Question 1

The classes of main entries found in the CPT index include all of the following EXCEPT:

Accepted Answer

The CPT (Current Procedural Terminology) index primarily categorizes entries based on organ or other anatomic sites, procedures or services, and includes synonyms, eponyms, and abbreviations to help users find the correct codes. It does not categorize entries based on chief complaints, as these are more relevant to diagnosis coding (like ICD codes) rather than procedural coding.

Question 2

When two or more modifiers are necessary to completely define a service, the medical office assistant should:

Accepted Answer

Modifier -99 is used to indicate that multiple modifiers are being used to fully describe a service. This tells the payer to look for additional information in the documentation to understand the modifiers being claimed.

Question 3

The codes to be reported for each day's service are ranked in order of: are ranked in order of:

Accepted Answer

The codes should be ranked in order of highest to lowest reimbursement rate to prioritize the most significant services in terms of cost.

Question 4

Examples of procedures or services include all of the following EXCEPT:

Accepted Answer

Abdominal distention is not a procedure or service, but rather a symptom or condition. The other options are all examples of procedures or services.

Question 5

When a physician performs a surgical procedure but does NOT provide the preoperative and/or postoperative management, the coder should use modifier:

Accepted Answer

Modifier -54 is used to indicate that a physician performed only the surgical care, without providing the preoperative and/or postoperative management.

Question 6

Which of the following can be billed separately in a surgical procedure?

Accepted Answer

Positioning the patient, fulguration of bleeding points, and exploration of the operative area are considered integral parts of the surgical procedure and are not billed separately.

Question 7

If only one code for a procedure or service occurs in the index, the user should:

Accepted Answer

When only one code for a procedure or service appears in the index, it is best practice to verify the code in the main text of the CPT (Current Procedural Terminology) book to ensure accuracy and that it fully captures the service provided.

Question 8

All services or procedures coded must be: (Select all that apply)

Accepted Answer

Services or procedures coded must be performed by the provider who is billing for the charge (A), and they must be documented in the patient's medical record (B). Insurance coverage (C) is not a requirement for coding, but it may affect reimbursement. Services should not be unbundled (D) if they are part of a larger, comprehensive service.

Question 9

The modifier used to report a bilateral procedure is:

Accepted Answer

The modifier used to report a bilateral procedure is -50. This modifier is used when a procedure is performed on both sides of the body (e.g. both ears, both eyes, both hips). It indicates that the service was performed bilaterally, so the insurer can reimburse the provider for both sides at the appropriate rate.

Question 10

Modifier -47 is used to report:

Accepted Answer

Modifier -47 is used to indicate anesthesia administered by the surgeon performing the procedure, not by an anesthesiologist or nurse anesthetist.

Question 11

If two codes apply to an entry in the CPT index, the codes are separated by a:

Accepted Answer

In the CPT (Current Procedural Terminology) index, when two codes apply to an entry, they are separated by a comma. This is a standard notation used to indicate that both codes should be considered for accurate coding of the procedure or service described.

Question 12

The usual services of an anesthesiologist include all of the following EXCEPT:

Accepted Answer

An anesthesiologist may administer the anesthesia themselves, or they may work with the surgeon to administer it, but it is not their usual service to perform the anesthesia themselves. The other options are all typical services provided by an anesthesiologist.

Question 13

A special report detailing increased time and difficulty should be submitted with a claim when which modifier is used?

Accepted Answer

Modifier -22 is used to indicate that a service or procedure required significantly more time or effort than typically required, and a special report detailing the increased time and difficulty should be submitted with the claim.

Question 14

A bundled code refers to a:

Accepted Answer

A bundled code refers to a group of related procedures covered by a single code.

Question 15

Within an indented series of codes, the first left-justified code is the:

Accepted Answer

The first left-justified code within an indented series of codes is typically the parent code. This code provides context for the more specific sub-terms that follow.

Question 16

The modifier used to report a procedure that was started and then discontinued is:

Accepted Answer

-53 is the modifier used to indicate a procedure that was started but then discontinued due to unforeseen circumstances that made the completion of the procedure unsafe for the patient.

Question 17

The proper use of CPT modifiers can result in:

Accepted Answer

The proper use of CPT modifiers can result in increased reimbursement by accurately capturing additional services or complexities involved in a procedure or service.

Question 18

Modifier -51 can be used to report which of the following situations?

Accepted Answer

Modifier -51 is used to indicate multiple procedures performed at the same session by the same provider. It can be applied to operative procedures, medical procedures, or a combination thereof, as long as they are related and performed during the same session.

Question 19

In the CPT index, all topics referring to CPT code sections or chapter headings are shown in:

Accepted Answer

In the CPT index, topics referring to CPT code sections or chapter headings are shown in bold uppercase letters.

Question 20

Anesthesia is reimbursed according to the:

Accepted Answer

Anesthesia is mostly reimbursed based on the time spent under anesthesia. This means that the longer the procedure, the higher the reimbursement. The type of drug administered and the experience of the anesthesiologist may also affect the cost, but they are not the primary factors. The type of surgery or procedure being performed may play a role in determining the anesthesia method, but it does not directly affect the reimbursement for anesthesia.

Quiz 7: Coding Procedures and Services