Ch. 7: HCPCS Level II National Coding
System Test-Graded A
HCPCS level II national codes were developed to complement the CPT coding system
and were introduced in... - ANSWER-1983 after Medicare found that its payers used
more than 100 different coding systems, making it difficult to analyze claims data.
The reason for the introduction to HCPCS level II was to... - ANSWER-furnish health
care providers and suppliers with a standardized language for reporting professional
and nonphysician services, procedures, supplies, and equipment.
CPT codes are considered... - ANSWER-HCPCS level I codes.
CMS developed HCPCS level II national codes to report: - ANSWER-DMEPOS and
other services.
CPT (HCPCS level I) codes are developed and published by the: - ANSWER-AMA
(American Medical Association)
Which codes are five characters in length, and begin with the letters A-V followed by
four numbers? - ANSWER-HCPCS level II codes
T codes - ANSWER-Reported to state Medicaid agencies when no HCPCs level II
permanent codes exist, but codes are needed to administer the Medicaid program.
These codes are not reported to Medicare, but they can be reported to private TPPs.
CMS has clarified that the use of HCPCS level I and II codes are reported for.... -
ANSWER-outpatient hospital services.
Do not add a modifier to a HCPCS level I or II code when its description indicates
multiple occurrences, such as: - ANSWER-* two or more lesions
* multiple extremities
* different body parts
Modifiers -GN, -GO, and -GP are added to codes reported for an outpatient plan of
care: - ANSWER-* Speech language therapy (-GN)
* Occupational therapy (-GO)
* Physical therapy (-GP)
, Which modifiers are added to codes reported for hospital outpatient surgical procedures
from the "CPT Surgery" section and certain codes from the "CPT Medicine" section
only? - ANSWER-* Modifier -50
(Bilateral Procedure)
* Modifier -73
(Discontinued Outpatient Hospital/ASC Procedure Prior to the Administration of
Anesthesia)
* Modifier - 74
(Discontinued Outpatient Hospital/ASC Procedure After the Administration of
Anesthesia)
Modifier -73 - ANSWER-Discontinued Outpatient Hospital/ASC Procedure Prior to the
Administration of Anesthesia
Modifier -74 - ANSWER-Discontinued Outpatient Hospital/ASC Procedure After the
Administration of Anesthesia
For physician services, what modifiers are added to codes reported for Surgery and
Medicine procedures? - ANSWER--50 (Bilateral Procedure)
-52 (Reduced Services)
-53 (Discontinued Procedure)
On a UB-04 claim, where are modifiers reported? - ANSWER-In Form Locator 44
On a CMS-1500 claim form, where are modifiers reported? - ANSWER-In Block 24D
On a UB-04 claim, up to how many modifiers can be reported? - ANSWER-Two; one in
field 6 and one in field 7.
Should I report the dash line that precedes a modifier? - ANSWER-No, do not report the
dash.
When multiple modifiers are added to a code, which should be reported first? -
ANSWER-The one that is the most specific is listed first.
Should modifier -50 be added to E/M, Anesthesia, Radiology, Pathology and
Laboratory, or Medicine procedures and services? - ANSWER-No.
Should modifier -50 be added to HCPCS level II codes? - ANSWER-No.
What modifiers are added to diagnostic and surgical procedure codes so hospitals can
be reimbursed for expenses incurred during the preparation of a patient for surgery,
which includes scheduling a room for performing the procedure? - ANSWER-modifiers -
73 and -74; they are modifiers for discontinued procedures for Outpatient Hospital/ASC
System Test-Graded A
HCPCS level II national codes were developed to complement the CPT coding system
and were introduced in... - ANSWER-1983 after Medicare found that its payers used
more than 100 different coding systems, making it difficult to analyze claims data.
The reason for the introduction to HCPCS level II was to... - ANSWER-furnish health
care providers and suppliers with a standardized language for reporting professional
and nonphysician services, procedures, supplies, and equipment.
CPT codes are considered... - ANSWER-HCPCS level I codes.
CMS developed HCPCS level II national codes to report: - ANSWER-DMEPOS and
other services.
CPT (HCPCS level I) codes are developed and published by the: - ANSWER-AMA
(American Medical Association)
Which codes are five characters in length, and begin with the letters A-V followed by
four numbers? - ANSWER-HCPCS level II codes
T codes - ANSWER-Reported to state Medicaid agencies when no HCPCs level II
permanent codes exist, but codes are needed to administer the Medicaid program.
These codes are not reported to Medicare, but they can be reported to private TPPs.
CMS has clarified that the use of HCPCS level I and II codes are reported for.... -
ANSWER-outpatient hospital services.
Do not add a modifier to a HCPCS level I or II code when its description indicates
multiple occurrences, such as: - ANSWER-* two or more lesions
* multiple extremities
* different body parts
Modifiers -GN, -GO, and -GP are added to codes reported for an outpatient plan of
care: - ANSWER-* Speech language therapy (-GN)
* Occupational therapy (-GO)
* Physical therapy (-GP)
, Which modifiers are added to codes reported for hospital outpatient surgical procedures
from the "CPT Surgery" section and certain codes from the "CPT Medicine" section
only? - ANSWER-* Modifier -50
(Bilateral Procedure)
* Modifier -73
(Discontinued Outpatient Hospital/ASC Procedure Prior to the Administration of
Anesthesia)
* Modifier - 74
(Discontinued Outpatient Hospital/ASC Procedure After the Administration of
Anesthesia)
Modifier -73 - ANSWER-Discontinued Outpatient Hospital/ASC Procedure Prior to the
Administration of Anesthesia
Modifier -74 - ANSWER-Discontinued Outpatient Hospital/ASC Procedure After the
Administration of Anesthesia
For physician services, what modifiers are added to codes reported for Surgery and
Medicine procedures? - ANSWER--50 (Bilateral Procedure)
-52 (Reduced Services)
-53 (Discontinued Procedure)
On a UB-04 claim, where are modifiers reported? - ANSWER-In Form Locator 44
On a CMS-1500 claim form, where are modifiers reported? - ANSWER-In Block 24D
On a UB-04 claim, up to how many modifiers can be reported? - ANSWER-Two; one in
field 6 and one in field 7.
Should I report the dash line that precedes a modifier? - ANSWER-No, do not report the
dash.
When multiple modifiers are added to a code, which should be reported first? -
ANSWER-The one that is the most specific is listed first.
Should modifier -50 be added to E/M, Anesthesia, Radiology, Pathology and
Laboratory, or Medicine procedures and services? - ANSWER-No.
Should modifier -50 be added to HCPCS level II codes? - ANSWER-No.
What modifiers are added to diagnostic and surgical procedure codes so hospitals can
be reimbursed for expenses incurred during the preparation of a patient for surgery,
which includes scheduling a room for performing the procedure? - ANSWER-modifiers -
73 and -74; they are modifiers for discontinued procedures for Outpatient Hospital/ASC
