Deck 8: Coding Procedures and Services

Question 1

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

A)assign the code.
B)look under a related procedure for more information.
C)refer to the patient chart for more information.
D)verify the code in the main text of the CPT book.

Answer 1

verify the code in the main text of the CPT book.

Question 2

The modifier used to report a bilateral procedure is:

A)-22.
B)-47.
C)-50.
D)-53.

Answer 2

-50.

Question 3

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

A)-22
B)-25
C)-63
D)-79

Answer 3

-22

Question 4

Codes used to report services provided on a given day are ranked in order of:

A)lowest to highest code number.
B)highest to lowest code number.
C)lowest to highest reimbursement rate.
D)highest to lowest reimbursement rate.

Question 5

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

A)-54.
B)-55.
C)-56.
D)-58.

Question 6

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

A)-52.
B)-53.
C)-73.
D)-74.

Question 7

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

A)abdominal distention.
B)arthroscopy.
C)osteopathic manipulation.
D)evaluation and management.

Question 8

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

A)organ, or other anatomic site.
B)chief complaint.
C)procedure or service.
D)synonyms, eponyms, and abbreviations.

Question 9

All services or procedures coded must be:

A)performed by the provider who is billing for the charge.
B)documented in the patient's medical record.
C)covered under the patient's insurance.
D)unbundled.

Question 10

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

A)hyphen.
B)comma.
C)colon.
D)semicolon.

Question 11

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

A)anesthesia performed by the surgeon.
B)routine preoperative visits to evaluate the patient for planned anesthesia.
C)monitoring the patient's postsurgery recovery from anesthesia.
D)administration of fluids and/or blood during the period of anesthesia care.

Question 12

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

A)bold uppercase and lowercase letters.
B)bold uppercase letters.
C)all uppercase letters, not bold.
D)all lowercase letters, not bold.

Question 13

The Anesthesia section of the code book can be found directly before the:

A)Evaluation and Management section.
B)Surgery section.
C)Radiology section.
D)Medicine section.

Question 14

The proper use of CPT modifiers can result in:

A)increased reimbursement.
B)claim-processing delays.
C)denials of claims.
D)reduced reimbursement.

Question 15

A bundled code refers to a:

A)group of unrelated procedures done on the same day.
B)group of procedures pertaining to the same diagnosis.
C)group of related procedures covered by a single code.
D)code used with modifier -99.

Question 16

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

A)main term.
B)parent code.
C)official code.
D)subterm.

Question 17

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

A)list each modifier on the same line as the CPT code, separated by commas.
B)repeat the CPT code and append each modifier as many times as necessary.
C)attach a special report instead of using the modifiers.
D)append modifier -99 to the basic procedure code and list the other modifiers as part of the description of service.

Question 18

Anesthesia is reimbursed according to the:

A)type of drug administered.
B)type of surgery or procedure being performed.
C)time under anesthesia.
D)experience of the anesthesiologist.

Question 19

Modifier -47 is used to report:

A)multiple procedures that involve anesthesia.
B)use of local anesthesia.
C)anesthesia administered by a surgeon.
D)procedure performed by a surgical assistant.

Question 20

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

A)Multiple, related operative procedures performed at the same session by the same provider
B)A combination of medical and operative procedures performed at the same session by the same provider
C)Multiple medical procedures performed at the same session by the same provider
D)All of the above

Question 21

The global surgical period is determined by the:

A)patient's primary care physician.
B)surgeon.
C)patient.
D)insurance carrier or other third-party payer.

Question 22

The subsections under Anesthesia in the CPT code book are organized by:

A)type of surgery or procedure.
B)time under anesthesia.
C)body site.
D)type of drug administered.

Question 23

The add-on code used to identify that a patient is younger than 1 year old and is receiving anesthesia is:

A)+99900.
B)+99110.
C)+99100.
D)+91000.

Question 24

A surgical package includes:

A)a group of codes authorized by the Centers for Medicare and Medicaid Services (CMS).
B)specific additional services in addition to a surgical procedure.
C)surgical procedures plus required anesthesia.
D)a discounted rate of payment when an elective procedure is performed at the same time as a medically necessary procedure.

Question 25

In coding radiology services, the part of the procedure that reflects the technologist and the equipment used is the:

A)technical component.
B)professional component.
C)supply and equipment component.
D)results component.

Question 26

The largest section of the CPT code book is:

A)Evaluation and Management.
B)Surgery.
C)Pathology and Laboratory.
D)Medicine.

Question 27

A complete pathology and/or laboratory procedure includes:
ordering the test.
handling the sample.
performing the test.
analyzing the results.
reporting on the results.

Question 28

Which type of procedure is reported as an additional procedure performed in addition to a main procedure?

A)Primary procedure
B)Elective procedure
C)Essential procedure
D)Secondary procedure

Question 29

A surgical package would include:

A)one evaluation and management (E/M) encounter on the date immediately prior to the date of the procedure.
B)all E/M encounters prior to the date of the procedure.
C)all general anesthesia services.
D)all care provided within 30 days of surgery.

Question 30

The physical status modifier that should be used for a patient with severe systemic disease that is a constant threat to life is:

A)P1.
B)P3.
C)P4.
D)P6.

Question 31

The use of the term supervision and interpretation (S&I) means that the radiology code represents only the:

A)technical component.
B)results component.
C)supply and equipment component.
D)professional component.

Question 32

Add-on codes describe procedures/services that are performed:

A)at a later date than the primary procedure.
B)in addition to the primary procedure.
C)as an elective part of the primary procedure.
D)in anticipation of the primary procedure.

Question 33

With respect to global surgical package guidelines, surgical supplies are:

A)always included in the global fee.
B)always billed separately from the surgical code.
C)billed separately only if they are over and above those usually included with procedures.
D)never coded.

Question 34

Which forms of specimen collection are coded separately from the laboratory test?

A)Venipuncture
B)Arterial puncture
C)Lumbar puncture
D)Fingerstick

Question 35

The Surgery section of the CPT code book is divided into subsections by:

A)type of procedure.
B)body system/anatomic area.
C)disease or condition.
D)place of service.

Question 36

The physical status modifier P1 refers to a:

A)normal, healthy patient.
B)patient with mild systemic disease.
C)patient with severe systemic disease.
D)patient who is not expected to survive without the surgery.

Question 37

Surgical procedures can be described as:

A)incision.
B)excision.
C)repair.
D)all of the above.

Question 38

A closed manipulation or repair of a fracture is considered to be which type of service?

A)Evaluation and Management
B)Surgery
C)Medicine
D)Physical Therapy

Question 39

A service NOT included in the surgical package code would be:

A)evaluating the patient in the postanesthesia recovery room.
B)immediate postoperative care, including talking with the patient's family.
C)surgical complications or the presence of other diseases requiring additional services.
D)one related evaluation and management (E/M) encounter on the date immediately prior to the date of the procedure.

Question 40

A physical status modifier is used with which of the following CPT codes?

A)Evaluation and Management
B)Anesthesia
C)Surgery
D)Radiology

Question 41

When add-on codes are used, the coder should also use modifier -51 to identify more than one code.

Question 42

A range of codes is shown when more than one code applies to a term (descriptor).

Question 43

To bill for services provided by an audiologist, the necessary CPT codes would be found in the:

A)Evaluation and Management section.
B)Anesthesia section.
C)Pathology and Laboratory section.
D)Medicine section.

Question 44

Codes identified by the symbol of a circle with a slash through it (null symbol) are:

A)required to use modifier -51.
B)exempt from modifier -51.
C)exempt from modifier -50.
D)required to be stand-alone codes.

Question 45

Laboratories that are part of a medical practice must be certified by which agency?

A)Laboratory Corporation of America
B)U.S. Food and Drug Administration
C)Clinical Laboratory Improvement Amendment (CLIA) program
D)Centers for Disease Control and Prevention

Question 46

If a physician repeats a basic procedure performed by another physician, the modifier -77 should be used.

Question 47

If a physician's office collects a blood sample and sends it to an outside lab, the physician:

A)can bill for obtaining the sample.
B)can never bill for any type of lab work.
C)can bill for analyzing the test results only in certain cases.
D)cannot bill for obtaining the sample.

Question 48

To bill for the services of a physical therapist, the necessary CPT codes would be found in the:

A)Evaluation and Management section.
B)Surgical section.
C)Pathology and Laboratory section.
D)Medicine section.

Question 49

In the CPT index, "See Also" directs the coder to look under another main term if the procedure is NOT listed under the first main index entry.

Question 50

To locate a code in the CPT index, the coder can look under the affected organ or anatomic site of the condition.

Question 51

To code for immunizations, the coder should use:

A)one bundled code for the administration and the vaccine given.
B)one code for the administration only.
C)one code for the vaccine given.
D)one code for the administration and one code for the vaccine.

Question 52

Examples of when add-on codes would be used include:

A)anesthesia for a patient more than 70 years old.
B)biopsy of a second and third lesion.
C)complicated closure of a second wound.
D)all of the above.

Question 53

All CPT codes contain either four or five digits.

Question 54

CPT codes for immunizations can be found in the:

A)Evaluation and Management section.
B)Medicine section.
C)Surgical section.
D)Pathology and Laboratory section.

Question 55

All coded and billed services or procedures must be documented in the patient's medical record.

Question 56

A special report should be included with all claim submissions to justify the procedure's medical necessity.

Question 57

The lowest level of an in-office lab certified by Clinical Laboratory Improvement Amendment (CLIA) can perform which tests?

A)CBC and dipstick urine
B)Urine pregnancy and blood alcohol level
C)Dipstick urine and urine pregnancy
D)CBC and blood alcohol level

Question 58

Modifier -63 (for a procedure performed on infants less than 4 kg) should only be used in coding surgical procedures.

Question 59

In pathology and laboratory services coding, a panel is reported when:

A)all of the listed tests are performed without substitution.
B)all of the listed tests are performed with one or two substitutions.
C)at least two of the listed tests are performed without substitution.
D)at least three of the listed tests are performed without substitution.

Question 60

Which type of code describes the total procedure or service that was performed?

A)Add-on code
B)Combination code
C)Code plus modifier -51
D)Stand-alone code

Question 61

Supplies and materials usually included with the office visit can be billed separately.

Question 62

The technical component of a radiology code reflects the physician's skill, time, and expertise used in performing the procedure.

Question 63

The period of time included in the surgical package is determined by each individual third-party payer.

Question 64

To locate the main term for a procedure or service in the CPT code book, the medical office assistant should use the __________ .

Question 65

A group of laboratory tests ordered together to detect a particular disease or organ malfunction is known as a(n) __________ .

Question 66

Repair, revision, and reconstruction are all descriptions related to surgical procedures.

Question 67

The number of days surrounding a surgical procedure during which all services relating to the procedure are considered part of the surgical package is the __________ .

Question 68

To indicate the patient's health status when coding Anesthesia services, the medical office assistant should use a(n) __________ modifier.

Question 69

A physical status modifier is only used to code anesthesia if there is an extraordinary condition or unusual risk factor.

Question 70

Unbundling (also known as fragmented billing) will result in higher reimbursement for the physician and should be done in as many circumstances as possible.

Question 71

The largest section of the CPT code book is __________ .

Question 72

A procedure performed in addition to the primary procedure is known as a(n) __________ procedure.

Question 73

Codes for services provided by an occupational therapist would be found in the Medicine section of the CPT code book.

Question 74

The most resource-intensive procedure performed during one encounter is the __________ procedure.

Question 75

Codes that cannot be used alone and are appended to the main procedure code to describe procedures that are performed in addition to the primary procedure are __________ codes.

Question 76

When contrast materials are administered orally for radiological services, the coder should look for the term "without contrast" for the correct code.

Question 77

An add-on code can be reported as a stand-alone code if the procedure was performed during a separate encounter.

Question 78

A single CPT code used to report a group of related procedures, as in the surgical package, is known as a(n) __________ code.

Question 79

Codes reported for services and procedures performed on the same day should be ranked from lowest to highest rate of reimbursement.

Question 80

Normal uncomplicated care following a surgical procedure is typically included in the global surgical fee.