CPT Questions and Answers (2022/2023)
Already Passed
CPT ✔✔Current procedural terminology
CPT is used for ✔✔reporting services and procedures by physicians
CPT is updated ✔✔Annually by the AMA
AMA ✔✔is the American
...
CPT Questions and Answers (2022/2023)
Already Passed
CPT ✔✔Current procedural terminology
CPT is used for ✔✔reporting services and procedures by physicians
CPT is updated ✔✔Annually by the AMA
AMA ✔✔is the American medical association
How many categories are there in CPT ✔✔3
CPT contains the following categories ✔✔Category I, services and procedures, category II
supplemental codes , and category III are temporary codes for emerging technologies
CPT is composed of how many sections ✔✔8
CPT sections ✔✔guidelines that provide specific coding rules for that section
CPT guidelines ✔✔usually contain definitions of terms, applicable modifiers, subsection
information, unlisted services, specific reports information, or clinical examples.
CPT sections named are ✔✔E/M, Anesthesia, Surgery, Radiology, Pathology and Laboratory,
medicine, Category 2, and category 3
CPT coding's format is ✔✔indented
CPT stand alone codes ✔✔contain the full description of the procedure code
CPT indented codes ✔✔listed under associated stand alone codes
CPT add-on codes ✔✔used for procedures that is always performed during the same operative
session as another surgery in addition to a primary service
CPT services rendered by a physician ✔✔uses a 5 digit numeric system
Modifiers ✔✔give an accurate description of the services
CPT triangle ✔✔represents a changed code description since last edition
CPT two facing triangles ✔✔represent changes in the text or definition between the triangles
CPT plus sign ✔✔indicates an add on code
CPT a circle with a line through it ✔✔represents exemption from the use of modifier -51
Evaluation and management ✔✔99201-99499
Anesthesia ✔✔00100-01999
Surgery ✔✔10021-69990
Radiology ✔✔77010-79999
Pathology ✔✔80048-89356
Medicine ✔✔90281-99199
CPT location methods are divided by ✔✔Service, anatomic site, condition or disease, synonym,
abbreviation
-24 ✔✔Unrelated E/M service by the same physician during a postoperative period. Service was
not part of the postoperative care which is usually part of a package of services.
-26 ✔✔Professional component.. attached to the procedure to indicate that the physician provide
don only the professional component
-32 ✔✔Mandated services .. This is used to indicate that the service provided was required by a
third party payer, governmental, legislative, or regulatory body
-50 ✔✔Bilateral Procedure
-51 ✔✔Multiple procedures.. more than one procedure is performed during the same surgical
episode
multiple modifier -51 is used ✔✔more than one procedure is performed during the same surgical
episode; one code dos not desc ribe all of the procedures performed; and the secondary
procedure is not minor or incidental to the major procedure.
-58 ✔✔Stated or Related procedure or service by the same physician during the postoperative
period
-78 ✔✔Return to the operating room for a related procedure during the postoperative period
-79 ✔✔Unrelated procedure or service by the same physician during the postoperative period
-90 ✔✔Reference (outside) laboratory
-99 ✔✔Multiple modifiers
evaluation and management (E/M) codes Key components are ✔✔Chief complaint; History of
present illness, review of system, past family and social history
Chief Complaint ✔✔or CC reason the patient came to see the physician
History of present illness ✔✔or HPI :chronological account of the illness
Review of systems ✔✔ROS; this is the inventory of the constitutional symptoms
Past, family and social history ✔✔(PFSH) patient's personal experiences with illness, surgeries
and injuries.
Unlisted procedures ✔✔procedures that are considered experimental or newly approved
Surgical Package ✔✔aka global surgery includes services rendered by the surgeon
Surgical package includes ✔✔surgical procedure performed; local infiltration; preoperative E/M
services on day immediately prior to or on day of procedure; immediate postoperative care;
normal, uncomplicated postoperative care
Health insurance ✔✔contract between a policy holder and the individual
Three ways of obtaining insurance are ✔✔group insurance, personal insurance, pre-paid health
plan
Group insurance ✔✔group of employees and dependants are insured under one policy
Personal insurance ✔✔issued to an individual
Pre-paid health plan ✔✔pre-determined set of benefits covered under one set annual fee
Types of insurance include ✔✔indemnity insurance, managed care plans
Indemnity insurance ✔✔is a fee for service based insurance. Listed in policy. Payments are
based on fees physicians charge for the service.
Managed Care plans ✔✔consist of HMO;PPO; POS
Health Maintenance Organization (HMO) ✔✔least costly, most restrictive. Uses a gatekeeper
physician (primary care physician) who the patient is required to visit first.
Preferred Provider Organization (PPO) ✔✔same as HMO provider enters into
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