Shared Flashcard Set

Details

Ch 8 Introduction to CPT and HCPCS Set 4
2010 Step by Step Medical Coding Carol J Buck, Introduction to CPT and HCPCS
30
Medical
06/18/2010

Additional Medical Flashcards

 


 

Cards

Term

a. 69799

b. 29999

c. 43499

Definition

For Surgery, give unlisted code for:

a) unlisted procedure; middle ear

b) unlisted procedure; arthroscopy

c) unlisted procedure; esophagus

Term

a. 88299

b. 81099

c. 84999

Definition

For Pathology and Laboratory, give unlisted code for:

a) unlisted procedure; cytogenetic study

b) urinalysis procedure

c) chemistry procedure

Term
99199
Definition

For Medicine, give the unlisted code for:

 

unlisted special service, procedure, or report

Term

a. 77799

b. 78999

Definition

For Radiology, give the unlisted code for:

a) unlisted procedure; clinical brachytherapy

b) unlisted miscellaneous procedures; diagnostic nuclear medicie

Term
Physicians Quality REporting Initiative
Definition
What does PQRI stand for?
Term
PQRI
Definition
a program within Medicare that pays physicians a bonus for reporting quality measures, which usually addresses at risk ailments that will develop as a result of a patient's illness
Term
e
Definition

With PQRI, there is a:

a) bundled code for systolic and diastolic blood pressure

b) systolic blood pressure code

c) diastolic blood pressure code

d) bundled systolic and diastolic code if normal, separate systolic and diastolic if abnormal 

e) b and c

f) PQRI uses ICD-9-CM codes

Term
1P, 2P, 3P, 8P
Definition
Four modifier codes that can only be used with Category II codes, and they report the reason the performance measure was not performed with PQRI reporting
Term
1P
Definition
PQRI modifier that states the performance measure was not performed due to medical reasons--such as a contraindicated due to adverse drug interaction
Term
2P
Definition
PQRI modifier that states a performance measure was not performed because of personal reasons of the patient--like religious beliefs
Term
3P
Definition
PQRI modifier that states performance measure not performed because of systemic reasons, such as equipment was not available
Term
8P
Definition
PQRI modifier that states a performance measure was not performed for an unspecified reason
Term
E/M, G
Definition
PQRI measures state that an ____ code from the CPT or a ___ code from HCPCS are the two types of codes permissible with Category II codes
Term

False

 

Some ICD-9-CM codes can be submitted with PQRI codes

Definition
T or F: ICD-9-CM codes are never used with Category II codes
Term
National Provider Identification
Definition
What does NPI stand for?
Term
NPI
Definition
a number that is assigned to a physician and tracks their quality measure submissions for PQRI
Term
Category III codes
Definition
codes that report emerging technology and are temporary codes for up to five years
Term
Category III code
Definition
There is a new technology with a Category III code. Do you use the Category III code or the Category I code?
Term
Category I code
Definition
codes that are used to describe services and procedures that have been approved by the FDA and have been proven to have clinical effectiveness
Term
e
Definition

Category III codes:

a) may not be approved by the FDA

b) may not be widely offered

c) may not have been proven clinically effective

d) identify emerging trends in health care

e) all of the above

Term
d
Definition

When do you need to submit a special report with a claim?

a) when you use an unusual, new, or seldom used procedure

b) use Category I unlisted code

c) use a Category III code

d) all of the above

e) all but a

Term
a, b
Definition

Special report submitted for a claim should include:

a) definition or description of the nature, extent, and need for procedure or service

b) time, effort, and equipment necessary to provide the service

c) skill of the physicians involved

d) all of the above

Term
multiple
Definition
A comma between numbers in the Index indicates that there are a _______ of codes
Term
range
Definition
A hyphen between numbers in the Index indicates that there is a ______ of codes
Term
False
Definition
T or F: A coder codes from the Index
Term
i
Definition

You can locate main terms in the index by:

a) service or procedure

b) anatomic site

c) condition or disease

d) synonym

e) eponym

f) abbreviation

g) numeric code

h)all of the above

i) all but g

j) all but d and f

Term
49900
Definition

Use the index to find the code for:

 

Repair Abdomen Suture

Term
27303
Definition

Use the index to find the code for:

 

Femur Abscess Incision

Term
27786-27814, 27792
Definition

Use the index to find the code(s) for:

 

Fracture Ankle Lateral

Term
99288
Definition

Use the index to find the code for:

 

Emergency Department Services, Physician Direction of Advanced Life Support