CDEO STUDY GUIDE QUESTIONS WITH COMPLETE
SOLUTION
Congestive |Heart |Failure |- |answerA |chronic |condition |in |which |the |heart |doesn't |pump |blood |as
|well |as |it |should.
Hypertension |- |answerA |condition |in |which |the |force |of |the |blood |against |the |artery |walls |is |too
|high.
HEDIS |- |answerHealthcare |Effectiveness |Data |and |Information |Set
HIPAA |- |answerHealth |Insurance |Portability |and |Accountability |Act
MPFS |- |answerMedicare |National |Physician |Fee |Schedule
Multiple |procedure |rule |- |answerThe |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 |- |answerIndicates |new |procedures |and |services |added |to |the |CPT |book.
Triangle |symbol |- |answerIndicates |that |the |description |of |the |code |has |been |revised
Opposing |horizontal |triangles |- |answerIndicates |new |and |revised |text, |other |than |in |procedure
|descriptors
Forbidden |symbol |- |answerIdentifies |codes |that |are |modifier |51 |exempt |and |exempt |from |the
|multiple |procedure |rule
, Bull's-eye |symbol |- |answerIdentifies |codes |that |include |moderate |sedation. |When |this |is |located
|next |to |a |code, |moderate |sedation |can |not |be |reported |separately.
Unlisted |procedure |code |- |answerThese |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 |- |answerThe |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 |- |answerDescription |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 |- |answerAnatomical |place, |position, |or |site |of |the |chief |complaint.
Quality |- |answerCharacteristics |about |the |problem, |such |as |how |it |looks |or |feels.
Severity |- |answerA |degree |or |measurement |of |how |bad |it |is.
Duration |- |answerHow |long |the |chief |complaint |has |been |occurring, |or |the |time |when |the |complaint
|occurred,
Timing |- |answerMeasurement |of |when |or |at |what |frequency |they |noticed |the |complaint.
Context |- |answerWhat |the |patient |was |doing, |their |environmental |factors, |the |circumstances
|surrounding |the |complaint.
SOLUTION
Congestive |Heart |Failure |- |answerA |chronic |condition |in |which |the |heart |doesn't |pump |blood |as
|well |as |it |should.
Hypertension |- |answerA |condition |in |which |the |force |of |the |blood |against |the |artery |walls |is |too
|high.
HEDIS |- |answerHealthcare |Effectiveness |Data |and |Information |Set
HIPAA |- |answerHealth |Insurance |Portability |and |Accountability |Act
MPFS |- |answerMedicare |National |Physician |Fee |Schedule
Multiple |procedure |rule |- |answerThe |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 |- |answerIndicates |new |procedures |and |services |added |to |the |CPT |book.
Triangle |symbol |- |answerIndicates |that |the |description |of |the |code |has |been |revised
Opposing |horizontal |triangles |- |answerIndicates |new |and |revised |text, |other |than |in |procedure
|descriptors
Forbidden |symbol |- |answerIdentifies |codes |that |are |modifier |51 |exempt |and |exempt |from |the
|multiple |procedure |rule
, Bull's-eye |symbol |- |answerIdentifies |codes |that |include |moderate |sedation. |When |this |is |located
|next |to |a |code, |moderate |sedation |can |not |be |reported |separately.
Unlisted |procedure |code |- |answerThese |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 |- |answerThe |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 |- |answerDescription |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 |- |answerAnatomical |place, |position, |or |site |of |the |chief |complaint.
Quality |- |answerCharacteristics |about |the |problem, |such |as |how |it |looks |or |feels.
Severity |- |answerA |degree |or |measurement |of |how |bad |it |is.
Duration |- |answerHow |long |the |chief |complaint |has |been |occurring, |or |the |time |when |the |complaint
|occurred,
Timing |- |answerMeasurement |of |when |or |at |what |frequency |they |noticed |the |complaint.
Context |- |answerWhat |the |patient |was |doing, |their |environmental |factors, |the |circumstances
|surrounding |the |complaint.
