FINALS - TEST - Ch. 19 QUIZ Flashcards
(17 cards)
When unbundling is done intentionally to receive more payment than is allowed, the claim is considered to be what?
Fraudulent
Which best describes the CPT code format?
5 digit numeric codes
When coding CPT procedures, what does an add-on code describe?
Other procedures done in addition to a main procedure
A healthcare provider who practices under false qualifications or credentials is guilty of what?
Fraud
A modifier indicates what?
Special circumstances apply to the procedure
The CPT is updated and new codes are provided beginning on what date?
Annually on January 1
Billing for a moderate level evaluation and management service when only a simple BP check & injection were carried out is an example of what?
Reporting services at a higher level than was carried out
What is the max # of modifiers a CPT procedure code can have?
4
What symbol appears next to a code that appears out of numerical sequence?
#
To ensure reimbursement at the highest allowed level, CPT codes must include what?
Codes and modifiers that reflect the services performed
Having a medical practice compliance plan in place shows what?
A “good-faith” effort to be compliant with coding regulations
Medical offices usually have what to help minimize the risk of fraud by discovering and correcting coding and billing problems?
Compliance plan
When a patient has no symptoms of a disease and the provider performs the tests for that disease at the patients request, the provider has committed which fraudulent coding and billing practices?
Performing procedures not related to the patient’s condition
How many codes are required for giving a patient an injection of a vaccine?
2
In order to find information regarding prefixes and suffixes used in the CPT coding manual, where would you look?
Introduction to the manual
What is not one of the 6 main sections in the CPT manual?
Physical Therapy
Which subsection of the surgery section include procedures on the spleen and bone marrow?
Hemic/Lymphatic Systems
