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2010 Step by Step Medical Coding Ch 8 Set 1
2010 Step by Step Medical Coding, Carol J. Buck Introduction to CPT and HCPCS
30
Medical
06/16/2010

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Cards

Term
Current Procedural Terminology
Definition
What does CPT stand for?
Term
CPT-4
Definition
another name for CPT
Term
CPT
Definition
coding system developed by the American Medical Association to convert descriptions of medical, surgical, and diagnostic services into five digit numbers
Term
American Medical Association
Definition
What does AMA stand for?
Term
Category I codes
Definition
majority of CPT codes are referred to as this and have been approved by the Editorial Panel of the AMA
Term
Category II codes
Definition
optional performance measure codes
Term
Category III codes
Definition
temporary codes that identify emerging technologies, services, and procedures
Term
g
Definition

CPT is used by:

a) hospitals

b) clinics

c) outpatient hospital departments

d) ambulatory surgery centers

e) third party payers

f) all of the above

g) all but a

h) all but c

Term
Centers for Medicare and Medicaid Service
Definition
What does CMS stand for?
Term
Health Care Financing Administration
Definition
What does HCFA stand for?
Term
CMS
Definition
What is HCFA now known as?
Term
Healthcare Common Procedural Coding System
Definition
What does HCPCS stand for?
Term
Level I codes
Definition
What CPT codes are, defines professional services
Term
Level II codes
Definition
What HCPCS are, alphanumeric codes that are used by providers to report services, supplies, and equipment provided to Medicare and Medicaid patients for which no CPT code exists
Term
not being reimbursed correctly, being penalized by the government
Definition
What are two possible consequences for submitting the wrong CPT code?
Term

False

 

Some HCPCS codes are assigned with CPT codes--like J codes (drug codes)

Definition
T or F: An HCPCS code is never used if there is a CPT Level I code available
Term
servics, procedures
Definition
Providers of health care are paid based on the codes submitted for _________ or _________ provided to the patient
Term
1966
Definition
When was the first CPT published?
Term
1983
Definition
What year were CPT codes incorporated as Level 1 codes into the Healthcare Procedural Coding System?
Term
c
Definition

Two surgeons do a surgery together.  Both are primary surgeons.  How would each report their billing:

a) One surgeon would claim 43820 for the surgery and the other wouldn't claim

b) Each surgeon would claim 43820 for the surgery

c) Each surgeon would claim 43820 and the modifier 62, which indicates two surgeons

d) Each surgeon would claim 43820 and a modifier that states whether they were the attending or consulting surgeon

Term
-50
Definition

What is the modifier in Appendix A for:

 

bilateral inguinal herniorrhaphy

Term
-78
Definition

What is the modifier in Appendix A for:

 

A postoperative ureterotomy patient has to be returned to the operating room (unplanned) for a complication related to the initial procedure during the postoperative period

Term
-57
Definition

What is the modifier in Appendix A for:

 

A decision to perform surgery is made during an evaluation and management service on the day before or the day of surgery

Term
-51
Definition

What is the modifier in Appendix A for:

 

multiple procedures performed during the same surgical session

Term
-66
Definition

What is the modifier in Appendix A for:

 

 A surgical team is required

Term
-80
Definition

Using Appendix A, what is the modifier for:

 

Physician A actively assists physician B during a surgical procedure

Term
f
Definition

The CPT does not list surgical or diagnostic procedures if:

a) they are experimental

b) they are newly approved

c) they are seldom used

d) advancements have created a variation of procedures currently performed

e) CPT lists all surgical and diagnostic procedures

f) all but e

g) a-c

Term
unlisted code
Definition
a code for a particular section that covers surgical and diagnostic procedures that aren't listed in CPT
Term
33999
Definition
What is the unlisted cardiac procedure code?
Term
32999
Definition
What is the unlisted Respiratory System code?