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Chapter 9 - Introduction to CPT Coding

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; - answer-Semicolon Symbol Save space, some CPT Code description are NOT printed next to a code number Entry is indented Must refer back to the common portion of the code description that is located BEFORE the semicolon (True/False) All payers accept claims that contain CPT Category II Codes. - answer-False. Some payers can deny claims that contain CPT Category II Codes (True/False) Bundling procedure codes are NOT separately coded and reported with the major procedure code - answer-True (True/False) CPT codes and descriptions are based on consistency with contemporary medical practice and are performed by clinical providers throughout the country - answer-True (True/False) Do not add a modifier to a CPT Unlisted procedure/service does because they do not include specific descriptions that would justify modifying their meaning - answer-True + - answer-Plus Symbol identifies add-on codes (Appendix D of CPT) for procedures that are commonly, but NOT always performed at the same time and by the same surgeon as the primary procedure A/B MACs - answer-MACs that process both hospital inpatient/outpatient and Medicare Parts A & B for physicians for claims Add-on Code - answer-reported when another procedure is performed in addition to the primary procedure during the same operative session and must never be reported as a stand-alone code Do not report Modifier -50 with add-on codes Bilateral procedures, the add-on code is reported twice Advanced Beneficiary Note (ABN) - answer-a form completed and signed by a medical beneficiary each time a provider believes a normally covered service will NOT be covered and provider wants beneficiary billed directly Appendix A - answer-Modifiers contains a list of CPT Modifiers and detailed descriptions Appendix B - answer-Summary of Additions, Deletions, and Revisions Service as the basis for updating interoffice documents and billing tools Appendix C - answer-Clinical Examples Contain clinical examples for codes found in the Evaluation/Management section Appendix D - answer-Summary of CPT Add-on Codes Contains a list of add-on codes that are identified throughout CPT with a "+" symbol Appendix E - answer-Summary of CPT Code exempts from Modifier -51 contains a list of codes that are exempt from Modifier -51 reported ruled and are identified throughout CPT with a Forbidden Symbol Appendix F - answer-Summary of CPT Codes Exempt from Modifier -63 contains a list of codes that are exempt from Modifier -63 Appendix G - answer-Summary of CPT codes that include moderate (conscious) Sedation removed from the CPT Coding Manual Appendix H - answer-Alphabetic Clinical Topics Listing was removed from CPT Coding manual and relocated to the AMA website with access available only to AMA Members - who must be physicians, medical graduates, and medical students Appendix I - answer-Genetic Testing Code Modifiers removed from the CPT Coding Manual Appendix J - answer-Electrodiagnostic Medicine Listing of Sensory, Motor, and Mixed Nerves contains an electrodiagnostic medicine, listing of sensory, motor and mixed nerves that are reported for motor and nerves studies EMG/Nerve Conduction Studies AMA CPT Changes 2006 - A Tool to Detect Outliers Appendix K - answer-Product pending FDA Approval Contains a list of products that are pending FDA Approval but they have been assigned CPT codes preceded by a flashing symbol Appendix L - answer-Vascular Families contains a list of vascular families that is intended to assist in the selection first-, second-, third-,. and beyond third-order branch arteries Appendix M - answer-Remembered CPT Codes - Citations Crosswalk contains a summary of cross walked deleted and renumbered codes and citations from (AMA discontinued practice in 2010) Appendix N - answer-Summary of Resequenced CPT Codes contains a list of CPT Codes that do not appear in numeric order so that existing codes can be relocated to a more appropriate location preceded by the number "#" symbol Appendix O - answer-Multianalyte Assays with Algorithmic Analyses MAAA includes administrative codes for procedure that by their nature are typically unique procedures that by their nature are typically unique to a single clinical laboratory or manufacturer Appendix P - answer-CPT Codes that may be used for synchronous telemedicine services includes codes for electronic communication using interactive telecommunications equipment c

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2024/2025
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Voorbeeld van de inhoud

CHAPTER 9 - INTRODUCTION
TO CPT CODING




a

, CHAPTER 9 - INTRODUCTION TO CPT
CODING
; - answer-Semicolon Symbol

Save space, some CPT Code description are NOT printed next to a code number

Entry is indented

Must refer back to the common portion of the code description that is located
BEFORE the semicolon

(True/False) All payers accept claims that contain CPT Category II Codes. -
answer-False. Some payers can deny claims that contain CPT Category II Codes

(True/False) Bundling procedure codes are NOT separately coded and reported
with the major procedure code - answer-True

(True/False) CPT codes and descriptions are based on consistency with
contemporary medical practice and are performed by clinical providers
throughout the country - answer-True

(True/False) Do not add a modifier to a CPT Unlisted procedure/service does
because they do not include specific descriptions that would justify modifying
their meaning - answer-True

+ - answer-Plus Symbol

identifies add-on codes (Appendix D of CPT) for procedures that are commonly,
but NOT always performed at the same time and by the same surgeon as the
primary procedure

A/B MACs - answer-MACs that process both hospital inpatient/outpatient and
Medicare Parts A & B for physicians for claims

Add-on Code - answer-reported when another procedure is performed in addition
to the primary procedure during the same operative session and must never be
reported as a stand-alone code

Do not report Modifier -50 with add-on codes

Bilateral procedures, the add-on code is reported twice

Advanced Beneficiary Note (ABN) - answer-a form completed and signed by a
medical beneficiary each time a provider believes a normally covered service will
NOT be covered and provider wants beneficiary billed directly

Appendix A - answer-Modifiers

contains a list of CPT Modifiers and detailed descriptions

Appendix B - answer-Summary of Additions, Deletions, and Revisions
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