Basic-CPT - Flashcard | StudyHippo.com

question

A _____ record is documentation that consists of both paper-based and computer generated information.

answer

hybrid

question

A health care provider initiates care using specific medications, goals, procedures, therapies and treatments for his patient. This section of the POR initial plan is called

answer

therapeutic plans

question

Assisting listening device, alerting, any type. Assign HCPCS code

answer

V5269

question

Observation care discharge, day management. Assign codes.

answer

99217

question

Physician direction of emergency medical systems (EMS) emergency care, advanced life support. Assign codes

answer

99288

question

Medical team conference, patient and/or family not present, 30 minutes or more participation by nonphysician qualified health care professional. Assign codes.

answer

99368

question

Anesthesia for procedures on heart, pericardial sac and great vessels of chest with pump oxygenator, younger than 1 year of age.

answer

00561

question

Anesthesia for open or surgical arthroscopic procedures of the elbow, repair of nonunion or malunion of humerus. Assign code.

answer

01744

question

Anesthesia for permanent transvenous Pacemaker insertion in 70- year old -patient with ESRD. Assign code.

answer

00530-P5

question

Incision of soft tissue abscess (e.g., secondary to osteomyelitis), deep or complicated. Assign codes.

answer

20005

question

Insertion of indwelling tunneled pleural catheter with cuff, imaging guidance performed. Assign codes

answer

32550—75989

question

Urinalysis, bactuemia screen, except by culture or dipstick.

answer

81007

question

Necropsy (autopsy) gross examination only, with brain and spinal cord. Assign codes

answer

88007

question

Flow cytometry, interpretation, 9-15 markers

answer

88188

question

Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility. Approx. 45-50 minutes face-to-face with patient. Assign codes

answer

90806

question

Biofeedback training by any modality

answer

90901

question

TEFRA legislated implementation of the_________ , which uses diagnosis-related groups (DRGs) to reimburse short term hospital for inpatient stays.

answer

inpatient prospective payment system

question

After the insurance claim was processed by Blue Cross/Blue Shield Association for services provided

answer

remittance advice

question

A physician under contract to a managed care plan is called a

answer

network provider

question

Explanation of benefits

answer

.

question

Which professional reviews health-related claims to determine whether claims are reasonably necessary?

answer

Health insurance specialist

question

The HIPAA small code set collects information concerning _________.

answer

Race, ethnicity, type of facility, type of unit

question

Which is an example of a third-party payer?

answer

Blue Cross/ Blue Shield Association

question

The coder is responsible for documenting and authenticating legible, complete, and timely patient records.

answer

False

question

On the UB-04 claim, procedures are linked to services for medical necessity purposes.

answer

False

question

Health insurance claims can be denied by third-party payers if medical necessity for the procedure or service is not established.

answer

True

question

Nurses and physicians use medical management software to create work schedules for the office staff.

answer

False

question

Coding internships are typically paid experiences.

answer

False

question

The Certified Medical Reimbursement Specialist (CMRS) exam is sponsored by the American Health Information Management Association.

answer

False

question

A classification system organizes a medical nomenclature according to similar conditions, diseases, procedures, services, or any combination of these.

answer

True

question

HIPAA requires code sets to be adopted for the purpose of tracking the licenses of health care providers.

answer

False

question

A commercial health insurance company is an example of a third-party payer.

answer

True

question

An integrated patient record is arranged in strict chronological date order.

answer

True

question

The UB-04 claim is submitted by physicians' offices to third-party payers.

answer

False

question

ICD-9-CM is considered level I of the Healthcare Common Procedure Coding System.

answer

False

question

In SNOMED CT, the abbreviation CT refers to current terminology.

answer

False

question

HIPAA's large code set collects data about the type of facility and the type of nursing unit.

answer

False

question

A health care clearinghouse is a third-party administrator.

answer

False

question

Upcoding refers to reporting codes that are not supported by documentation in the record for the purpose of increasing reimbursement.

answer

True

question

Assumption coding is considered fraudulent.

answer

True

question

A manual record is paper based.

answer

True

question

A source-oriented record is also known as a sectionalized record.

answer

True

question

The coding student reports to the supervisor at the professional practice experience (or internship) site.

answer

True

question

In the physician's office, reports are organized according to the documentation gathered. This type of report is called

answer

source-oriented record

question

Which professional reviews health-related claims to determine whether costs are reasonable and medically necessary?

answer

Health insurance specialist

question

HIPAA requires health plans that do not accept standard code sets to modify their systems to accept all valid codes or to contract with a(n) _____.

answer

health care clearinghouse

question

SNOMED was originally developed by the _____.

answer

College of American Pathologists

question

Which is a secondary purpose of the patient record?

answer

Evaluating quality of care

question

A physician lists "viral pneumonia" as the final diagnosis. However, the coder notes that laboratory results state "gram-negative bacteria." There is also documentation of chest pain, fever, and dyspnea due to pneumonia. What should the coder do?

answer

Query the physician regarding the diagnosis of pneumonia

question

Chief complaint, social data, and past medical history are considered part of the PORs _____.

answer

Database

question

Observations about the patient's physical findings or lab results would be found in the _____ heading of a POR's SOAP note.

answer

Objective

question

Automated case abstracting software is used by hospitals to _____.

answer

collect data for statistical analysis

question

Medical management software is used to _____.

answer

organize physician office data

question

Which statement about reporting data to payers is true?

answer

The UB-04 claim is submitted by hospitals to third-party payers for reimbursement purposes.

question

Medical management software is used most frequently by _____.

answer

medical assistants

question

The CMS-1500 claim is submitted by _____.

answer

physician offices

question

The process of converting patient records to an electronic image and saving them on storage media is called _____.

answer

document imaging

question

The patient's care, treatment, response to care, and condition on discharge are documented in the _____.

answer

Discharge summary

question

A patient's medial record consists of handwritten progress notes and physician orders as well as automated laboratory results and transcribed reports. This is an example of a(n) _____ record.

answer

hybrid

question

A physician query generated during inpatient hospitalization is considered _____.

answer

concurrent

question

The Health Insurance Portability and Accountability Act of 1996 legislation _____.

answer

expanded continuity of health insurance coverage

question

A patient's statement about how she feels, including symptomatic information, is located in the POR _____ note.

answer

subjective

question

The HCPCS level II national coding classification system contains alphanumeric codes.

answer

True

question

HCPCS level II was introduced in the 1990s.

answer

False

question

Many Medicaid programs and commercial payers use the HCPCS level II coding system.

answer

True

question

CPT describes durable medical equipment, prosthetics, orthotics, and supplies.

answer

False

question

The AMA is responsible for annual updates to HCPCS level II codes.

answer

False

question

HCPCS is a reimbursement methodology.

answer

False

question

Submission of an HCPCS level II code guarantees health insurance coverage

answer

False

question

Approximately 50 percent of HCPCS level II codes are temporary codes.

answer

False

question

All HCPCS level I and II codes require modifiers.

answer

False

question

A modifier may be added to a procedure code to add more information regarding the anatomic site of the procedure.

answer

True

question

When multiple modifiers are added to a code, the most specific modifier is listed first

answer

True

question

The dash that precedes a modifier should be reported.

answer

False

question

When modifier -50 is reported, modifiers -RT and -LT should also be reported

answer

False

question

Modifiers -LT and -RT should be added to the code for a bilateral procedure

answer

False

question

When a radiology procedure is canceled, report a code to describe the extent of the procedure performed.

answer

True

question

Some services must be reported by assigning both a CPT and HCPCS level II national code.

answer

True

question

Most supplies are not included in the charge for an office visit or procedure.

answer

False

question

All HCPCS level I and II services are payable by Medicare

answer

False

question

The Drugs Administered Other than Oral Method section of HCPCS level II includes codes for drugs that ordinarily cannot be self-administered.

answer

True

question

DME MACs have the authority and responsibility to establish local policies.

answer

True

question

Currently there are _____ levels of codes associated with HCPCS.

answer

Two

question

Processing of DMEPOS claims for a specific geographic region is done by _____.

answer

a DME Medicare administrative contractor

question

Coding questions asked by the DMEPOS dealer should be checked with the _____.

answer

SADMERC

question

An HCPCS level II code begins with the letter "K." This signifies that the Medicare administrative contractor responsible for processing the claim is a _____.

answer

DME MAC

question

HCPCS level II _____ are attached to any HCPCS level I or II code to provide additional information regarding the product or service reported.

answer

Modifiers

question

Which of the following modifiers may be added to a code for CPT radiology services?

answer

-59

question

When assigning HCPCS level II codes, _____.

answer

some HCPCS level I and II services are not payable by Medicare

question

The Administrative, Miscellaneous, and Investigational section of HCPCS level II includes codes for all of the following EXCEPT _____.

answer

ancillary transportation-related fees

question

Codes for outpatient PPS would include which of the following?

answer

Biologicals

question

What are used to report product-specific HCPCS codes to obtain reimbursement for biologicals, devices, drugs, and other items associated with implantable device technologies?

answer

C codes

question

A patient is prescribed orthopedic shoes. A code to reflect the shoes would be found under the _____ section

answer

Orthotic

question

A patient who is severely diabetic received a below-knee test socket. The code assigned would be found under the _____ section.

answer

Prosthetic Procedure

question

A patient was supplied with a water pressure mattress. Report code _____.

answer

E0187

question

A patient was assessed for a hearing aid. Report code _____.

answer

V5010

question

A patient received an injection of morphine sulfate, 10 mg (preservative-free sterile solution). Report code _____.

answer

J2275

question

A 10-year-old patient required sign language services for 30 minutes. Report code(s) _____.

answer

T1013, T1013

question

A patient was administered butorphanol tartrate (trade name Stadol NS), nasal spray, 25 mg. Report code _____.

answer

S0012

question

The provider transported portable x-ray equipment to the nursing home for the purpose of testing several patients. Report code _____.

answer

R0075

question

A patient was given a 30-day supply of prenatal vitamins. Report code _____.

answer

S0197

question

An outpatient received hyperbaric oxygen therapy, 60 minutes. Report code(s) _____.

answer

C1300, C1300

question

CPT was adopted as part of the Healthcare Common Procedure Coding System (HCPCS) as HCPCS level 1.

answer

True

question

Use of CPT is mandated for reporting Medicare Part B physician services.

answer

True

question

The publisher of CPT is _____.

answer

the AMA

question

There are _____ categories of CPT codes.

answer

Three

question

In the CPT index, main terms are printed in _____.

answer

boldface

question

The symbol located to the left of a code number that identifies a code description that has been revised is _____.

answer

triangle

question

The appendix that contains a list of codes that are exempt from modifier -51 is _____.

answer

E

question

Revised guidelines and notes are identified by a _____.

answer

horizontal triangles

question

The symbol that identifies codes that are exempt from modifier -51 is _____.

answer

the forbidden symbol

question

The symbol that indicates that a procedure includes conscious sedation is a _____.

answer

bulls-eye

question

When two primary surgeons are required during an operative session, each performing distinct parts of a reportable procedure, modifier _____ should be assigned.

answer

-62

question

When a procedure was repeated because of special circumstances involving the original service and the same physician performed the repeat procedure, modifier _____ should be recorded.

answer

-76

question

A patient underwent closed treatment of a medial malleolus fracture with manipulation and skeletal traction. Record code _____.

answer

27762

question

A pregnant woman underwent a complete Doppler echocardiogram for evaluation of her fetus. Record code _____.

answer

76827

question

A patient underwent posterior osteotomy of the spine, three thoracic vertebral segments. Record code(s) _____.

answer

22212, 22216, 22216

question

A patient underwent total gastrectomy with intestinal pouch, by two surgeons. Record code _____.

answer

43622-62

question

A patient presented to the physician's office for removal of five plantar warts on his feet. During the procedure, the patient became extremely anxious, and the procedure was discontinued. Record code _____.

answer

17110-53

question

A patient underwent a costochondral cartilage graft procedure. She also underwent a nasal septal cartilage graft procedure during the same operative session. Record code(s) _____.

answer

20910, 20912

question

A patient fractured his left leg. An assistant surgeon participated in the open reduction and internal fixation of the tibial fracture, proximal end. Record code _____.

answer

27535-80-LT

question

A 59-year-old male underwent a unilateral hydrocelectomy. Report code _____.

answer

55040

question

A patient underwent laparoscopic cholecystectomy. Report code _____.

answer

47562

question

A patient underwent a total thyroxine lab test that was sent to an outside laboratory. Report code _____

answer

84436-90

question

Which of the following refers to type of service?

answer

Critical care

question

When selecting an E/M code, it is important to review patient record documentation to consider up to _____ components

answer

seven

question

Which of the following is a key component?

answer

medical decision making

question

Evaluation and management code selection is based on _____ key components.

answer

three

question

A limited examination of the affected body part or organ system and other symptomatic or related organ systems is a(n) _____ examination.

answer

expanded problem-focused

question

CPT recognizes _____ types of presenting problems.

answer

five

question

A problem that runs a definite and prescribed course, is transient in nature, and is not likely to permanently alter health status is _____.

answer

self-limited

question

Dr. Taylor reviewed the x-ray report on her patient and then discussed the results with him by telephone. Which E/M subsection would be referenced to assign the appropriate code?

answer

Non-face-to-face physician services

question

Patient record documentation states "patient has a history of alcohol and drug use as a teenager and smokes one to two packs of cigarettes daily." This would be found under the heading _____.

answer

social history

question

The physician spent 30 minutes providing telephone services to a distraught patient who had been seen in the office 2 weeks ago. The patient was calm by the end of the call, and the physician scheduled an appointment to see the patient the next day. Which is reported?

answer

no code reported

question

Dr. Lee saw Kenya Yatani in her office for the first time for treatment of a mild sprain. A problem-focused history and exam were performed, and medical decision making was straightforward. Report code _____.

answer

99201

question

An established patient was seen in his primary physician's office. The patient fell at home and came to the physician's office for examination. Due to a possible concussion, the patient was sent to the hospital to be admitted as an observation patient. A detailed history and examination were performed, and the medical decision was of low complexity. The patient stayed overnight and was discharged the next afternoon. Report code(s) _____.

answer

99218, 99217

question

Dr. Lewis treated an established patient in the office who complained of a 3-month history of fatigue and weight loss. Comprehensive history and exam were performed; medical decision making was of high complexity. Report code _____.

answer

99215

question

A physician returns a call to a patient who needs clarification about instructions for taking a medication prescribed during an office visit 10 days ago. Medical discussion was 8 minutes in duration, and the physician confirmed that the patient would be seen in the office in 2 weeks. Report code _____.

answer

99441

question

Dr. Wisniewski treated a 9-month-old new female patient in the office for diaper rash. A detailed history and examination were performed, and medical decision making was straightforward. Report code _____.

answer

99202

question

Dr. O'Connor treated a 42-year-old male in the hospital emergency department. The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Connor documented a chief complaint, a brief history of present illness, and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Connor also documented a complete examination of all body systems, which included all required elements. Medical decision making was of moderate complexity. Report code _____.

answer

99283

question

Janet Bell was seen by hr physician and underwent a workers' compensation evaluation. Report code _____.

answer

99455

question

An office consultation is performed for a postmenopausal woman who is complaining of spotting in the past 6 months with right lower quadrant tenderness. A detailed history and physical are performed with a low complexity of medical decision making.

answer

99243

question

An out-of-town patient presents to a walk-in clinic to have a prescription refilled for a nonsteroidal anti-inflammatory drug. The physician performs a problem-focused history and physical examination with straightforward decision making. Report code _____.

answer

99201

question

Well-baby checkup on a 2-month-old female new patient. Report code _____.

answer

99381

question

Topical application of a local anesthetic cream is an example of _____.

answer

surface anesthesia

question

The dollar amount assigned to a geographic location is the _____.

answer

anesthesia conversion factor

question

Which modifier should be assigned to indicate the patient's condition at the time anesthesia was administered?

answer

-P1

question

The term that is used to identify those times when anesthesia is provided during difficult situations that make the administration of the anesthesia more difficult is _____.

answer

qualifying circumstances

question

Jane Smith underwent amniocentesis. She has petit mal epilepsy. Using the Anesthesia section, apply code _____.

answer

00842-P2

question

Ron McAllister underwent extracorporeal shock wave lithotripsy. He suffers from controlled hypertension. Using the Anesthesia section, report code _____.

answer

00873-P2

question

An anesthesiologist provided general anesthesia monitored to a normal healthy patient who underwent diagnostic arthroscopy on the right knee. Report code _____.

answer

01382-P1-AA

question

An anesthesiologist provided general anesthesia services to a patient with a history of prior myocardial infarction who underwent excision of a cyst of the left humerus. Report code _____.

answer

01758-P3-AA

question

An anesthesiologist provided monitored anesthesia care to a patient with severe systemic disease who underwent cardiac catheterization, including coronary angiography and ventriculography. Report code _____.

answer

01920-P3-AA-QS

question

A CRNA provided general anesthesia services to a 5-year-old normal healthy patient who underwent third-degree burn debridement of the chest, 5 percent of total body surface area. Report code _____.

answer

01952-P1-QX

question

Review of a patient record reveals the following: The anesthesia code has a basic unit value of 5, and the physical status modifier -P2 has a relative value of 0. Anesthesia time is 30 minutes. A conversion factor of $17.04 is assigned to Alabama. Payment for anesthesia services is calculated as _____.

answer

$119.28

question

The HCPCS level II modifier that is assigned to indicate anesthesia services were performed personally by an anesthesiologist is _____.

answer

-AA

question

A patient with morbid obesity undergoes a prostatectomy under general anesthesia. What physical status modifier would be added to the anesthesia code?

answer

-P3

question

An anesthesiologist provided general anesthesia services to a morbidly obese 55-year-old female who underwent total knee replacement. Report anesthesia code _____.

answer

01402-P3

question

A healthy 10-month-old patient received general anesthesia services from an anesthesiologist for low abdominal hernia repair. Report code(s) _____.

answer

00834-P1-AA

question

A patient undergoes a surgical procedure that requires 60 minutes of anesthesia time. The patient received _____ unit(s) of anesthesia time.

answer

4

question

The maximum number of procedures an anesthesiologist or a CRNA medically directs within the context of a single procedure and when the procedures overlap each other is referred to as _____.

answer

concurrent medically directed anesthesia procedures

question

A 32-year-old patient with type 1 diabetes mellitus underwent biopsy of the liver for which an anesthesiologist provided anesthesia services. Report code _____.

answer

00702-P3-AA

question

Which of the following modifiers should never be assigned to an anesthesia code?

answer

-47

question

The modifier that indicates CRNA service with medical direction by a physician is _____.

answer

-QX

question

Information applicable to a particular CPT section is located in the _____.

answer

guidelines

question

Which is a diagnostic procedure?

answer

Endoscopy

question

Select the modifier for "unrelated procedure."

answer

-79

question

Select the modifier for "staged or related procedure."

answer

-58

question

A patient had intermediate closure of a 1 cm laceration of the neck and a 6 cm laceration of the foot. Report code _____.

answer

12042

question

One benign lesion measuring 0.5 cm is removed from the right hand, and another benign lesion measuring 0.5 cm is removed from the left foot. Report code(s) _____.

answer

11420, 11420-59

question

Two simple repairs of the scalp are done; one laceration was 10 cm, and the other laceration was 5 cm. Report code(s) _____.

answer

12005

question

Adjacent tissue transfer (1 sq cm) of skin defect of the chin, which was the result of an excision of benign skin lesion (1 cm) of the chin (performed during the same operative procedure). Report code(s) _____.

answer

14040

question

How is the Surgery section organized?

answer

Body system

question

Excision of two 1 cm benign skin lesions of the face. Report code(s) _____.

answer

11441, 11441-59

question

When unlisted service or procedure codes are reported, a _____ is also required.

answer

special report

question

A patient had avulsion of four nail plates. Report code(s) _____.

answer

11730, 11732, 11732, 11732

question

A patient sustained a 2 cm chin laceration, a 3 cm cheek laceration, and a 4 cm forearm laceration. He also suffered a 5 cm thigh laceration and 6 cm laceration of his calf. The lacerations of the forearm and thigh required 9 cm simple closure of the skin and subcutaneous tissues. The deep calf laceration required 6 cm intermediate closure. The facial lacerations were deep and quite dirty, requiring complex closure. Report code(s) _____.

answer

13132, 12032-51, 12004-51

question

Replacement of breast tissue expander with breast prosthesis (permanent). Report code _____.

answer

11970

question

Electrodesiccation basal cell carcinoma (1 cm), face. Report code _____.

answer

17281

question

A surgeon performed bilateral breast biopsies; the left breast mass was completely removed, but only a portion of the right breast was removed due to its large size. Frozen section revealed the right breast mass to be malignant; a modified radical mastectomy was performed during the same operative session. Report code(s) _____.

answer

19307-LT, 19120-51, RT

question

Mastectomy for gynecomastia. Report code _____.

answer

19300

question

A large basal cell carcinoma on a patient's forehead is removed using Mohs' chemosurgery. The first stage involves removing all visible tumor and preparing six specimens using mapping, color coding, and microscopic examination. Report code(s) _____.

answer

17311, 17315

question

The patient undergoes breast biopsy following a complaint of a lump in the left breast. The entire lump is excised, and upon pathologic examination, it is determined that the lump is benign. No further surgery is necessary. Report code _____.

answer

19120

question

Patient had 16 skin tags removed from the upper chest and neck area. Report code(s) _____.

answer

11200, 11201

Basic-CPT – Flashcard

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards