chapter 7 cpt coding Flashcards
care plan oversight services
cover the providers time supervising a complex and multidisciplinary care treatment program for a specific patient who is under the care of a home health agency hospice or nursing facility
case managemnt services
process by which an attending physician coordinates and supervise care provided to a patient by other providers
category 1 codes
procedurze service identified by a five digit cpt code and descriptor nomenclature these code are traditionally associated with cpt and organized within six sections
category II codes
optional evidence based performance measurement tracking codes that are assigned an alphanumeric identifier with a letter in the last field
category III codes
temporary codes for data collection purposes that are assigned an alphanumeric identifier with a letter in t he last field
comprehensive assessment
must include an assessment ofthe patients functional capacity identification of potential problems and a nursing plan to enhance or at least maintain the patients physical and psychosocial functions
concurrent care
provision of similar services such as hosptial inpatient visits to the same patient by more than one provider on the same day
consultation
examination of a patient by a health care provider usually a specialist for purpose of advising the referring or attending physician in the evaluation and or management of a specific problem with a know diagnosis
contributory components
include conseling coordination of care nature of presenting problem and time
coordination of care
provider makes arrangements with other providers or agencies for services to be provided to apatient
counseling
discussion with a patient and or family concerning one or more of the following areas diagnostic results impression and or recommended diagnostic studies prognosis risk and benefits of management options instructions for management and or follow up importance of compliance with chosen management options risk factor reduction and patient and family education
boldface type
highlights main terms in the cpt index and categories subcategories headings and code numbers in the cpt manual
cross reference terms see, see also
direct coders to a different cpt index entry because no code are found under the original entry
descriptive qualifier
terms that clarify assignment of a cpt code
guidelines
define terms and explain the assignment of codes for procedures and services located in a particular section
inferred words
used to save space in the cpt index when referencing subterms
instructional notes
appear throughout cpt sections to clarify the assignment of codes
italicized type
used for teh cross reference term
bullet symbol
bullet located to the left of a code number identifies new cpt procedures and services
triangle symbol
triangle located to teh left of a code number identifies a revised code description
horizontal triangles symbol
surround revised guidelines and notes this symbol is not used for revied code description
semicolon
saves space in cpt so that some code descriptions are not printed in their entirety next to a code number the entry is indented and the coder refers back to the common portion of the code description located before the semicolon
plus symbol
identifies add on codes for procedures that are commonly but not always performed at the same time and buy the same surgeon as the primary procedure
forbidden symbol
identifies codes that are not to be appended with modifier -51
flash symbol
indicates that a code is pending d=fda approval but that it has been assigned a cpt code
number symbol
precedes cpt codes that appear out of numerical order
star symbol
cpt codes that rae reported for synchronous telemedicine services and require addition of modifier -95
green reference symbol
that the coder should refer to the cpt assistance monthly newsletter
blue reference symbol
that the coder should refer to the cpt changes
red reference symbol
that the coder should refer to the clinical examples in radiology quarterly newsletter