiple procedure rule
, Bull's-eye symbol - CORRECT ANSWER - Identifies codes that include moderate
sedation. When this is located next to a code, moderate sedation can not be reported separately.
Unlisted procedure code - CORRECT ANSWER - These are reported when an existing
CPT code does not describe the procedure. To facilitate these claims, provide the operative
report and suggest an appropriate fee.
Chief complaint - CORRECT ANSWER - The reason for the encounter. A CC is required
for every encounter except a preventive service. If the CC is missing, you are to report CPT code
99499: Unlisted E&M service. "Follow up" can not be the reason for the visit.
HPI - CORRECT ANSWER - Description of the development of the patient's illness from
the list of signs or symptoms, or from the previous encounter, to the present. The provider must
document the HPI. There are 8 elements of the HPI.
Location - CORRECT ANSWER - Anatomical place, position, or site of the chief
complaint.
Quality - CORRECT ANSWER - Characteristics about the problem, such as how it looks
or feels.
Severity - CORRECT ANSWER - A degree or measurement of how bad it is.
Duration - CORRECT ANSWER - How long the chief complaint has been occurring, or
the time when the complaint occurred,
Timing - CORRECT ANSWER - Measurement of when or at what frequency they noticed
the complaint.
Exam Questions and CORRECT Answers
Congestive Heart Failure - CORRECT ANSWER - A chronic condition in which the heart
doesn't pump blood as well as it should.
Hypertension - CORRECT ANSWER - A condition in which the force of the blood
against the artery walls is too high.
HEDIS - CORRECT ANSWER - Healthcare Effectiveness Data and Information Set
HIPAA - CORRECT ANSWER - Health Insurance Portability and Accountability Act
MPFS - CORRECT ANSWER - Medicare National Physician Fee Schedule
Multiple procedure rule - CORRECT ANSWER - The highest value code is paid at 100%.
The second highest value code is paid at 50%. Each additional code is paid at 25%. Add on
codes are exempt from the multiple procedure rule. They are paid at 100%.
Bullet symbol - CORRECT ANSWER - Indicates new procedures and services added to
the CPT book.
Triangle symbol - CORRECT ANSWER - Indicates that the description of the code has
been revised
Opposing horizontal triangles - CORRECT ANSWER - Indicates new and revised text,
other than in procedure descriptors
Forbidden symbol - CORRECT ANSWER - Identifies codes that are modifier 51 exempt
and exempt from the multiple procedure rule
, Bull's-eye symbol - CORRECT ANSWER - Identifies codes that include moderate
sedation. When this is located next to a code, moderate sedation can not be reported separately.
Unlisted procedure code - CORRECT ANSWER - These are reported when an existing
CPT code does not describe the procedure. To facilitate these claims, provide the operative
report and suggest an appropriate fee.
Chief complaint - CORRECT ANSWER - The reason for the encounter. A CC is required
for every encounter except a preventive service. If the CC is missing, you are to report CPT code
99499: Unlisted E&M service. "Follow up" can not be the reason for the visit.
HPI - CORRECT ANSWER - Description of the development of the patient's illness from
the list of signs or symptoms, or from the previous encounter, to the present. The provider must
document the HPI. There are 8 elements of the HPI.
Location - CORRECT ANSWER - Anatomical place, position, or site of the chief
complaint.
Quality - CORRECT ANSWER - Characteristics about the problem, such as how it looks
or feels.
Severity - CORRECT ANSWER - A degree or measurement of how bad it is.
Duration - CORRECT ANSWER - How long the chief complaint has been occurring, or
the time when the complaint occurred,
Timing - CORRECT ANSWER - Measurement of when or at what frequency they noticed
the complaint.
