CPT Final Exam Questions with Certified Solutions

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CPT Final Exam Questions with Certified Solutions CPT and HCPCS codes are used in what type of healthcare setting? ✔✔Hospital outpatient, physician offices CPT is ✔✔current procedural terminology HCPCS is ✔✔healthcare common procedure coding system Who publishes CPT (Level I HCPCS)? How often is it updated? When is it updated? ✔✔AMA publishes cpt, it is updated annually, on Jan. 1 of each year CPT Category 1 codes consist of: ✔✔Anesthesia, Evaluation and management, surgery, radiology, pathology and laboratory, medicine What are Category 2 CPT codes for? What does the Category 2 code consist of? ✔✔Performance Measures consist of 4 numbers followed by a capital F, such as 1000F What are Category 3 CPT codes for? What does the Category 3 code consist of? ✔✔New & Emerging Technology consist of 4 numbers followed by a capital T, such as 2000T What are modifiers Why are they used? ✔✔Supplementary Codes to provide additional information to a code What is a HCPCS level II code used to report? What does the HCPCS level II code consist of? ✔✔Are used for supplies, DME, injectable substances, dental and chiropractic as well as orthotics Structure: J1885 - capital letter followed by 4 numbers What are HCPCS level II codes also called? ✔✔National codes Who developed the HCPCS level II codes? How often are they updated? When are they updated? ✔✔Developed by CMS, they are updated yearly update Jan1 NCCI ✔✔National Correct Coding Initiative What does the National Correct Coding Initiative edits do? ✔✔Helps CMS to detect inappropriate codes submitted on claims - CPT coding guidelines - Current standards of medical/surgical coding practice - Advice from specialty societies List 3 NCCI edits and the definition of those edits. ✔✔1. Comprehensive/component edit = edit pertains to HCPCS codes that should NOT be used together. 2. Mutually exclusive edit = edit applies to improbable or impossible combinations of codes 3. Medical unlikely edits = for part B claims, CMS has developed medical unlikely edits to reduce error rates for items on the claim form that reference units of service • (bullet) ✔✔new code ; (semi-colon) ✔✔main entry applies to & is part of all indented entries that follow Δ (triangle) ✔✔revision code . ˃˂ (Facing triangles) ✔✔beginning and ending of new or revised text + (plus symbol) ✔✔add on code ʘ (circled bullet) ✔✔moderate sedation Ø (Null symbol) ✔✔exemptions to modifier 51 (Pending symbol) ✔✔product pending FDA approval # ✔✔Out of numerical sequence code ○ ✔✔Recycled/reinstated code modifier -51 ✔✔multiple procedures - used by Physicians ONLY What about modifier -66? ✔✔Surgery Team - Physicians use ONLY modifier -59 ✔✔distinct procedural service. Used by BOTH Physician and Hospital What all does the CPT definition of a surgical pac

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