Chapter 8 Flashcards Preview

Medical Billing, Insurance, and Coding - Smith Fall 2020 > Chapter 8 > Flashcards

Flashcards in Chapter 8 Deck (58)
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1

CPT codes are used by: (5)

Physician's offices and clinics
Hospitals
Rehab units
Ambulance services
Long-term care facilities

2

CPT forms... (paragraph)

...the basis for a universal communication system that ensures accuracy and clarity when the procedures and services delivered within the health care system are described

3

Six main divisions in Category I of the CPT manual

1. Evaluation and Management (E/M)
2. Anesthesia
3. Surgery
4. Radiology
5. Pathology and Laboratory
6. Medicine

4

The universal paper form

CMS-1500

5

Services that are reported electronically by the CMS-1500

Outpatient services

6

Appendix A

Modifiers

7

Appendix B

Additions, Deletions, Revisions

8

Appendix C

Clinical Examples, E/M Codes

9

Appendix D

Add-on Codes

10

Appendix E

-51 Exempt Codes

11

Appendix F

-63 Exempt Codes

12

Appendix G

Include Moderate Conscious Sedation

13

Which appendix gives coders examples of how to apply E/M codes?

Appendix C

14

One subsection of E/M is...

...Office or Other Outpatient Services

15

What indicates that a portion of text has been changed?

right- and left- facing triangles surrounding the parenthetical note below the code description

16

An add-on code: (3)

1. May only be used with another specific code
2. Is never used alone
3. Requires no reduction for multiple services

17

Where is the full list of add-on codes listed?

Appendix D

18

What is the purpose of an add-on code?

Additional code to show the furthest extent of the procedure

19

-51 Exempt Codes are services...

typically exempt from multiple procedure reductions

20

When is a modifier -51 used?

When multiple surgeries are performed on the same day during the same surgical session

21

Modifier -51 should not be used with...

...add-on codes

22

Symbol: plus (+) sign

add-on code

23

Symbol: circle with a line through it

"-51 may not be used with these codes"

24

Why is evaluation and management section listed first?

Procedures and services listed in the E/M section are frequently used

25

How is the CPT categorized?

Sections
Subsections
Subheadings
Categories

26

The surgery section is subdivided by...

...body systems

27

Subdivisions may be categorized by:

Anatomy: knee or shoulder
Procedure: incision or excision
Condition: fracture or dislocation
Description: cast or strap
Surgical approach: anterior cranial fossa or middle cranial fossa

28

Where do guidelines appear in the CPT manual?

At the start of each section of the CPT

29

Where do notes appear in the CPT?

Throughout and are listed before and after the codes that they reference

30

What are notes?

Special instructions that must be followed for coding to be accurate