Intro CPT-4 FINAL PREP.txt

  1. If a coder is unable 2 loc a cde tht describes the exact Serv provided, it is acceptable 2 use a cde tht approximates the serv provided???


    • "FALSE"- It is UNACCEPTABLE
  2. According 2 the Surgery guidelines, Surgical Destruction may B considered prt of a surg procedure???
    • "TRUE"
  3. There R various types of anesthesia, these incl. General, Regional, Local, Moderate/Conscious Sedation???
    • "TRUE"
  4. Local anesthesia is a type of anesthesia tht provides a decreased level of consciousness(moderate)
    • "FALSE" ~ *Moderate Sedation*


  5. Only 1 CPT procedure cde may b represented by 1 anesthesia cde...
    • "FALSE"
  6. Anesthesia serv's incl PST/op visits 2 the pt hy the anesthesiologist...
    • " TRUE"
  7. Qualifying anesthesia circumstances r adjunct codes & r used whn the administration of the anesthesia is more difficult.
    • "TRUE"
  8. The words tht follow a code # in the CPT manual are called:
    a.) Procedure/Service Descriptor
    b.) Listing Order
    c.) Format Descriptor
    d.) identified descriptor
    • "Procedure/Service descriptor"
  9. A cde tht has all of the wrds tht describe the code tht follows is wht type of cde:
    a.) developed c.) stand alone
    b.) isolated d.) complete
    • "Stand Alone" cde
  10. Procedures tht are Experimental, Newly Approved, or Seldom Used are reported w/wht type of cde:
    a.) unlisted/category III c.) modified
    b.) technical d.) variable
    • " Unlisted/Category III" cde
  11. Who requires a special report w/the use of unlisted codes:
    a.) AMA c.) modified
    b.) 3rd prty payers d.) National Center 4 Health Care
    • "3rd-Party Payers"
  12. Which of the foll represents (3) of the (6) elements tht a "special report" mst contain:

    a.) cond, serv, description c.) nature, extent, need
    b.) anatomic site, serv, extent d.) serv, extent, procedure
    • "Nature, Extent, Need"
  13. In which CPT appendix would Additions, Deletions, & Revisions be found:

    a.) Appendix A c.) Guidelines
    b.) Appendix B d.) Introduction
    • "Appendix B"
  14. In which CPT Appendix would all modifiers be found:
    a) Appendix A c) Appendix C
    b) Appendix B d) Appendix D
    • "Appendix A"

    **Appendix H has been deleted frm the manual as it's 2 long...CMS has made it avail on/line if needed**
  15. CPT stands 4:
    a) Current Phys Term b) Current Proced'l Term
    b) Current Proced Term c) Current Proced'l Terms
    • "Current Procedural Terminology"
  16. Which term reflects the techonologic advances made in medicine tht R incorportated in/2 the CPT Manaual...
    a) Revisions c) Special Reports
    b) Modifiers d) Guidelines
    • "Revisions"
  17. Where is specific coding info abt ea section loc'd....
    "Guidelines"
  18. What yr was CPT 1st developed...
    "1966"
  19. Who publishes CPT...
    "AMA: Amer Medical Association"
  20. Category I CPT codes have __ digits...
    "5"
  21. The universal health ins form 4 submission of out/pt serv is the...
    "CMS-1500"
  22. Wht is NOT a reason for the CPT coding sys...
    "Increased Reimbursement"
  23. What is the function of an Add-on cde...
    "Identifies a code tht is never used alone"
  24. How mny main sections are in the CPT manual...
    "6"
  25. When will unclear terminology CPT be replaced w/more precise definitions...
    "Upon publication of CPT-5"
  26. A modifier...
    "Provides add'tl info 2 the 3rd-Party Payer"
  27. According 2 the notes preceding the Category III codes in the CPT manaual, the digits of the Category III codes R not intended 2 reflect the placement of the code in the Category I section of the CPT...
    "Nomenclature"
  28. According 2 the CPT manual, modifier -91 is not 2 B used whn tests R __ 2 confirm initial results...
    "Rerun"
  29. According 2 the E/M guidelines, time is not a descriptive component 4 the ___ dep't levels of E/M serv...
    "Emergency"
  30. The level of E/M serv is based on...
    • * Documentation
    • * Key Components
    • * Contributing Factors
  31. Medical Decision Making {MDM} is based on the ___ the phys mst consider abt the mang't of a pt's cond...
    • * # of dx's
    • * Risk of Morbidity
    • * Amt of Data
  32. The request 4 advice or opinion frm 1 phy 2 another phys is wht type of serv...
    "Consultation"
  33. Critical care codes R reported based on...
    "Time"
  34. According 2 E/M guidelines, a ___ exam encompasses a complete single-specialty exam or a complete multi-sys exam...
    "Comprehensive"
  35. Whn tme is calculated 4 anesthesia serv's, the tme begins whn...
    "The Anesthesiologist begins preparing the pt 2 receive anesthesia"
  36. Wht type of nurse can administer anesthesia under the direction of an anesthesiologist...
    "CRNA" {Cert'd Registered Nurse of Anesthetics}
  37. Modifiers may affect...
    "The way payment is made by a 3rd-Party Payer"
  38. Modifiers R used 2 indicate wht type of info...
    • * Bilateral Procedure
    • * Multiple Preocedures
    • * Service greater than usually required
  39. Concurrent anesthesia care modifiers R used 2 describe...
    "a # of cases an anesthesiologist is directing or supervising @ 1x"
  40. Modifier -57, decision 4 surgery, is used on wht type of serv...
    "E/M"
  41. Modifier -79, unrelated procedure or serv by the sme phys during the post/operative period, is used on wht type of serv...
    "Surgery"
  42. Modifier -51 Multiple Procedure, is used on wht type of serv's...
    "Surgery"
  43. Modifier -80, Ass't Surgeon, is used when...
    "A 2nd surgeon provides assistance 2 the primary surgeon"
  44. Modifier -32 is used 2 indicate a serv is mandated. Wht is an ex of whn a serv is "mandated?"...
    "An ins Co requires a 2nd opinion prior 2 surgery"
  45. Modifier -25 significant, separately identifiable E/M serv by the same phys on the sme day of the procedure or other serv, is used 2 report an E/M serv tht was...
    * "provided in the sme day as a minor procedure performed by the same phys"
  46. Modifier -59, distinct procedure Serv, is used 2 indicate tht:
    "Serv's tht R usually bundled in/2 1 payment were provided as sep serv's"
  47. Modifier -58, staged or related procedure or Serv by the same phys during the PST/Op period, is used 2 indicate:
    "Tht subsequent surgery was planned @ the time of the 1st surgery"
  48. 99100 is an ex of:
    "Qualifying circumstance"
  49. Modifier -52, reduced serv's, is used 2 indicate:
    "A Serv was reduced w/out changing the definition of the code"
  50. In the anesthesia section of the CPT manual l, the procedure codes r divided 1st by:
    "Anatomic Site"
  51. Wht is the type of sedation tht allows a procedure 2 B performed w/out pain 2 the pt, but the pt is not completely asleep???
    "Conscious or Moderate" sedation
  52. The society tht published the Relative Value Guide 4 anesthesia services is the:
    "American Society of Anesthesiologists"
  53. The aneshtesia formula is:
  54. "(B + T + M) x (CF)"
  55. Which codes begin w/the # 99 & are used 2 indicate anesthesia serv's provided during situations tht mke the administration of the anesthesia more difficult???
    "Qualifying Circumstances"
  56. The anesthesia status modifer tht indicates the pt's condition @ the time anesthesia was administered is:
    " Physical"
  57. The modifier -AA is an ex of wht type of modifier???
    "HCPCS"
  58. The multiple modifier is indicated w/which modifer???
    "-99"
  59. The modifier tht indicates only the professional component of the service was provided is:
    "-26"
  60. The modifier tht indicates multiple precedures is:
    "-51"
  61. A ___ ____ mst accompany claims when using an unlisted procedure code.
    "Special Report"
  62. The _____ section guidelines contain the definition of the chief complaint.
    "E/M"
  63. The ____ section guidelines contian the definition of separate procedure.
    "Surgery"
  64. Using the index of the CPT manual, the range of code(s) 4 the entry Paravertebral Nerve, Destruction is _______.
    "64622-64627"
  65. The two digit modifier 4 a return 2 the operating room 4 a related procedure during a post/op period is ____.
    "-78"
  66. The two digit modifier used by by an Ambulatory Surgery Center {ASC} or Hospital out/pt unit 4 a discontinued
    "-73"
  67. According 2 the CPT Surgery Guidelines, wht is the code 4 the following unlisted procedures: Unlisted procedure, Neck or Thorax???
    "21899"
  68. According 2 the CPT Surgery Guidelines, wht is the code 4 the foll unlisted procedures: Unlisted procedure, Arthroscopy???
    "29999"
  69. According 2 the CPT Surgery Guidelines, wht is the code for the foll unlisted procedures: Unlisted Laparoscopic procedure, Liver???
    "47379"
  70. The correct order frm the largest 2 smallest division of the CPT hierarchy in the CPT manual is _____.
    a. category
    b. subsection
    c. section
    d. subheading
    • 1. Section
    • 2. Subsection
    • 3. SubHeading
    • 4. Category
  71. Appendix C of the CPT manual contians examples of ___ Codes
    "Clinical Examples"
  72. There R 2 types of codes, but only ____ codes hve the full description.
    • "Stand Alone"
  73. When two surgeons work 2/gether as primary surgeons performing distinct parts of a procedure, ea surgeon would report modifier ____ w/his/her procedure code.
    • "-62"
  74. An established pt is one who has received face/2/face professonal serv's frm the physician or another physician of the same specialty in the same group w/in the past __ yrs.
    "3"
  75. The term used 2 describe a pt who has not been formally admitted 2 a health care facility is ____.
    "Out/Pt"
  76. Complete the foll blanks tht refer 2 the 3 factors tht the coder mst consider in the assignment. ___ of serv, ___ of serv____ status.
    • "Type or Place"
    • "Type of Pt"
    • "Level of Serv"
  77. The 4 types of pt status are: ____, _____, ____ & ____
    • 1. "Out/Pt"
    • 2. "In/Pt"
    • 3. "New"
    • 4. "Est"
  78. The _____ is a statement describing the reason for the encounter & is a history element.
    "Chief Complaint" {C/C}
  79. _____ lists some HCPCS modifiers in the CPT book
    "Appendix A"
  80. Physicial status modifier P3 indicates a pt w/______
    "Severe Systematic Disease"
  81. Codes for Qualifying Circumstances are found in both the Anesthesia Guidelines & the ____ section of the CPT book.
    "Medical"
  82. What modifer would you use if you were coding only for the Professional Component fo a diagnostic procedure?
    • "-26"
  83. What modifier would you use if you were coding only the technical component of a diagnostic procedure?
    "TC"
  84. Moderate or ______ sedation is a type of sedation tht may be provided by the physician performing the procedure.
    Conscious"
  85. If anesthesia was provided 2 a pt who is not expected 2 survive w/out the surgical procedure being performed, the ___ physicial status modifier would be appended 2 the anesthesia code.
    "-P5"
  86. Match the term 2 the correct symbol:

    a. Filled in Circle
    b. +
    c. R & L Triangle
    d. Triangle
    e. Circle w/line
    • 1. Revised txt: Rght/Lft Triangles
    • 2. Revised Code: Triangle
    • 3. New Code: Filled in Circle
    • 4. Add-On Code: +
    • 5. Modifier -51 exempt
  87. Name the 6 basic location methods 2 loc main terms in the index of CPT...
    • 1. "Procedure"
    • 2. "Anatomic Site or Organ"
    • 3."Condition
    • 4. "Synonyms"
    • 5. "Eponyms"
    • 6. "Abbreviations"
  88. What R the 4 elements of history???
    • 1. "CC" {Chief Complaint}
    • 2. "HPI" {History Present Illness}
    • 3. "ROS" {Range of Serv}
    • 4. "PFSH" {Present Family Social Hist}
  89. Complexity of medical decision making is based on what 3 elements???
    • 1. "Amt of "Data"
    • 2. "Risk of Complication"
    • 3. "# of Dx's"
  90. 4. Wht R the 3 key components tht R present in every pt case, except counseling encounters or time based codes, & enable the coder 2 choose the appropriate level of serv???
    • 1. "History"
    • 2. "Exam"
    • 3. "MDM" {Med. Dec. Making}
  91. Wht R the 4 levels of hist???
    • 1. "Problem Focused" {PF}
    • 2. "Expanded Problem Focused {EPF}
    • 3. "Detailed/Extensive"
    • 4. "Comprehensive"
  92. Wht R the 4 levels of MDM complexity???
    • 1. SF {Straight Forward}
    • 2."LC" {Low Complexity}
    • 3. "MC" {Moderate Complexity}
    • 4. "HC" {High Complexity}
  93. Wht R the 4 Contributing Factors???
    • 1. "Time"
    • 2. "Coordination of Care"
    • 3. "Counseling"
    • 4. "Nature of Presenting Illnes"
  94. Coding Convention:

    *Moderate Sedation*
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BrowneeE
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Intro CPT-4 FINAL PREP.txt
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Intro CPT-4 FINAL PREP
Updated