Deck 5: Procedural Coding: CPT and HCPCS

Question 1

When did HCPCS become mandatory for coding and billing?

A) 1966
B) 1996
C) 1980
D) It is not mandatory.

Answer 1

1996

Question 2

What kinds of services support treatment, like rehabilitation, occupational therapy, and nutrition therapy?

A) ancillary services
B) dental procedures
C) evaluation and management services
D) secondary services

Answer 2

ancillary services

Question 3

In CPT, what type of code is described by the following entry? +33884 each additional proximal extension (List separately in addition to code for primary procedure).

A) observation code
B) new code
C) add-on code
D) E/M code

Answer 3

add-on code

Question 4

A0210 is an example of which level of HCPCS code?

A) Level I
B) Level III
C) Level II
D) Level IV

Question 5

Which symbol is used to designate a new code?

A) a bullet
B) facing triangles
C) a plus sign
D) a triangle

Question 6

Which of the following temporary codes was developed to assist DMERCs?

A) K codes
B) G codes
C) Q codes
D) C codes

Question 7

Physicians may only code from

A) any CPT section
B) Evaluation and Management section of CPT.
C) Surgery section of CPT.
D) Medicine section of CPT

Question 8

Which of the following is not a main term in the CPT index?

A) abbreviations
B) all of these are main terms
C) eponyms
D) anatomical site of the procedure

Question 9

Routine annual physical examinations are reported using which type of E/M codes?

A) Consultation codes
B) Preventive Medicine Services codes
C) Office Services codes
D) Critical Care Services codes

Question 10

HCPCS Level II codes begin with

A) either an alphabetic character or numeric character.
B) an alphabetic character.
C) a numeric character.
D) neither an alphabetic character nor numeric character.

Question 11

Which appendix in CPT contains the Summary of Modifier 63 exempt codes?

A) Appendix D
B) Appendix F
C) Appendix G
D) Appendix E

Question 12

In CPT, the term ___________ describes services that a provider performs at the request of another provider after which the patient is returned to the requesting provider's care.

A) consultation
B) referral
C) critical care
D) office visit

Question 13

CPT codes are used to report the following

A) surgical procedures.
B) all of these are reported by CPT.
C) medical services.
D) diagnostic procedures.

Question 14

Which two sections follow the same types of guidelines?

A) E/M and Radiology
B) Surgery and Anesthesia
C) Radiology and Surgery
D) E/M and Surgery

Question 15

Which of the following are used to report services not completely described by any code within a section?

A) Category III codes
B) Unlisted procedure codes
C) Category II codes
D) Category I codes

Question 16

What was set up to give health care providers a coding system that describes specific products, supplies, and services that patients receive?

A) CPT
B) Level I
C) HCPCS
D) ICD-10-CM

Question 17

In CPT, a lightning bolt symbol next to a code indicates a(n)

A) revised code descriptor.
B) code pending FDA approval.
C) add-on code.
D) new/revised text other than the descriptor.

Question 18

How many key components are there when evaluating an E/M code?

A) two
B) three
C) five
D) four

Question 19

What is required of the physician in order to report the professional component of a CPT code from the Radiology section?

A) performing both the test and the reading
B) reading the radiological examination and writing a report of interpretation
C) reading the radiological examination
D) writing a report of interpretation

Question 20

A patient is to have a diagnostic arthroscopy of the left knee. The physician inserted the arthroscope and the patient went into respiratory distress. The arthroscope was withdrawn and the procedure was terminated. What is a correct modifier?

A) -53 Discontinued procedure
B) -51 Multiple procedures
C) -76 Repeat procedure
D) -26 Professional component

Question 21

In CPT, some codes have both a technical component and another component representing the physician's skill, time, and expertise. What is the name of this other component?

A) combination
B) evaluation and management
C) panel
D) professional

Question 22

The chest X-ray was performed before placing a chest tube and then again after the chest tube placement to verify the position. What is a correct modifier?

A) -76 Repeat procedure
B) -51 Multiple procedures
C) -26 Repeat procedure
D) -53 Discontinued procedure

Question 23

How many parts do radiological procedures have?

A) only one
B) up to four
C) three
D) two

Question 24

CPT codes for initial hospital care can be reported

A) these are reported by the hospital only.
B) every day the patient is hospitalized.
C) every 24 hours a patient is hospitalized.
D) only once per hospitalization.

Question 25

The last step in the coding process is

A) Identify the main term.
B) verify the code in the CPT text.
C) determine the need for modifiers.
D) locate the Main term in the index.

Question 26

When a medical practice receives a revised edition of CPT, what activities should follow?

A) Educate medical professional staff.
B) Update patient billing software.
C) Update encounter forms.
D) All of these.

Question 27

DME is the abbreviation for

A) doctors machines and equipment.
B) durable machines and equipment.
C) durable medical equipment.
D) doctors medical equipment.

Question 28

A complete procedure includes all the following except

A) the operation.
B) the use of local anesthetic.
C) postoperative complications.
D) postoperative care.

Question 29

When selecting an Evaluation and Management code, three components are considered: the type of history, the physical examination, and the

A) interval history.
B) diagnoses options.
C) medical decision making.
D) family background.

Question 30

Which symbol is used to designate revised text?

A) a plus sign
B) a bullet
C) a triangle
D) facing triangles

Question 31

Which of the following is the best process to correctly select CPT codes?

A) Locate the probable code, determine the procedures and services it covers, and determine the need for modifiers.
B) Determine the correct codes and modifiers, and then place them in the proper order from primary to secondary procedures.
C) Determine the procedures and services to report, identify the correct codes, and determine the need for modifiers.
D) Flip through the index until you find a code that matches your procedure.

Question 32

Durable medical equipment (DME), such as wheelchairs, is reported using

A) ICD-10-CM codes.
B) local Medicare carrier codes.
C) CPT codes.
D) HCPCS codes.

Question 33

Of the four types of examinations that a physician can perform, which level is the most complete?

A) comprehensive
B) expanded problem-focused
C) problem-focused
D) detailed

Question 34

Which of the following temporary codes is for the professional component of services and procedures not found in CPT?

A) G codes
B) C codes
C) K codes
D) Q codes

Question 35

The divisions of CPT, such as Anesthesia and Radiology, are referred to as

A) chapters.
B) sections.
C) components.
D) parts.

Question 36

Under CPT's definition, who takes responsibility for the patient's care after a referral?

A) the physician to whom the patient is referred
B) the emergency room physician
C) the physician who referred the patient
D) the physician who admits the patient to the hospital

Question 37

Unbundling is

A) using an add-on code only.
B) separately reporting anything that is included in the bundled code.
C) using an inappropriate modifier.
D) reporting anything extra.

Question 38

In CPT, a single code grouping laboratory tests is called a(n)

A) panel.
B) E/M code.
C) E code.
D) V code.

Question 39

In CPT, E/M is the abbreviation for Evaluation and

A) Maintenance.
B) Management.
C) Manifestation.
D) Mammography.

Question 40

A podiatrist performs a bunionectomy on the great toe and during the same operation corrects a hammertoe on the third toe. What is a correct modifier?

A) -76 Repeat procedure
B) -51 Multiple procedures
C) -26 Professional component
D) -53 Discontinued procedure

Question 41

Which of the following temporary codes is valid for Medicare claims only?

A) K codes
B) C codes
C) G codes
D) Q codes

Question 42

A graft was performed 10 days following an allograft application to allow the underlying tissues time to heal. The surgeon knows at the time of the allograft that the grafting will be performed within 10 to 15 days. What is a correct modifier?

A) -22 Increased Procedural Services
B) -58 Staged procedure
C) -52 Reduced services
D) -50 Bilateral Procedure

Question 43

The physician performed a carpal tunnel release on the right and left median nerves during the same operative session. What is a correct modifier?

A) -50 Bilateral Procedure
B) -52 Reduced services
C) -22 Increased Procedural Services
D) -58 Staged procedure

Question 44

The CMS HCPCS Workgroup maintains the

A) permanent national codes.
B) temporary national codes.
C) DME MACs.
D) all of these are correct.

Question 45

Which of the following regulates which tests can be completed in an in-office laboratory setting?

A) OSHA
B) CLIA
C) CMS
D) OIG

Question 46

Laminotomy, one lumbar interspace with decompression of nerve roots, with excessive bleeding and lysis of scar tissue with sharp dissection requires an additional 60 minutes of time in surgery. What is a correct modifier to report the extended time?

A) -58 Staged procedure
B) -22 Increased procedural service
C) -50 Bilateral procedure
D) -52 Reduced services

Question 47

A neurosurgeon and an otorhinolaryngologist are working as co-surgeons in performing transsphenoidal excision of a pituitary neoplasm. What is a correct modifier?

A) -62 Two surgeons
B) -76 Repeat procedure
C) -26 Professional component
D) -51 Multiple procedures

Question 48

How many possible add-on qualifying circumstances are there in the Anesthesia Section?

A) ten
B) two
C) four
D) eight

Question 49

With E/M coding, physicians must

A) analyze.
B) all of these are needed.
C) make decisions.
D) gather information.

Question 50

To avoid reduced payment for multiple procedures, the coder should use modifier __________ to indicate distinct procedures.

A) 59
B) 51
C) 66
D) 99

Question 51

In CPT, what do facing triangles that appear in front of a code indicate?

A) new/revised text other than a code descriptor
B) add-on code
C) revised code
D) new code

Question 52

Codes in CPT's Anesthesia section generally cover

A) all of these are correct.
B) routine postoperative care.
C) preoperative evaluation and planning.
D) care during the procedure.

Question 53

Codes in the anesthesia section are paid according to the

A) severity of the surgery.
B) time.
C) severity of the diagnosis.
D) the type of anesthesia used.

Question 54

When listing multiple procedures, the coder should

A) unbundle all applicable codes.
B) use a modifier 51.
C) list the most complex code first.
D) report a separate code for a procedure that is included in the bundled code.

Question 55

A __________ is a procedure that is usually part of a surgical package but may also be performed separately.

A) complication
B) global package
C) separate procedure
D) modifier

Question 56

Which symbol is used to designate it is an add-on code?

A) a plus sign
B) a triangle
C) facing triangles
D) a bullet

Question 57

Which of the following is a cross-reference that might be seen in CPT?

A) See Also
B) Neither "See" nor "See Also" is seen
C) See
D) Both "See" and "See Also" are seen

Question 58

A complete procedure in the pathology and laboratory section includes all of the following except

A) performing the test.
B) ordering the treatment based on the results.
C) ordering the test.
D) handling the sample.

Question 59

When selecting an E/M for the Emergency Department the coder needs to know

A) none of these are determining factors in E/M Emergency Department coding.
B) if the patient is new.
C) what time the patient came to the Emergency Department.
D) if the patient is established.

Question 60

What does HCPCS use to provide additional information about services, supplies, and procedures?

A) Level IV modifiers
B) All of these are correct
C) Level III modifiers
D) Level II modifiers

Question 61

Which of the following is used with an anesthesia code to indicate a patient's health status?

A) qualifying circumstances
B) E/M codes
C) physical status modifiers
D) HCPCS modifiers

Question 62

Common descriptors in CPT begin with a(n)

A) capital letter
B) number.
C) minus sign.
D) plus sign.

Question 63

Which of the following items could be found on the HCPCS website?

A) a list of current HCPCS codes
B) an alphabetical index of HCPCS codes by type of service or product
C) an alphabetical table of drugs for which there are Level II codes
D) all of these are correct

Question 64

Which group identifies services for which new HCPCS level II codes are needed?

A) CMS HCPCS Workgroup
B) DMEPOS
C) OCR
D) AMA

Question 65

Level I codes in the Health Care Common Procedure Coding System (HCPCS) are

A) new codes.
B) alphanumeric codes.
C) HCPCS codes.
D) Current Procedural Terminology (CPT) codes.

Question 66

Which of the following is not a key component in E/M coding?

A) medical decision making
B) treatment
C) history
D) exam

Question 67

A ___________ is a single code grouping laboratory tests frequently done together.

A) microscopy
B) bundle
C) sample
D) panel

Question 68

In the CPT entry 50400 Pyeloplasty (Foley Y-pyeloplasty) the words in parentheses are referred to as

A) descriptor.
B) procedure.
C) narrative.
D) diagnosis.

Question 69

The Evaluation and Management section was first introduced in what year?

A) 1970
B) 1966
C) 1946
D) 1992

Question 70

The use of CPT Category II codes does not affect reimbursement and is

A) optional.
B) mandatory.
C) required.
D) None of these are correct.

Question 71

The Anesthesia section's subsections are organized by

A) procedure.
B) body site.
C) diagnosis.
D) type of anesthesia.

Question 72

Under CPT's definition, after a consultation, who takes responsibility for the patient's care?

A) The consulting physician
B) The nurse practitioner
C) the referring physician
D) The specialist

Question 73

The E/M coding method came from the

A) joint effort of CMS and AMA.
B) CMS.
C) WHO.
D) AMA.

Question 74

CPT Level I modifiers are made up of how many digits?

A) two digits
B) modifiers are not used with Level I codes
C) one digit
D) three digits

Question 75

The term __________ refers to using a single payment for two or more related procedure codes.

A) bundling
B) unbundling
C) grouping
D) surgical package

Question 76

A radiologist reads and prepares a written report for a frontal and lateral chest X-ray. What is a correct modifier?

A) -26 Professional component
B) -76 Repeat procedure
C) -53 Discontinued procedure
D) -51 Multiple procedures

Question 77

Codes that are used to indicate that the administration of the anesthesia involved difficult circumstances are called

A) add-on codes.
B) E/M codes.
C) physical status modifiers.
D) anesthesia codes.

Question 78

CPT codes from the Anesthesia section have what two types of modifiers?

A) physical status modifiers and duration modifiers
B) nonstandard modifiers and physical status modifiers
C) standard modifiers and physical status modifiers
D) standard modifiers and duration modifiers

Question 79

Which appendix in CPT contains the Summary of Modifier 51 exempt codes?

A) Appendix F
B) Appendix E
C) Appendix G
D) Appendix D

Question 80

Under CPT guidelines, all services related to a surgical procedure are not additionally reimbursed

A) after the global period.
B) before the global period.
C) during the E/M period.
D) during the global period.