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Chapter 8 Worksheet 3 2 1 Code It!

True/False Indicate whether the statement is true or false.

1. CPT was adopted as part of the Healthcare Common Procedure Coding System (HCPCS) as HCPCS level 1.

2. Use of CPT is mandated for reporting Medicare Part B physician services.

3. The Tax Equity and Fiscal Responsibility Act mandated that CPT codes be reported for outpatient hospital surgical procedures.

4. CPT does not support electronic data interchange.

5. CPT Category II codes contain "emerging technology" temporary codes.

6. The descriptions of all codes listed for a specific procedure must be carefully reviewed before a final code is selected.

7. An experienced coder may code solely from the index.

8. Boldface is used for the cross-reference term.

9. Appendix H contains an alphabetic index of performance measures by clinical condition or topic.

10. A bullet located to the left of a code number identifies new procedures and services added to CPT.

11. Revisions marked with horizontal triangles are included in Appendix B.

12. CPT uses a semicolon to save space.

13. Appendix L contains a list of vascular families that assists in the selection of branch arteries.

14. Codes that classify products that are pending FDA approval are identified by the flash symbol.

15. CPT Category I codes are organized according to five sections.

16. Instructional notes appear throughout CPT sections to clarify the assignment of codes.

17. Modifier -55 (Postoperative Management Only) should be assigned when a provider other than the surgeon is responsible for postoperative management.

18. The National Correct Coding Initiative was implemented by the American Medical Association.

19. The Omnibus Budget Reconciliation Act of 1986 mandated that CPT codes be reported for outpatient hospital surgical procedures.

20. Reporting bundled procedure codes in addition to the major procedure code is characterized as unbundling.

21. The draping and positiong of a patient is coded as integral to the standard of practice.

22. NCCI edits are updated annually and available to Medicare administrative contractors.

23. The National Correct Coding Initiative (NCCI) edits available as paid subscriptions only.

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Completion Complete each statement.

24. Established patient seen in PCP's office for LLQ pain, diagnosis appendicitis, level 2 E/M, arrangements for surgery made and patient sent to hospital. Assign code with appropriate modifier.

25. Patient seen for trimming of three nondystrophic nails, becomes extremely anxious, physician chooses to administer anesthetic to make patient more at ease. Assign code with appropriate modifier.

26. Patient falls during scheduled work hours. Company's insurance carrier requested a second opinion regarding worker's need for manipulation of hip joint. Assign code with appropriate modifier.

27. Transcriptionist developed pain in right and left wrists. PCP diagnosed carpal tunnel syndrome. Corticosteroids were injected. Assign code with appropriate modifier.

28. Patient with a fractured cervical vertebra undergoes a surgical fusion. One surgeon harvests a section of bone from the hip; second surgeon performs the procedure. Assign code with appropriate modifier.

29. Patient sent to laboratory for general health panel blood draw. Sample was inadvertently dropped and the patient was asked to return that afternoon to give another sample. Assign code with appropriate modifier.

30. New patient visit to discuss new diagnosis of diabetes mellitus, level 3 E/M with 45 minutes used explaining proper procedures for management of disease. Assign code with appropriate modifier.

31. Surgeon performs emergency laparoscopic cholecystectomy on a 550-pound patient. Complicated and extensive measures were necessary to complete the procedure. Assign code with appropriate modifier.

32. Surgeon enters operating suite to perform ureterolithotomy on an anesthetized patient, before the procedure begins, patient's pulse rate drops too low and the procedure is cancelled. Assign code with appropriate modifier.

33. While on vacation, a patient is rushed to surgery for laparoscopic treatment of ectopic pregnancy, she will see her regular OB/GYN when she returns home for aftercare. Assign code with appropriate modifier.

34. Dermatologist performs shaving of dermal lesion, 1.5 cm on arm of patient; at same time, a 2.3 lesion was removed from the patient's eyelid. Assign code with appropriate modifier.

35. Patient receives preoperative examination, level 4 E/M, by his PCP the day before the scheduled surgical procedure. Assign code with appropriate modifier.

36. Postsurgical patient presents to surgeon's office for a follow-up visit; nurse reports elevated blood pressure and a prescription for hypertension is provided, resulting in a level 3 E/M examination. Assign code with appropriate modifier.

37. Surgeon in hospital setting documents multiple codes for a procedure. What modifier would the coder use to alert third-party payers that more than the allowable modifier(s) are added to a procedure or service code? Assign appropriate claim form and modifier.

38. Surgeon repaired reducible umbilical hernia on infant weighing less that 4 kg. Assign code with appropriate modifier.

39. PCP sends patient out of office for a heavy metal screening to be performed at an outside clinical laboratory. Assign code with appropriate modifier.

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40. Accident victim has been declared brain dead in the ED, driver's license relates that she is an organ donor. Arrangements are made by hospital donor team to harvest organs. Assign code with appropriate modifier.

41. On-call radiologist is called to the ED to review the four x-ray views of a skull taken by radiology technician Assign code with appropriate modifier.

42. Excision of rectal tumor, transanal endoscopic microsurgical (TEMS) approach. Surgeon supplied regional anesthesia. Assign code with appropriate modifier.

43. During an emergency cesarean section of quadruplets, on-call physician requires another physician to assist in the delivery. Assign code with appropriate modifier.

Multiple Choice Identify the choice that best completes the statement or answers the question.

44. The publisher of CPT is a. the AHA c. the CMS b. the AMA d. Medicare

45. There are categories of CPT codes. a. two c. four b. three d. five

46. In the CPT index, main terms are printed in a. boldface c. boldface and are underlined b. italics d. italics and are underlined

47. The symbol located to the left of a code number that identifies a code description that has been revised is

a. a bullet c. horizontal triangles b. a triangle d. a plus sign

48. The appendix that contains a list of codes that are exempt from modifier -51 is a. A c. b. B d. G

49. Revised guidelines and notes are identified by a a. bullet c. triangle b. square d. horizontal triangles

50. The symbol that identifies codes that are exempt from modifier -51 is a. the forbidden symbol c. bullet b. triangle d. section symbol

51. The symbol that indicates that a procedure includes conscious sedation is a a. bullet c. question mark b. lightning bolt d. bull's-eye

52. When two primary surgeons are required during an operative session, each performing distinct parts of a reportable procedure, modifier should be assigned. a. -58 c. -66 b. -62 d. -82

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53. When a procedure was repeated because of special circumstances involving the original service and the same physician performed the repeat procedure, modifier should be recorded. a. -27 c. -76 b. -51 d. -77 54. A patient underwent closed treatment of a medial malleolus fracture with manipulation and skeletal traction.

Record code a. 27760 c. 27766 b. 27762 d. 27780 55. A patient presented to the physician's office for removal of five plantar warts on his feet. During the procedure,

the patient became extremely anxious, and the procedure was discontinued. Record code a. 17110 c. 17111 b. 17110-53 d. 17111-53 56. A patient underwent laparoscopic cholecystectomy. Report code

a. 47562 c. 47564 b. 47563 d. 47600 57. A patient underwent a total thyroxine lab test that was sent to an outside laboratory. Report code

a. 84436-91 c. 84439 b. 84436-90 d. 84439-90 58. The regulation that required new, revised, and deleted CPT codes to be implemented each January 1 was a

result of the: a. Medicare Prescription Drug, Improvement, and Modernization Act (MMA) b. Omnibus Budget Reconciliation Act (OBRA). c. American Medical Association CPT Editorial Board's publication of 'early release' codes d. Health Insurance, Portability, and Accountability Act (HIPAA) 59. The code description for CPT code 70492:

a. requires the coder to report both codes 70492 and 70490 b. requires the coder to refer back to code 70490 for the common portion of the code

description c. results in CPT code 70492 being considered a stand-alone code. d. contains the entire description next to the code number 60. Headings and subheadings are also called:

a. categories and subcategories c. sections and subsections b. main terms and subterms d. titles and subtitles 61. Guidelines, notes, and descriptive qualifiers are found in CPT:

a. sections, subsections, headings, and subheadings b. headings only c. sections and headings only d. sections only 62. 'Radiology' and 'Pathology and Laboratory' are CPT:

a. sections b. descriptive qualifers c. headings d. subsections under the 'laboratory' section of CPT.

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Matching

Match each event with a year listed below. a. 1966 b. 1970 c. 1983 d. 2003 e. 2004

63. CPT published 64. HCPCS level III codes eliminated 65. MMA legislation 66. CPT adopted as part of HCPCS 67. five-digit CPT codes introduced

Match each code number with a section description listed below. a. Radiology b. Pathology and Laboratory c. Medicine d. Surgery e. Evaluation and Management

68. 90281 69. 70010 70. 10021 71. 80048 72. 99201

Match each content description with an appendix listed below. a. Appendix A b. Appendix B c. Appendix C d. Appendix I e. Appendix K

73. contains annual CPT coding changes 74. contains genetic testing modifiers 75. contains a list of codes pending FDA approval 76. contains clinical examples for codes found in the Evaluation and Management section 77. contains a list of CPT modifiers and detailed descriptions

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Match each interpretation with a modifier listed below. a. -47 b. -22 c. -52 d. -53 e. -73

78. Reduced Services 79. Increased Procedural Services 80. Discontinued Outpatient Procedure Prior to Anesthesia 81. Anesthesia by surgeon

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