Chapter 7 Study Guide CPT Coding

1. CPT-4 is published annually by AMA CMS WHO Medicare 2. The hospital assigns CPT codes to report Inpatient ancillary services Inpatient and outpatient surgery Inpatient surgical procedures Outpatient services and procedures

3. CPT Category I contains _____ sections. Four Five Six Seven 4. When reporting CPT codes on the CMS-1500 claim, medical necessity is proven by Attaching a special report to the CMS-1500 claim Linking the CPT code to its ICD-9-CM counterpart Reporting ICD-9-CM codes for the patient’s condition Sequencing CPT codes in a logical, chronological order

5. New CPT codes go into effect Twice each year, on January 1 and July 1 Twice each year, on October 1 and April 1 Once each year, on October 1 Once each year, on December 1 6. CPT Appendix A contains information about Deleted codes Modifiers New code descriptions Revised codes

7. Modifiers are reported to Alter or change the meaning of the code reported on the CMS-1500 claim Decrease the reimbursement amount to be processed by the payer Increase the reimbursement amount to be processed by the payer Indicate an alteration in the description of the procedure service performed 8. A black triangle located to the left of a CPT code indicates that the code Has been deleted and should not be used Has been revised from previous CPT publications Has special rules that apply to its use Is new to this edition of CPT

9. A bullet or black dot located to the left of a CPT code indicates A deleted CPT code that should not be used A new, never previously published CPT code A revised CPT code from an earlier publication That special rules apply to the use of this code 10. CPT index terms that are printed in boldface are called Descriptors Essential modifiers Main terms Subterms

11. To save space in the CPT index when referencing subterms, the practice of _______________ words is used. Abbreviated Boldfaced Reduction Splinting 12. Critical care services codes are based on the Length of time the patient is in the critical care unit Number of services provided to the patient Total number of consecutive days the physician cares for the patient Total time a physician spends in constant attendance with the patient

13. Critical care services codes are based on the Length of time the patient is in the critical care unit Number of services provided to the patient Total number of consecutive days the physician cares for the patient Total time a physician spends in constant attendance with the patient 14. Prolonged services codes are assigned in addition to other E/M services when treatment exceeds the time included in the CPT description by ______ minutes. 10 15 20 30

15. Which type of code can be used for a physician who is required to spend a prolonged period of time without patient contact waiting for an event to occur that will require the physician’s services? Case management services Physician standby services Preventive medicine services Prolonged services 16. Initial office visit for a patient with left knee pain. Detailed history and examination was documented, along with low-complexity medical decision making. 99202 99203 99204 99213

17. 45-yer old patient seen for annual physical examination by his physician. 99368 99412 99386 99396   18. Anesthesia administered for vaginal hysterectomy. The patient is a healthy 55-year old woman. 00944-P1 00944-P2 58552-P1 58200-P2

19. Excision of a 1.0-cm malignant lesion of the nose, with simple closure 11440 11601 11621 11641 20. Closed reduction of humeral shaft fracture, with skeletal traction 23600 23625 24500 24505

21. Thyroid scan, with uptake (single determination). 78000 78001 78003 78006 22. Lipid panel, performed by outside lab. 80061-90 82465-90, 83718-90, 84478-90 83721-90 83718-90

23. Surgical pathology, gallbladder 88300 88302 88304 88305 24. DTP vaccine, intramuscular 90471 90471, 90472, 90701 96413 96411

25.Chemotherapy administration, intravenous, push technique, 45 minutes. 96409, 96413-51 96409 96413 96411 (CPT codes 96409, 96411, and 96416 were added in 2006.)