Quiz 7: CPT Coding

Procedures and services submitted on a claim must be linked to the __________ that justifies the need for the service or procedure. A) CPT code B) HCPCS code C) ICD-10-CM code D) HCPCS level I code

With what type of codes are procedures/services identified by a five-digit CPT code and descriptor nomenclature (these are codes traditionally associated with the CPT and organized within six sections)? A) Category I codes B) Category II codes C) Category I and II codes D) Category III codes

Which are "performance measurements" tracking codes that are assigned an alphanumeric identifier with a letter in the last field? A) Category I codes B) Category II codes C) Category III codes D) Category IV codes

What type of codes contain "emerging technology," are temporary codes assigned for data collection, and are still used by some third-party payers? A) Category I codes B) Category II codes C) Category III codes D) Category IV codes

Most CPT procedures and services are classified as __________ codes, which include a complete description of the procedure or service. A) indented B) individual C) separate D) stand-alone

To save space in CPT, some descriptions are not printed in their entirety next to a code number, and a(n) __________ code appears below a another code, requiring the coder to refer back to the common portion of the code description that is located before the semicolon. A) indented B) individual C) separate D) stand-alone

A bullet located to the left of a code number identifies codes that were __________. A) added to CPT for new procedures and services B) deleted from CPT since its last edition C) reinstated or recycled since the last edition D) revised since the last edition of CPT

A triangle located to the left of a code number identifies a code description that has been __________. A) added to CPT for new procedures and services B) deleted from CPT since its last edition C) reinstated or recycled since the last edition D) revised since the last edition of CPT

Horizontal triangles surround revised __________. A) codes and code descriptions B) guidelines and notes C) modifiers and descriptions D) procedures and services

A semicolon is used to save space in CPT, which means __________. A) add-on codes are assigned procedures performed during another procedure B) modifiers are never assigned for described procedures and services C) revised procedures and services have been added to the code description D) some code descriptions are not printed in their entirety next to a code number

The plus symbol identifies __________ for procedures that are commonly, but not always, performed at the same time and by the same surgeon as the primary procedure. A) add-on codes B) indented codes C) modifiers D) parenthetical notes

The forbidden symbol identifies codes that are not to be used with modifier __________. A) -25 B) -26 C) -51 D) -59

The bull's-eye symbol located next to a code number indicates that the procedure __________. A) has been revised since the last edition of the CPT manual B) includes moderate (conscious) sedation C) is being performed on a patient of extreme age D) was performed on both sides of the body

Moderate (conscious) sedation is the administration of moderate __________, which results in a drug-induced depression of consciousness. A) epidural injections B) general anesthesia C) local anesthetics D) sedation or analgesia

The flash symbol indicates codes that classify products that are pending __________ approval but have already been assigned a CPT code. A) CMS B) FDA C) HHS D) MAC

The hollow circle symbol next to a CPT code indicates a(n) __________ or recycled CPT code. A) added B) deleted C) reinstated D) revised

The number symbol precedes CPT __________ codes, which appear out of numerical order. A) added B) deleted C) resequenced D) revised

Which define terms and explain the assignment of codes for procedures and services located in a particular section of the CPT manual? A) boldfaced terms B) guidelines C) symbols D) unlisted codes

Which type of procedure or service code is assigned when the provider performs a procedure or service for which there is no CPT code? A) add-on code B) indented code C) stand-alone code D) unlisted code

When an unlisted procedure or service code is reported, a __________ must accompany the claim to describe the nature, extent, and need for the procedure or service along with the time, effort, and equipment necessary to provide the service. A) CMS-1500 claim B) copy of the record C) remittance advice D) special report

Which appear throughout CPT sections to clarify the assignment of codes? A) add-on codes B) guidelines C) instructional notes D) special reports

Which are terms that clarify the assignment of a CPT code and can occur in the middle of a main clause or after the semicolon, and may or may not be enclosed in parentheses? A) code descriptions B) descriptive qualifiers C) instructional notes D) modifiers

Main terms in the CPT index are printed in __________. A) all capitals B) boldface type C) italics D) underlined type

Which is a CPT cross-reference that directs coders to an index entry under which codes are listed? A) See B) See also C) See category D) See code

Which typeface is used for cross-reference terms in the CPT index? A) all capitals B) boldface C) italics D) underlining

To save space in the CPT index when referencing subterms, __________ words are used. A) add-on B) inferred C) presumptive D) speculative

CPT modifiers __________ the meaning of services and procedures performed by providers. A) clarify and alter B) completely change C) delete D) revise

The Evaluation and Management section is located at the beginning of CPT because these codes describe __________. A) encounters that have unusual circumstances B) health care rendered by nonphysicians only C) procedures performed by anesthesiologists D) services most frequently provided by physicians

The Evaluation and Management __________ of service reflects the amount of work involved in providing health care to a patient. A) complexity B) level C) place D) type

The __________ of service refers to the physical location where health care is provided to patients. A) complexity B) level C) place D) type

The __________ of service refers to the kind of health care services provided to patients. A) complexity B) level C) place D) type

A new patient is one who has not received any professional services from the physician, or from another physician of the same specialty who belongs to the same group practice, within the past __________ year(s). A) one B) two C) three D) four

An established patient is one who has received professional services from the physician, or from another physician of the same specialty who belongs to the same group practice, within the past __________ years. A) one B) two C) three D) four

Concurrent care is the provision of similar services, such as hospital inpatient visits, to __________ on the same day. A) different patients by more than one provider B) different patients by the same provider C) the same patient by more than one provider D) the same patient by the same provider

Transfer of care occurs when a physician who is managing some or all of a patient's problems releases the patient to the care of another physician who is __________. A) consulting on the case in the office B) not providing consultative services C) providing consultative services D) terminating all care provided

CMS developed Evaluation and Management Documentation Guidelines, which explain how CPT evaluation and management codes are assigned according to __________ associated with comprehensive multisystem and single-system examinations. A) documentation B) elements C) office visits D) reimbursement

The __________ components of history, examination, and medical decision making are required when selecting an evaluation and management level of service code. A) collaborative B) key

The __________ components include counseling, coordination of care, nature of presenting problem, and time. A) collaborative B) key

A history is an interview of the patient that includes which of the following elements? A) chief complaint, history of present illness, past/family/social history B) chief complaint, history of present illness, past/family/social history, physical examination C) chief complaint, history of present illness, past/family/social history, review of systems D) chief complaint, past/family/social history, physical examination, review of systems

The CPT __________ of history is categorized according to four levels. A) extent B) level C) range D) type

The CPT problem-focused history includes the __________. A) chief complaint and brief history of present illness or problem B) chief complaint, brief history of present illness or problem, and problem-pertinent system review C) chief complaint, extended HPI, problem-pertinent system review extended to include a limited number of additional systems, and pertinent PFSH directly related to the patient's problem D) chief complaint, extended HPI, ROS directly related to the problem(s) identified in the HPI in addition to a review of all additional body systems, and complete PFSH

The CPT expanded problem-focused history includes the __________. A) chief complaint and brief history of present illness or problem B) chief complaint, brief history of present illness or problem, and problem-pertinent system review C) chief complaint, extended HPI, problem-pertinent system review extended to include a limited number of additional systems, and pertinent PFSH directly related to the patient's problem D) chief complaint, extended HPI, ROS directly related to the problem(s) identified in the HPI in addition to a review of all additional body systems, and complete PFSH

The CPT detailed history includes the __________. A) chief complaint and brief history of present illness or problem B) chief complaint, brief history of present illness or problem, and problem-pertinent system review C) chief complaint, extended HPI, problem-pertinent system review extended to include a limited number of additional systems, and pertinent PFSH directly related to the patient's problem D) chief complaint, extended HPI, ROS directly related to the problem(s) identified in the HPI in addition to a review of all additional body systems, and complete PFSH

The CPT comprehensive history includes the __________. A) chief complaint and brief history of present illness or problem B) chief complaint, brief history of present illness or problem, and problem-pertinent system review C) chief complaint, extended HPI, problem-pertinent system review extended to include a limited number of additional systems, and pertinent PFSH directly related to the patient's problem D) chief complaint, extended HPI, ROS directly related to the problem(s) identified in the HPI in addition to a review of all additional body systems, and complete PFSH

Which is an assessment of the patient's body areas and organ systems? A) physical examination B) review of systems

The CPT __________ of examination is categorized according to four levels. A) extent B) level C) range D) type

The CPT problem-focused examination includes a(n) __________. A) extended examination of the affected body areas and other symptomatic or related organ systems B) general multisystem examination or a complete examination of a single organ system C) limited examination of the affected body area or organ system D) limited examination of the affected body areas or organ systems and other symptomatic or related organ systems

The CPT expanded problem-focused examination includes a(n) __________. A) extended examination of the affected body areas and other symptomatic or related organ systems B) general multisystem examination or a complete examination of a single organ system C) limited examination of the affected body area or organ system D) limited examination of the affected body areas or organ systems and other symptomatic or related organ systems

The CPT detailed examination includes a(n) __________. A) extended examination of the affected body areas and other symptomatic or related organ systems B) general multisystem examination or a complete examination of a single organ system C) limited examination of the affected body area or organ system D) limited examination of the affected body areas or organ systems and other symptomatic or related organ systems

The CPT comprehensive examination includes a(n) __________. A) extended examination of the affected body areas and other symptomatic or related organ systems B) general multisystem examination or a complete examination of a single organ system C) limited examination of the affected body area or organ system D) limited examination of the affected body areas or organ systems and other symptomatic or related organ systems

CPT medical decision making refers to the complexity of __________ as measured by the number of diagnoses or management options, amount and/or complexity of data to be reviewed, and risk of complications and/or morbidity or mortality. A) assessing patient data in a group or single practice B) completing a comprehensive history and physical examination C) establishing a diagnosis and/or selecting a management option D) ordering ancillary tests and interpreting their results

CPT defines counseling as it relates to evaluation and management coding as a(n) __________ concerning areas that involve diagnostic results, impressions, recommended diagnostic studies, and so on. A) assessment that impacts patient care B) discussion with a patient and/or family C) order for further ancillary testing D) way to guarantee quality patient care

When the physician makes arrangements with other providers or agencies for services to be provided to a patient, this is called __________ of care. A) coordination B) delivery C) quality D) transfer

Which is considered when determining the number of diagnoses or management options for medical decision-making complexity? It includes a disease, condition, illness, injury, symptom, sign, finding, complaint, or other reason for the encounter, with or without a diagnosis being established at the time of the encounter. A) chief complaint B) history of present illness C) nature of presenting problem D) review of systems

Which is the amount of time the office or outpatient care provider spends with the patient and/or family? A) face-to-face time B) unit/floor time

Which is the amount of time the provider spends at the patient's bedside and at management of the patient's care on the inpatient unit or floor? A) face-to-face time B) unit/floor time

Observation services furnished in a hospital outpatient setting where the patient is considered an outpatient __________. A) are reimbursed when ordered by a physician B) include a bed but no monitoring procedures C) must be preauthorized by Medicare D) routinely convert to an inpatient admission

Subcategories of hospital inpatient evaluation and management services include initial hospital care, which includes the __________. A) admission and discharge from observation/inpatient status on the same day B) final examination of the patient, discussion of hospital stay with patient or caregiver, instructions for continued care, and preparation of discharge records, prescriptions, and referral forms C) inpatient's first encounter D) review of the chart for changes in patient's condition, results of diagnostic studies, and/or reassessment of patient's condition since performance of last assessment

Subcategories of hospital inpatient evaluation and management services include subsequent hospital care, which includes the __________. A) admission and discharge from observation/inpatient status on the same day B) final examination of the patient, discussion of hospital stay with patient or caregiver, instructions for continued care, and preparation of discharge records, prescriptions, and referral forms C) inpatient's first encounter D) review of the chart for changes in patient's condition, results of diagnostic studies, and/or reassessment of patient's condition since performance of last assessment

Subcategories of hospital inpatient evaluation and management services include observation or inpatient care services, which include the __________. A) admission and discharge from observation/inpatient status on the same day B) final examination of the patient, discussion of hospital stay with patient or caregiver, instructions for continued care, and preparation of discharge records, prescriptions, and referral forms C) inpatient's first encounter D) review of the chart for changes in patient's condition, results of diagnostic studies, and/or reassessment of patient's condition since performance of last assessment

Subcategories of hospital inpatient evaluation and management services include hospital discharge services, which include the __________. A) admission and discharge from observation/inpatient status on the same day B) final examination of the patient, discussion of hospital stay with patient or caregiver, instructions for continued care, and preparation of discharge records, prescriptions, and referral forms C) inpatient's first encounter D) review of the chart for changes in patient's condition, results of diagnostic studies, and/or reassessment of patient's condition since performance of last assessment

Which describes the short-term, intensive treatment program where individuals who are experiencing an acute episode of an illness can receive medically supervised treatment during a significant number of daytime or nighttime hours? A) inpatient hospitalization B) outpatient hospitalization C) partial hospitalization D) skilled nursing facility hospitalization

Which is the examination of a patient by a health care provider, usually a specialist, for the purpose of advising the referring or attending physician in the evaluation and/or management of a specific problem with a known diagnosis? A) consultation B) discharge C) referral D) transfer

Which occurs when a patient reports that another provider sent the patient to the provider, but the first provider did not schedule the appointment or document a request for services? A) consultation B) discharge C) referral D) transfer

Which occurs when a surgeon requests a specialist or other physician to examine a patient to determine if the patient can withstand the expected risks of a specific surgery? A) consultation B) preoperative clearance C) referral D) transfer

Which are provided in a hospital that is open 24 hours for the purpose of providing unscheduled episodic services to patients who require immediate medical attention? A) ambulatory services B) emergency department services C) inpatient services D) outpatient services

Which are reported when a physician directly delivers medical care for a critically ill or critically injured patient? A) critical care services B) emergency department services C) inpatient services D) outpatient services

Which are provided at an intermediate care facility or mentally handicapped, long-term care facility, or psychiatric residential treatment facility? A) critical care services B) inpatient services C) nursing facility services D) outpatient services

A nursing facility comprehensive assessment is documented when the patient is __________. A) admitted as a new patient to the facility B) admitted or readmitted to the facility C) readmitted to the nursing facility D) reassessed on a routine basis

Care plan oversight services cover the physician's time __________ the complex and multidisciplinary care treatment program for a specific patient who is under the care of a domiciliary or rest home or who resides at home. A) auditing B) justifying C) operating D) supervising

Home services are provided to individuals in __________ to promote, maintain, or restore health and/or to minimize the effects of disability and illness, including terminal illness. A) an inpatient hospice B) ambulatory care settings C) health care facilities D) their place of residence

Physicians' services involving patient contact that are considered beyond the usual service in either an inpatient or outpatient setting may be reported as __________ services. A) case management B) critical care C) prolonged D) unlisted

Prolonged physician service with direct patient contact refers to __________ patient contact on an inpatient or outpatient basis. A) critical care B) face-to-face C) standby D) unusual

Prolonged physician service without direct patient contact refers to __________ patient contact on an inpatient or outpatient basis. A) critical care B) non-face-to-face C) standby D) unusual

Which cover physicians who spend prolonged periods of time without direct patient contact, until physician's services are required? A) critical care services B) face-to-face services C) standby services D) unusual services

Which include processes in which a physician is responsible for direct care of a patient and for coordinating and controlling access to or initiating and/or supervising other health care services needed by the patient? A) case management services B) face-to-face services C) standby services D) unusual services

Which include routine examinations or risk management counseling for children and adults who exhibit no overt signs or symptoms of a disorder while presenting to the medical office for a preventive medical physical? A) case management services B) preventive medicine services C) prolonged services D) standby services

Newborn care includes services provided to newborns in a(n) __________. A) ambulatory care setting B) inpatient hospital C) nursing facility D) variety of health care settings

When anesthesia services are provided during situations or circumstances that make anesthesia administration more difficult, report a qualifying circumstances code from the CPT __________ section. A) Anesthesia B) Evaluation and Management C) Medicine D) Surgery

A physical status modifier is added to each reported CPT Anesthesia section code to indicate the patient's condition __________. A) at the time anesthesia was administered B) during the post-anesthesia recovery period C) for the purpose of increasing reimbursement D) to reduce the complexity of services provided

Which service is included as part of the surgical package (or global surgery)? A) complicated postoperative care B) general anesthesia C) repeat surgery, if necessary D) surgical procedure performed

The global period is the number of days associated with the surgical package (or global surgery) and is designated by the payer as __________. A) a specific number of days for each surgery B) including the management of any complications C) requiring a repeat surgery, if indicated D) treating the patient until (s)he is healed

Which parenthetical note follows a code description to identify procedures that are an integral part of another procedure or service? A) add-on procedure B) routine procedure C) separate procedure D) unlisted procedure

When billing multiple surgical procedures, the code __________ should be reported first on the claim. A) associated with topical anesthesia B) for the major surgical procedure C) in straight numerical order D) that justifies all of the diagnoses

The number of radiologic views includes studies taken from different angles for one x-ray as described in a radiology report, and this __________ selected on the encounter form. A) always results in many different codes B) determines the particular Radiology code C) makes it difficult to identify code(s) to be D) triggers a claims audit based on code(s)

The supervision of the radiologic procedure and the interpretation and writing of a report describing the examination and its findings are considered the __________ component of a radiologic examination. A) complete B) professional C) technical D) unusual

The use of the equipment, supplies provided, and employment of radiologic technicians are considered the __________ component of a radiologic examination. A) complete B) professional C) technical D) unusual

In the Laboratory and Pathology section of CPT, single code numbers are assigned to __________ panels, which consist of a series of blood chemistry studies routinely ordered by providers at the same time for the purpose of investigating a specific organ or disorder. A) laboratory B) organ- or disease-oriented C) pathology D) surgical

The National Correct Coding Initiative has resulted in numerous __________ that cannot be reported on the same claim for the same date of service. A) code pairs B) coding conventions C) guidelines D) instructional notes

Which were incorporated into the National Correct Coding Initiative to compare units of service (UOS) with CPT and HCPCS level II codes reported on claims for the purpose of indicating the maximum number of UOS allowable by the same provider for the same beneficiary on the same date of service under most circumstances? A) comprehensive code edits B) edit pairs (or code pairs) C) medically unlikely edits D) mutually exclusive code edits

Which code represents a new patient exam in which the physician documents a detailed history, detailed examination, and medical decision making of low complexity? A) 99203 B) 99204 C) 99213 D) 99214

Which code represents anesthesia for repairs in the upper abdomen of an omphalocele? A) 00700 B) 00703 C) 00750 D) 00754

Which code represents fine needle aspiration with imaging guidance? A) 10021 B) 10022 C) 88172 D) 88137

Which code represents removal of foreign body, intranasal, by lateral rhinotomy? A) 30220 B) 30300 C) 30310 D) 30320

Which code represents transection of esophagus with repair for esophageal varices? A) 43330 B) 43401 C) 43410 D) 43425

Which code represents repair of the anomalous coronary artery from pulmonary artery origin (Takeuchi procedure)? A) 33500 B) 33502 C) 33505 D) 33506

Which code represents meningocele repair, 4 cm? A) 63700 B) 63700-63 C) 63705 D) 63704

Which code represents electroencephalogram, cerebral death evaluation only? A) 95812 B) 95824 C) 95827 D) 95927

Which code represents ultrasonic guidance for amniocentesis, imaging supervision and interpretation? A) 76941 B) 76942 C) 76945 D) 76946

Which code represents suture of lumbar plexus? A) 64858 B) 64861 C) 64862 D) 64864

Which code represents deoxyribonucleic acid antibody, native or double stranded? A) 86215 B) 86220 C) 86225 D) 86226

Which code represents hemodialysis procedure with physician evaluation? A) 90935 B) 90937 C) 90939 D) 90940

Which code represents simple incision and drainage of pilonidal cyst? A) 10060 B) 10080 C) 11770 D) 11772

Which code represents intrathoracic tracheoplasty? A) 31750 B) 31760 C) 31766 D) 31770

Which code represents excision of lip, full thickness, reconstruction with cross lip flap (Abbe-Estlander)? A) 40510 B) 40525 C) 40527 D) 40530

Which code represents laparoscopy, surgical with vaginal hysterectomy, for uterus weighing 300 grams? A) 58546 B) 58550 C) 58552 D) 58553

Which code represents computed tomography, head or brain, without contrast material, followed by contrast material and further sections? A) 70450 B) 70460 C) 70470 D) 76376

Which code represents excision of 6.2 centimeter malignant lesion including margins, face? A) 11606 B) 11640 C) 11644 D) 11646

Which code represents drug screen, presumptive, single drug class from Drug Class List B, by immunoassay (eg., ELISA)? A) 80301 B) 80302 C) 80303 D) 80304

Which codes represent decompression of spinal cord using transpedicular approach, three lumbar segments? A) 63056, 63057 B) 63056, 63057, 63057 C) 63064, 63066 D) 63064, 63066, 63066

The patient underwent intramuscular injection of influenza virus vaccine. The vaccine was derived from cell cultures, subunit, preservative, and antibiotic free. Which CPT codes are assigned? A) 90660, 90472 B) 90661, 90473 C) 90661, 90471 D) 90662, 90473

Which codes represent critical care, evaluation and management of the critically injured patient for 90 minutes? A) 99285, 99288 B) 99288, 99291 C) 99291, 99292 D) 99292, 99292, 99292

Which codes represent dermal xenograft for temporary closure on small child's neck, 2 percent of body area? A) 15271, 15272 B) 15273, 15274 C) 15275, 15276 D) 15277, 15278

Which code represents removal of lung, extrapleural pneumonectomy? A) 32440 B) 32445 C) 32480 D) 32488

Which code represents mitral valve replacement with cardiopulmonary bypass? A) 33420 B) 33422 C) 33430 D) 33460

Which code represents an established patient home visit evaluation and management service (problem-focused history and examination, and straightforward medical decision making)? A) 99347 B) 99348 C) 99349 D) 99350

Which code represents an intermediate closure of a heavily contaminated hand wound, 14.3 cm? A) 12001 B) 12005 C) 12035 D) 12045

Which code represents complicated LeFort III open treatment of craniofacial separation that required the use of multiple surgical approaches? A) 21431 B) 21432 C) 21433 D) 21435

Which code represents implantation of patient-activated event recorder including programming? A) 33249 B) 33265 C) 33282 D) 33284

Which codes represent diagnostic amniocentesis with ultrasonic guidance (imaging supervision and interpretation)? A) 59000, 76945 B) 59000, 76946 C) 59001, 76945 D) 59001, 76946

Which code represents photochemotherapy, tar, and ultraviolet B (Goeckerman treatment)? A) 96910 B) 96913 C) 96912 D) 96999

Which code represents transcatheter placement of two intracoronary stents, percutaneous, with or without other therapeutic intervention, any method, single vessel? A) 92920 B) 92928 C) 92933 D) 92943

Which code represents syndactylization, toes (Kelikian-type procedure)? A) 28280 B) 28285 C) 28286 D) 28289

Which code represents percutaneous ablation of renal tumors, bilateral, using radiofrequency? A) 50590 B) 50592-50 C) 50593 D) 50593-50

Which code represents revision of gastroduodenal anastomosis with reconstruction, with vagotomy? A) 43850 B) 43855 C) 43860 D) 43865

Which code(s) represent(s) venous catheterization for selective organ blood sampling with venous sampling through catheter (radiologic supervision and interpretation)? A) 36481 B) 36500, 75893 C) 36500, 75894 D) 36500-51

Which code represents closure of cystostomy? A) 51860 B) 51880 C) 51920 D) 51940

Which code represents bilateral excision of hydrocele? A) 55040 B) 55040-50 C) 55041 D) 54901

Which code represents lysis of labial adhesions? A) 53060 B) 56405 C) 56441 D) 56442

Which code represents exploratory supratentorial craniectomy? A) 61304 B) 61305 C) 61314 D) 61320

Which code represents drainage of lacrimal gland via incision? A) 68020 B) 68400 C) 68440 D) 68500

Which code represents modified radical mastoidectomy? A) 69502 B) 69505 C) 69511 D) 69540

Which code represents pelvimetry with placental localization? A) 74470 B) 74710 C) 74742 D) 74775

Which code represents ligation of thoracic duct, abdominal approach? A) 38300 B) 38380 C) 38381 D) 38382

Which code represents biopsy of vestibule of mouth? A) 40490 B) 40799 C) 40808 D) 40812

Which code represents needle biopsy of salivary gland? A) 42100 B) 42300 C) 42400 D) 42405

Which code represents closure of gastrocolic fistula? A) 43860 B) 43870 C) 43880 D) 43881

Which code represents cholecystectomy with exploration of common duct? A) 47600 B) 47605 C) 47610 D) 47612

Which code represents insertion of tunneled intraperitoneal catheter for dialysis, open? A) 49419 B) 49421 C) 49422 D) 49425