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Medical Studies > QUESTIONS & ANSWERS > CPMA Exam Chapter 3, Questions and answers, 100% Accurate, rated A+ (All)

CPMA Exam Chapter 3, Questions and answers, 100% Accurate, rated A+

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CPMA Exam Chapter 3, Questions and answers, 100% Accurate, rated A+ Accurate reimbursement begins with - ✔✔-accurate coding and rules that vary by payer The CPT codebook contains - ✔✔-inst ... ructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. - ✔✔-An auditor must be able to apply payer variations to the CPT guidelines during an audit, and must communicate the differences in a way that will make sense to the provider. Add-on codes - ✔✔-Listing found in Appendix D in the CPT codebook Add-on code are carried out in addition to the primary procedure Add-on codes are never reported alone, and always accompany specific primary procedure codes. There is a parenthetical note following the add-on code to indicate the associated primary code(s) When the list of associated add-on codes is too extensive, - ✔✔-there will not be a list of applicable primary codes in a parenthetical note following the add-on code All add-on codes are - ✔✔-exempt from the multiple procedure concepts (modifier 51) See Appendix A Multiple surgical procedure reduction is applied when - ✔✔-multiple procedures are performed during the same operative session. The highest valued code is paid at 100% The 2nd highest valued code is paid at 50%. And each additional procedure is paid at 25% If a claim exceeds five line items, payers may evaluate for special pricing The fee schedule for add-on codes already accounts for - ✔✔-the reduction, and the payment is made at 100% The Medicare National Physician Fee Schedule (MPS) Relative Value File is useful for - ✔✔-determining if procedures are subject to the multiple procedure payment reduc [Show More]

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