HCPCS CODING - Flashcards | StudyHippo.com

question

If a coder is unable to locate a code that describes the exact service provided, it is acceptable to use a code that approximates the service provided.

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False

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According to the surgery guidelines, surgical destruction may be considered part of a surgical procedure.

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True

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The words that follow a code number in the CPT manual called:

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Procedure/service descriptor

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Who requires a special report with the use of unlisted codes?

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Third-party payers

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A listed of the unlisted procedures for use in a specific section of the CPT manual is contained in:

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Guidelines

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In which CPT appendix would all modifiers be found?

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Appendix A

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CPT stands for:

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Current Procedural Terminology

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Where is specific coding information about each section located?

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Guidelines

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Who publishes CPT?

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AMA

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Health care providers are _____ based on the codes submitted on a claim form for procedures and services rendered.

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Reimbursed

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Category I CPT codes have ____ digits.

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5

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Which of the following is NOT a reason for the CPT coding system?

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Increased reimbursement

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The rules that govern coding in various health care settings are:

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Variable

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An Unlisted Procedure Code:

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Is a procedure or service not found in the CPT manual Is located int the Section Guidelines Is located at the end of the subsection or subheading

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According to the notes preceding the Category III codes in the CPT manual, the digits of the Category III codes are not intended to reflect the placement code of the Category I section of the CPT:

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Nomenclature

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According to the Radiology Guidelines, these are methods that qualify as "with contrast."

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Intravascularly, Intra-articularly, Intrathecally

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Which code is an example of an add-on code?

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15201

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Level II codes are not used in which setting?

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Inpatient

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Modifiers are used to indicate what type of information?

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Bilateral Multiple Procedures Service Greater Than Usually required

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Modifier -57, decision for surgery, is used on what type of service?

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E/M

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Modifier -51, Multiple Procedure, is used on what type of services?

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Surgery

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Modifier -80, Assistant Surgeon, is used when:

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A Second Surgeon Provides Assistance to the Primary Surgeon

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Modifier -59, distinct procedure service, is used to indicate that:

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Services that are usually bundled into one paymetn were provided as separate services

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Modifier -58, staged or related procedure or service by the same physician during the postoperative, is used to indicate:

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That a subsequent surgery was planned at the time of the first surgery

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Mulitple Modifiers are indicated with which modifier?

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-99

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The modifier that indicates the only professional component of the service was provided is:

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-26

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These elements would be part of the ____ history: employment,education, use of drugs

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Social

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Bruising would be an element of review of this organ system

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Hematologic

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The HPI must be documented in the medical record by

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The Physician

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The examination is the ____ portion of the E/M service

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Objective

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Medical decision making(MDM) is based on the ____ Physician must consider about the management of the patient's condition

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Number of diagnoses Risk of morbidity Amount of data

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The hospital Inpatient Services subsection is used for patients admitted to

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An acute care facility

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The request for advice or opinion from one Physician to another Physician is this type of service

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Consultation

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Critical care codes are reported based on

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Time

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Codes from the E/M subsection Nursing Facilities Service are used to report services provided in nursing facilities that used to be known as:

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Skilled nursing facility Intermediate care facility Long-term care facility

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When a Physician performs a preventive care service, the extent of the exam is determined

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Age

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According to information in 99468, what is the age of neonate

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28 days or younger

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Mr. Smith presents to the Emergency Department at the local hospital for chest pain and see by the ED Physician on duty. The physician obtains an extended HPI, an extended ROS, and a pertinent PFSH. What is the level of history?

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Detailed

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The Physician must consider multiple diagnoses and management options. There is a moderate amount of data tp be reviewed and the risk of complications or death is moderate. What is the level of MDM?

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Moderate

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What CPT code is assigned to an ED service that has a detailed history and exam with a moderate level of MDM

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99284

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A person can live without a spleen.

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True

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A common abbreviation for a transurethral electrosurgery of the prostate is TURP.

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False

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One of the most common conditions of the prostate is BPH.

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True

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Nephrectomy is the excision of the renal pelvis.

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False

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Code 54699 is the correct code to report an unlisted procedure of the male genital system.

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False

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The ____ manufactures most blood cells.

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Bone Marrow

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The spleen is composed of this material that also surrounds veins and arteries.

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Lymph Tissue

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This type of lymphadenectomy is the removal of the lymph nodes, glands, and surrounding tissues:

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Radical

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The lymph node excision category codes are based on what two things?

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Method and location

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How many categories are located in the Mediastinum subheading?

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4

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A diaphragmatic hernia is also known as a

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Esophageal Hiatal Hernia

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This bone marrow is taken from a close relative, so there is a genetic similarity.

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Allogeneic

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This bone marrow is collected from the patient and later transplanted or reinfused back into the patient from whom it came.

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Autologenic

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What word describes a lymphadenectomy in which only the lymph nodes are removed?

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Limited

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What is it called when the diaphragm is out of normal position and has moved up farther into the thoracic cavity?

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Eventration

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A gastrostomy tube is placed inside the stomach for:

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Feeding Purposes

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When a diagnostic colonoscopy is coded, the code includes:

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Anoscopy Proctosigmoidoscopy Sigmoidoscopy

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The procedure used to develop an artificial opening through the abdominal wall is:

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Exteriorization

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What two words are important factors in coding hernia repair?

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Incarcerated/Strangulated

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When urodynamics are performed and the physician only interprets the results, the correct modifier would be:

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-26

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To report the cystourethroscopic removal of a self-retaining indwelling ureteral stent, the correct codes would be 52310 or 52315. What modifier would be applied?

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-58

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The type of treatment used to treat prostate cancer by placing the radioactive elements directly into the prostate.

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Brachytherapy

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When lithotripsy is performed, the patient may be surrounded by:

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Liquid

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What do the letters in UPP stand for?

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Urethral Pressure Profile

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The term that describes the study of the motion and flow of urine is:

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Urodynamics

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A code that has all of the words that describe the code that follows is what type of code?

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Stand Alone

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Procedures that are experimental, newly approved, or seldom used are reported with what type of code?

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Unlisted/ Category III

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Which punctuation mark between codes in the index of CPT manual indicates a range of codes avaliable?

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Hyphen

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According to the CPT manual, modifier, -91 is not to be used when test are _____ to confirm initial results?

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Rerun

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According to the E/M guidelines, time is not a descriptive component for the ____ department levels of E/M service.

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Emergency

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Multiple modifiers are indicated with which modifier

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-99

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Local anesthesia is a type of anesthesia that provides a decreased level of consciousness.

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False

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Qualifying anesthesia circumstances are adjunct codes and are used when the administration of the anesthesia is more difficult

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True

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Third-party payer determine the contents of a surgical package

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True

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The codes for wound exploration can be reported for exploration of any type of wound

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False

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A needle biopsy is a way of obtaining a piece of tissue out of the body, using tiny incision, so the tissue can be examined under a microscope by a pathologist. Because this biopsy is performed through the skin, it is called a percutaneous biopsy,

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False

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99100 is and example of

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Qualifying circumstance

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In the Anesthesia section of the CPT manual, the codes are usually divided first by which of the following?

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Anatomic site

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What is the type of sedation that allows a procedure to be performed without pain to the patient, but the patient is not completely asleep?

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Conscious or moderate

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The society that publishes the Relative Value Guide for anesthesia services is the

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American Society of Anesthesiologists

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The anesthesia status modifier that indicated the patient's condition at the time of anesthesia was administered is

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Physical

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The usual global surgery period for a major procedure is

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90 days

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The CPT code that is used to report materials and supplies by the physician for which no other more CPT code exist is

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99070

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When the words "Separate procedure" appear after the descriptor of a code, you will know which of the following about that code?

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The procedure was a minor procedure that would only be reported if it was the only service provided

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The correct code for an unlisted procedure for the breast is

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19499

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Which treatment of a fracture requires the fracture to be exposed to view or open at the remote site for nailing across the fracture?

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Open

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Which of the following terms describes traction by use of strapping, elastic wraps, or tape?

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Skin

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Wound exploration codes have the following service(s) bundled into the codes

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exploration, including enlargement, debridement, removal of foreign body(ies), minor vessel ligation, repair

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This type of graft is often taken from the upper thigh area

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Fascia lata

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Fracture codes are based on

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Treatment type

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Open treatment of a fracture is when the

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Fracture site is surgically opened and visualized or open remotely

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Where is the bimalleolar bone located

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Ankle

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What is the difference between the code for a soft tissue abscess in the Musculoskeletal System subsection and the codes for abscess, in the Integumentary System subsection?

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The code in the Musculoskeletal System subsection is associated with deep tissue possibly to the bone

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Arthrocentesis is

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An injection into the joint

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A ___ arthroscopy is always included in a surgical arthroscopy

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Diagnostic

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Bone grafts for spinal surgery are often coded in conjunction with a surgical procedure. What is the appropriate modifier to apply to the bone graft code>

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No Modifier

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The mediastinum is located between the lungs.

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True

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The stem cell harvesting in 38205 is the collection of stem cells from the bone marrow.

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False

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The mucosal and submucosal tissue of the lips and cheeks are included in the oral cavity.

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True

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The correct code for an intraoperative colonic lavage is 44701.

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True

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With the exception of incisional and ventral hernias, the use of mesh or other prosthesis is not separately reported when performing hernia repairs.

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True

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For a fine needle aspiration of the salivary gland, the correct code would be 42400.

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False

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Code 45999 is the correct code to report an unlisted laparoscopic procedure of the anus.

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False

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The Urinary System subsection is first arranged anatomically.

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True

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Priapism is when a male cannot obtain an erection.

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False

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The insertion and removal of a temporary stent during diagnostic or therapeutic cystourethroscopic interventions is included in 52320-52355 and not reported separately.

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True

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_____ is a malignant disease of the bone marrow in which excessive white blood cells are produced.

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Leukemia

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Mediastinum codes are identified by which factor?

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Surgical Approach

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The first step in choosing the correct digestive endoscopic procedure code is to identify the ____ of the procedure.

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Extent

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An instillation procedure of the bladder is performed for treatment of

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Bladder Cancer

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Within the Male Genital System, the greatest numbers of codes fall under what category?

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Penis

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Endoscopic procedures within the Urinary subsection, Kidney subheading, are often divided based on this unique factor:

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Existence of Stoma

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Urethral dilation codes are often divided based on this factor:

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Initial or Subsequent

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It is acceptable for the radiologist to communicate his/her opinion via telephone instead of a written report.

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False

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Pathologists have specific codes for clinical pathology consultations.

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True

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Transfusion Medicine codes are located in the Pathology and Laboratory section.

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True

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The postmortem codes 88000-88099 represent physician services only.

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True

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An interactive psychiatric diagnostic interview examination is typically furnished to children

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True

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A ____ procedure is one that is performed independently of and not immediately related to, another service.

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Separate

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What is the modifier used to identify the technical component of a radiologic procedure?

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-TC

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What are the radioisotopes that attach themselves to red blood cells called?

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Tracer

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What is the name of the high-frequency sound waves in an imaging process that is used to diagnose patient illness?

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Ultrasound

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According to CPT Guidelines, Radiation Oncology codes include normal follow-up care during the course of treatment and ________ following its completion.

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Includes 3-month global period

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How many levels of Surgical Pathology are there?

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6

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In what section would you locate codes to report venipunctures and arterial punctures?

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Surgery

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What is the name of the subsection within Pathology/Laboratory that deals with the laboratory work performed to determine cellular changes?

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Cytopathology

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In the Pathology/Laboratory section of the CPT, drugs are listed by their ____ names.

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Generic

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What name is given to cultures for identification of organisms, as well as the identification of sensitivities of the organism to antibiotics?

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Culture/Sensitivity

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Qualitative analysis is defined as:

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Analysis of a substance in order to ascertain the nature of chemical constituents

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Codes in the Pathology/Laboratory section, Evocation/Suppression Testing include which of the following?

answer

Test only

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What word is used to describe the pushing of liquid into the body over a long period of time?

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Infusion

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What must always be documented in the patient record and is the major billing factor for reporting codes in the Psychiatric subsection?

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Time

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What is the name of the dialysis that involves using a body cavity as a filter?

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Peritoneal

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The Cardiovascular subsection contains many diagnostic/therapeutic procedures and services that are primarily divided as to whether the procedures or services are invasive or:

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Noninvasive

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Which of the following would be used to code drugs?

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J codes

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Codes 90951-90962 are reported ____ to distinguish age-specific services related to the patient's end-stage renal disease performed in an outpatient setting depending on the number of visits.

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Once per month

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A routine ECG with 12 leads, tracing only was performed.

answer

93005

question

When doing osteopathic manipulative treatment, which of these body regions is not included in the regions listed with-in the CPT manual?

answer

Caudal

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Codes for arthrodesis include the bone graft and instrumentation and these cannot be coded separately

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False

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Concurrent modifiers are used to describe

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A number of cases an anesthesiologist is directing or supervising at one time

question

The anesthesia formula is

answer

B + T + M

question

The modifier "-AA" is an example of what type of modifier?

answer

HCPCS

question

The global surgery periods includes

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All routine and postoperative care

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This information is placed after some codes in the CPT manual and contains helpful information

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Parenthetical information

question

What code is used to report routine postoperative care?

answer

99024

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Excision including simple closure of benign lesions of the skin include these type of anesthesia

answer

Local

question

What are the divisions of the Surgery section based on ?

answer

Body system

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The CPT code that is used to report materials and supplies by the physician for which no other more specific code exist is

answer

99070

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When the words "separate procedure" appear after the descriptor of a code, you know which of the following about that code?

answer

The procedure was a minor procedure that would only be reported if it was the only service provided

question

Which of the following represents the contents of the surgical package?

answer

Preoperative Intraoperative Postoperative

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Which term describes reduction

answer

manipulation

question

Which treatment of a fracture requires the fracture to be exposed to view or opened at the remote site for nailing across the fracture?

answer

Open

question

Which of the following terms describes traction by the use of strapping, elastic wraps, or tape?

answer

Skin

question

Wound exploration codes have the following service(s) bundled into the codes?

answer

Exploration, including enlargement; debridement, removal of foreign body(ies), minor vessel ligation, repair

question

This type of graft is often taken from the upper thigh area?

answer

Fascia lata

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Fast becoming of treatment of choice for many orthopedic surgical procedures is what type of procedure?

answer

Endoscopy/Arthroscopy

question

Which of the following is not a fracture treatment?

answer

Replantation

question

Which of the following flaps describes a bone graft that is taken along with the skin and tissue that overlies the bone?

answer

Free Osteocutaneous

question

A hip replacement code is based on the

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Medical reason for the surgery

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Where is the bimalleolar bone located ?

answer

Ankle

question

Arthrocentesis is

answer

An injection of the joint An aspiration of fluid from the joint Puncture of a joint

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The acronym ORIF stands for

answer

Open reduction with internal fixation

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___ is the attachment of the spinal fixation device at each end of the area being repaired and at least one other attachment in the repaired

answer

Segmental Instrumentation

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Electrical ultrasound stimulation is used to

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Promote healing

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Surgical and fracture repair codes n the musculoskeletal subsection

answer

Include the application and removal of the initial casts, splints, or strapping applied by the treating physician

question

A __ arthroscopy is always included in a surgical arthroscopy

answer

Diagnostic

question

The following is NOT a type of bunionectomy

answer

Mumford

question

A physician applies a cranial halo on a patient with a C-1 fracture. After the fracture is healed, the same physician removes the halo. Code ONLY the removal of the halo?

answer

99024

question

Bone grafts for spinal surgery are often coded in conjunction with a surgical procedure. What is the appropriate modifier to apply to the bone graft code?

answer

No modifier

question

Services in pathology/laboratory are provided by a physician or by technologists under responsible supervision of a physician.

answer

True

question

When reporting organ or disease-oriented panels, if all but one of the tests within the panel is substantiated by the physician's documentation, it is acceptable to assign the code with modifier -52 to the code used to report the service.

answer

False

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When coding chemistry tests, an analyte is measured in multiple specimens from different sources, or in specimens that are obtained at different times, the analyte is reported separately for each source and for each specimen.

answer

True

question

The use of a hand-held Doppler device that does not produce hard copy output, or that produces a record that does not permit analysis of bidirectional vascular flow, is considered to be part of the physical examination of the vascular system and is not separately reported.

answer

True

question

The modifier reported when a physician component is reported separately is:

answer

-26

question

A ___ procedure is one that is performed independently of, and not immediately related to, another service.

answer

Separate

question

The divisions of the Radiation Oncology section of the CPT manual are divided into subsections based on what?

answer

Type of service

question

What is the standard measure of energy in radiation treatment?

answer

MeV

question

Codes 76801 and 76802 include determination of the number of gestational sacs and fetuses, gestational sac/fetal measurements appropriate for gestation <14 weeks 0 days, and:

answer

Survey of visible fetal and placental anatomic structure, qualitative assessment of amniotic fluid/gestational sac shape, examination of the maternal uterus and adnexa

question

A needle with a suture attached is passed through an incision into the stomach. The needle is snared and removed via the mouth. A gastrostomy tube is connected to the suture and passed through the mouth into the stomach and out the abdominal wall. What is the correct code for this procedure?

answer

None of the Above

question

The procedure is a percutaneous transhepatic dilation of biliary duct stricture with or without placement of a stent. How would the radiological supervision and interpretation be coded?

answer

74363

question

What type of drug test measures the presence of a drug in the specimen?

answer

Qualitative

question

What type of drug test measures the amount of a drug in the specimen?

answer

Quantitative

question

What is the name given to grouped laboratory work that represents those tests commonly performed together?

answer

Panels

question

A sample of tissue from a suspect area can be further divided into which of the following?

answer

Block/ Section

question

Psychiatric diagnostic interview examination includes:

answer

History Mental status Disposition and communication with family or other sources

question

If an established patient is given an immunization during an office visit, and the only service provided was the immunization, what type of codes would you use to report the service?

answer

Medicine section immunization code and an administration code

question

Outpatient dialysis services are usually reported on this basis.

answer

Monthly

question

What is the name of the process that routes the blood including waste products outside the body through filters?

answer

Hemodialysis

question

What is the name of the procedure that is performed to assess the intraocular pressure of the eye?

answer

Tonometry

question

What does the abbreviation EMG stand for?

answer

Electromyography

question

On what basis are the dermatology codes usually used by the dermatologist who sees patients in the office?

answer

Consultation

question

Level II national codes are not used in which setting?

answer

Inpatient

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