front 1 To ensure reimbursement at the highest allowed level, CPT codes must? | back 1 INCLUDE CODES AND MODIFIERS THAT REFLECT THE SERVICES PERFORMED |
front 2 The most frequently used CPT codes are? | back 2 EVALUATION AND MANAGEMENT CODES |
front 3 For reporting an evaluation and management code, CPT considers a patient to be "new" if the patient has not received professional services from any provider in the medical practice within the last ? years? | back 3 THREE |
front 4 When unbundling is done intentionally to receive more payment than is allowed, the claim is likely to be considered? | back 4 FRAUDULENT |
front 5 The healthcare common procedure coding system (HCPCS) was originally developed for use in coding services, such as durable medical equipment for? | back 5 MEDICARE PATIENTS |
front 6 Analysis of the connection between the diagnostic and procedural information on a claim is called? | back 6 CODE LINKAGE |
front 7 An act of deception used to take advantage of another person or entity is called? | back 7 FRAUD |
front 8 A healthcare provider who practices under false qualifications or credentials is guilty of?> | back 8 FRAUD` |
front 9 Medical offices usually have a(n) ? to help minimize the risk of fraud by discovering and correcting coding and billing problems? | back 9 COMPLIANCE PLAN |
front 10 Having a medical practice compliance plan in place? | back 10 SHOWS A "GOOD-FAITH" EFFORT TO BE COMPLIANT WITH CODING REGULATIONS |
front 11 A medical provider bills separately for a comprehensive metabolic panel and a quantitative glucose test, which is normally included in the metabolic panel. This is an example of which of the following fraudulent coding and billing practices? | back 11 BILLING SEPERATLEY FOR SERVICES THAT ARE BUNDLED IN A SINGLE PROCEDURE CODE |
front 12 When a patient has no symptoms of a disease and the provider performs the tests for that disease at the patients request, the provider has committed which of these fraudulent coding and billing practices? | back 12 PERFORMING PROCEDURES NOT RELATED TO THE PATIENTS CONDITION |
front 13 Billing for a moderate level evaluation and management service when only a simple BP check and injection were carried out it and example of? | back 13 REPORTING SERVICES AT A HIGHER LEVEL THAN PERFORMED |
front 14 There is a question concerning a claim for a procedure submitted last year. Where will you look to double-check the codes in question? | back 14 LAST YEARS CPT CODES |
front 15 A plus sign (+) is used to indicate? | back 15 ADD-ON CODES |
front 16 Modifiers to CPT codes indicate? | back 16 THAT SOME SPECIAL CIRCUMSTANCE APPLIES TO THE SERVICE |
front 17 National codes issued by CMS that cover many supplies and durable medical equipment are? | back 17 HCPCS LEVEL II CODES |
front 18 Inaccuracy in linking diagnostic codes will result in all of the following except? | back 18 INTERNAL CODING AUDITS |
front 19 The CPT is updated and new codes are provided for use beginning? | back 19 ANNUALLY JANUARY 1 |
front 20 Which of the following is NOT one of the 6 main sections in the CPT manual? | back 20 PHYSICAL THERAPY |
front 21 In order to find information regarding prefixes and suffixes used in the CPT coding manual, you would look in the? | back 21 INTRODUCTION TO THE MANUAL |
front 22 Which of the following best describes the CPT code format? | back 22 5-DIGIT NUMERIC CODES |
front 23 To complete the description for a CPT code that has an indented description you should? | back 23 REFER TO THE DESCRIPTION FOR THE PREVIOUS CPT CODE TO COMPLETE THE DESCRIPTION |
front 24 When coding CPT procedures, an add-on code will describe? | back 24 OTHER PROCEDURES DONE IN ADDITION TO A MAIN PROCEDURE |
front 25 If a code description has changed since the last revision of the CPT manual, what symbol is placed next to the CPT code? | back 25 BLUE TRIANGLE |
front 26 What symbol next to a CPT code tells you that moderate sedation is included in the procedure? | back 26 BULL'S-EYE |
front 27 What symbol appears next to codes that are new since the last CPT revision? | back 27 RED DOT |
front 28 What symbol appears next to a code that appears out of numerical sequence? | back 28 POUND (#) SIGN |
front 29 A modifier indicates? | back 29 SPECIAL CIRCUMSTANCES APPLY TO THE PROCEDURE |
front 30 Where in the CPT manual will information about the proper use of modifiers be found? | back 30 APPENDIX A |
front 31 Where in the CPT manual can you find a complete listing of all add-on codes?` | back 31 APPENDIX D |
front 32 Dr. Moore is scheduled to perform a routine removal of a mole from Ralph's left shoulder under local anesthesia. Dr. Moore has injected the local anesthetic and is about to begin the procedure when Ralph suddenly has a panic attack and states, "I just cant handle this!" Dr. Moore halts the procedure. When you code for this procedure what modifier will you use? | back 32 52: REDUCED SERVICES |
front 33 Dr. is scheduled to perform a cyst removal on Haley's right hand. After he begins the procedure, he notices that the cyst is much larger than anticipated and is involved with nerves and ligaments in the right thumb. Complete cyst removal takes 30 minutes longer than expected. Which modifier do you use? | back 33 22: INCREASED PROCEDURAL SERVICES |
front 34 An example of a Category II code is used for? | back 34 WEIGHT REDUCTION COUNSELING |
front 35 Which of the following items is NOT required for a service to be considered a consultation? | back 35 REVISION OF THE INITAL DIAGNOSIS |
front 36 Counseling codes are only used if? | back 36 A COMPLETE HISTORY AND PHYSICAL EXAM DOES NOT OCCUR |
front 37 Which of the following is NOT a potential reason for downcoding? | back 37 THE INSURANCE CARRIER DOES NOT COVER THE SERVICES INCLUDED ON THE CLAIM |
front 38 For coding purposes, which of the following is NOT a level of patient history? | back 38 EXPANDED DETAILED |
front 39 For coding purposes, which of the following is NOT a complexity leer for medical decision making? | back 39 GENERAL-PURPOSE MDM |
front 40 Nathan is in the medical office today complaining of a sore throat and fever. After ruling out strep throat, the practitioner diagnoses a common cold and tells Nathan to take OTC medications for symptom relief. In which category does Nathan's CC fall? | back 40 SELF-LIMITED COMPLAINT |
front 41 Which of the following statements about surgical coding for the musculoskeletal system is NOT true? | back 41 MUSCULOSKELETAL SUBHEADINGS BEGIN WITH THE FOOT AND TOES AND WORK THEIR WAY UP TO THE HEAD |
front 42 Which subsection of the surgery section include procedures on the spleen and bone marrow? | back 42 HEMIC/LYMPHATIC SYSTEMS |
front 43 How many codes are required for giving a patient an injection of a vaccine? | back 43 TWO |
front 44 When coding a surgical code, where should you look to be sure you find the correct code? | back 44 USE THE ALPHABETIC LISTING OF PROCEDURES AT THE BACK OF THE CPT MANUAL |
front 45 You have consulted the index in the CPT and discovered that a dressing for a burn is found in the procedure codes 16010-16030. To correctly code the dressing you should? | back 45 CHECK EACH CODE IN THE RANGE TO CHOOSE THE CORRECT ONE |
front 46 After you decide on the appropriate CPT code(S) for a procedure you should? | back 46 CONSULT APPENDIX A, IN THE CPT TO CHECK FOR APPLICABLE MODIFIERS` |
front 47 Which of the following best describes HCPCS level II codes? | back 47 THE CODES HAVE FIVE CHARACTERS: NUMBERS, LETTERS OR A COMBINATION OF BOTH |