Chapter 12 Anesthesia 2014 Step-By-Step Medical Coding – Flashcards

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Anesthesia sservices are based on ______time the patient is under the anesthesiologist's care. Calculation of units of time is determined by the third-party payer.
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total
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Anesthesia time begins when the anesthesiologist______continues_______the procedure, and ends when________.
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begins to manage patient in the operating room throughout procedure patient is turned over to post-anesthesia caregiver
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According to the Anesthesia Guidelines, what is the one modifier that is not used with anesthesia procedures?
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47
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"P1" is an example of what type of modifier?
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physical status
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What word means "in a dying state"?
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moribund
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What word means "affecting the body as a whole"?
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systemic
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The letter "P" in combination with what number indicates a brain-dead patient?
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P6
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What type of circumstance identifies a component of anesthesia service that affects the character of the service?
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qualifying
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According to the Anesthesia Guidelines, the Seperate or Multiple Procedures section, when multiple surgical procedures are performed during a single anesthetic administration, the anesthesia code representing the most ________ procedure is reported and the time reported is the__________
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complex combined total
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Is it true that a physician who personally administers the anesthesia to the patient upon whom he/she is operating cannot bill the third-party payer
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no
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What is the name of the guide that is published (annually) by the American Society of Anesthesiologists and provides the weights of various anesthesia services?
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relative value guide (RVG)
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Anesthesia for tendon repair of the shoulder, normal, healthy patient
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01610-P1
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Anesthesia for a cesarean hysterectomy following neuraxial labor anesthesia, normal healthy patient
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10967-P1 01969-P1
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Anesthesia for a missed abortion procedure in which the mother is in grave danger of death
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01965-P5
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Cranioplasty for a depressed skull fracture, simple, extradural, for a patient with mild diabetes, well-controlled
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00215-P2
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Total hip replacement in a 75 -year- old patient with hypertension that is well controlled with medication
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01214-P2 99100
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Burn excision of 5% of the total body surface with skin grafting of the abdomen. Patient is 9 months old and in stable condition
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01952-P1 99100
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Hospital management of a continuous epidural drug delivery system for 5 days
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01996 x5
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Arthroscopic total wrist replacement in a normal, healthy patient
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01832-P1
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theraputic
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treating
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diagnostic
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trying to diagnose problem
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anesthesia formula
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B+T+M B-Base Unit, T-Time Unit, M-Modifying Unit
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Base Unit (B)
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Based on complexity Base Unit Value (BUV) assigned nuerical values to each service
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Time Unit (T)
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Patient record indicates time, e.g., 15,30,60 minutes Often, 15 minutes= 1 unit 60 minutes= 4 units Begins: anesthesiologist begins to manage patient in the operating room-preop Continues: throughout procedure-intraop Ends: Patient no longer under care of anesthesiologist-postop PACU=Post-Anesthesia Care Unit (recording total time)
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Modifying Unit (M)
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Physical conditon indicated by physical status modifier P1-P6, Anesthesia Guidelines Risk Factor NOT reported for Medicare
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Physical Status Modifiers P1-P6
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these modifiers indicate the patient's condition at the time the anesthesia was administered and identify level of complexity of the services provided to the patient. Used after the five-digit CPT code. Payment differential based on some physical status ratings.
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P1
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Normal, healthy
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P2
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Mild systemic disease
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P3
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Severe systemic disease
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P4
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Severe systemic disease and in constant threat to life
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P5
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Not expected to survive without operation
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P6
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Brain dead
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Most anesthesia codes are divided:
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First by anatomic site and then by specific type of procedure
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HCPCS Modifiers
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Added to anesthesia code: -AA, -AD, -G8 MAC, -G9 MAC, QK, QS MAC, QX CRNA, QY MAC, QZ CRNA
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-AA
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Anesthesia by Anesthesiologist
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-AD
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Physician, medical supervision, 4+ concurrent procedure
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-G8 MAC
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(monitored anesthesia care), complex procedures
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-G9 MAC
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patient history of severe cardiopulmonary condition
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-QK
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qualified individual, medical direction of 2, 3, 4 concurrent cases
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-QS MAC
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monitored anesthesia care
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-QX CRNA
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(certified registered nurse anesthetist) service, directed by physician
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-QY MAC
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anesthesiologist directing one CRNA
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-QZ CRNA
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without direction
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Anesthesiologist
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physicians specializing in perioperative care, development of an anesthetic plan, and the administration of anesthetics
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Anesthetist
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a nurse who specializes in the administration of anesthesia
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Another Modifying Unit
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*Qualifying Circumstances, 99100-99140 *In Anesthesia Guidelines *Also in Medicine section *Not reported in Medicare
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What two words describe a decreased level of consciousness that does not put patients completely to sleep and allows the patient to breathe on their own during a surgical procedure?
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moderate/conscious sedation
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What do the initials CRNA stand for?
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certified registered nurse anesthetist
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CMS publishes an anuual list of _____values for anesthesia codes
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base unit
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The "M" in the anesthesia formula stands for_______unit
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modifying
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What is the term that describes the services provided to a patient by the physician before surgery?
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pre-op
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What is another term for the time after the surgery when the physician provides services to the patient?
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post-op
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The______factor for the locale is multiplied by the number of base units in the procedure plus the time units to determine the price of the anesthesia service
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conversion
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The modifier indicates that a CRNA service with medical direction by a physician was provided
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-QX
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Patient with a severe systemic disease that is a constant threat to life
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P4
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Normal, healthy patient
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P1
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Patient with a severe systemic disease
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P3
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Declared brain-dead patient whose organs are being removed for donor purposes
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P6
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Patient with mild systemic disease
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P2
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Moribund patient who is not expected to survive the surgery without the operation
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P5
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Diagnostic arthroscopic procedure of knee joint
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anesthesia,knee 01382
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Radical hysterectomy
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anesthesia, hysterectomy-radical 00846
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corneal transplant
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anesthesia, corneal transplant 00144
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cesarean delivery only
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anesthesia, cesarean delivery 01961
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Otoscopy used in procedure for middle ear
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anesthesia, otoscopy 00124
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Transurethral resection of the prostate
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anesthesia, transurethral procedures 00914
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Anesthesia for a cardiac catherization patient having mild systemic disease
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01920-P2
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Anesthesia for a myringotomy on a health 5-year-old patient
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00120-P1
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Diverticulitis of colon with hemorrhage
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ICD-9: 562.13
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Atherosclerosis of coronary artery bypass graft utilizing internal mammary artery
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ICD-9: 414.04
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Toxic diffuse goiter with thyrotoxic crisis
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ICD-9: 242.01
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Mitral Valve regurgitation as a late effect of Fen-Phen, taken as prescribed, initial encounter
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ICD-9: 424.0 & 909.5
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