Ch. 08 intro to CPT coding questions and answers graded A+

Ch. 08 intro to CPT coding questions and answers graded A+ To promote national correct coding methodologies and control the improper assignment of codes that result in inappropriate reimbursement of Medicare Part_____ ...

Ch. 08 intro to CPT coding questions and answers graded A+ To promote national correct coding methodologies and control the improper assignment of codes that result in inappropriate reimbursement of Medicare Part_________ claims, CMS implemented the NCCI. ✔✔B The NCCI was initially developed for use by Medicare administrative contractors (MACs) that process Medicare Part B claims for physician office services; in August 2000, NCCI edits were added to the Outpatient Code ____________ for use by MACs to process Medicare Part B claims for outpatient hospital services. ✔✔outpatient code editor The NCCI code pairs that should not be billed together because one service inherently includes the other are called column 1/column 2 edits, while the NCCI code pairs that, for clinical reasons, are unlikely to be performed on the same patient on the same day are called ___________ ________________ edits. ✔✔mutually exclusive When a submitted claim for reimbursement is denied because of incorrect coding rather than medical necessity, the provider cannot submit an Advance Beneficiary Notice (ABN) or a Notice of Exclusions from Medicare ________ to seek payment from a Medicare beneficiary. ✔✔benefits A 34-year-old male underwent upper gastrointestinal endoscopy, which included visualization of the esophagus, stomach, and duodenum. During endoscopy, brushings collected esophageal specimens and esophageal biopsy was performed. Upon review of CPT Surgery code descriptions for 43235 and 43239, the coder assigned 43239 only (because 43235 is considered a component of the total procedure, 43239). Reporting both codes would be considered ______________ ✔✔unbundling The regulation that required new, revised, and deleted CPT codes to be implemented each January 1 was a result of the: ✔✔Medicare Prescription Drug, Improvement, and Modernization Act. The draping and positioning of a patient is coded as: ✔✔integral to the standard of practice. The code description for CPT code 70492: ✔✔requires the coder to refer back to code 70490 for the common portion of the code description. Using the CPT index, select the main term, subterm, and qualifier, respectively, that results in the assignment of a code for "percutaneous transcatheter placement of intracoronary stent(s), with coronary angioplasty when performed; single major coronary artery or branch." ✔✔insertion, stent, coronary Using the CPT index, select the main term, subterm, and qualifier, respectively, that results in the assignment of a code for "liver imaging with vascular flow." ✔✔liver, nuclear medicine, imaging Code 45379 defines a colonoscopy with removal of foreign body. Using the CPT index, determine which main term would be used to locate that code. ✔✔removal Appendix P contains a summary of CPT codes that include: ✔✔telemedicine services Which symbols identify CPT codes that are listed in its appendices? ✔✔plus, forbidden, star A triangle symbol located to the left of a CPT code number signifies that the code is: ✔✔revised Which symbol indicates that a change has been made to a CPT code, code description, guideline, and/or note when compared with the previous year's coding manual? ✔✔triangle Headings and subheadings are also called: ✔✔categories and subcategories. Guidelines, notes, and descriptive qualifiers are found in CPT: ✔✔sections, subsections, headings, and subheadings. "Radiology" and "Pathology and Laboratory" are CPT: ✔✔sections. If an unrelated evaluation and management service by the same physician is provided during a postoperative period, which CPT modifier is added to the reported E/M code? ✔✔-24 Terms found in provider documentation (e.g., difficult, extensive, or unusual) would support adding modifier _________ to a CPT code. ✔✔-22 An intoxicated patient was brought to the emergency department with a skin laceration, for which he received stitches. The patient became combative and subsequently tore out the stitches, which were repaired by the same physician. Which CPT modifier would be reported for the second stitching procedure? ✔✔-76 Which CPT modifier(s) are reported when surgery is performed by two surgeons? ✔✔-62 Which CPT modifier is reported when a procedure is performed on an infant who weighs less than 4 kilograms (kg)? ✔✔-63 NCCI edits are updated _________ and available to _________. ✔✔quarterly, everyone The National Correct Coding Initiative (NCCI) edits are available via: ✔✔spreadsheets. single code ✔✔single code number listed in cpt semicolon ✔✔used to save space in cpt code descriptions notes ✔✔appear throughout cpt sections to clarify the assignment of codes inferred words ✔✔used to save space when referencing subterms appendix F ✔✔contains codes exempt from -63 appendix A ✔✔contains list of cpt mods flash symbol ✔✔located left of cpt code that IDs products pending FDA approval but have a cpt code descriptive qualifiers ✔✔clarify assignment of cpt code; occur in the middle of a main clause or after semicolon; maybe be in parentheses column 1/2 edit ✔✔code pairs that should NOT be paired togethe, because on services includes the other. category III codes ✔✔"emerging tech" temp cpt code for data collection purposes. Archived after 5 years if not given a category I code. Category II code ✔✔Optional CPT codes that track performance measures for a medical goal such as reducing tobacco use. category I code ✔✔procedures/services ID by 5-digit cpt code and descriptor. associated with cpt and in 6 sections bullet symbol ✔✔New procedure or service code added since last edition blue reference symbol ✔✔refers code to CPT assistant monthly newsletter appendix P ✔✔includes codes for telecom, uses modifier -95 appendix O ✔✔includes admin code for for procedures specific to single labs/manufacturers appendix N ✔✔contains list of cpt codes that are resequenced appendix M ✔✔contains list of deleted cpt codes w/ crosswalks to new codes appendix L ✔✔contains list of vascular families appendix K ✔✔codes pending FDA approval. aPPEAR W/ THE FLASH SYMBOL appendix J ✔✔contains electrodiagnostic medicine listing of sensory, motor and mixed nerves.