Introduction to CPT and HCPCS coding Exam Questions and Answers

Introduction to CPT and HCPCS coding Exam Questions and Answers What are CMS 1500 forms? -Answer-universal health insurance form used for submission of outpatient services to insurance carriers Who publishes the CPT? -Answer-American Medical Association What is a modifier? -Answer-Additional code that provides information to the 3rd party payer What does CPT stand for? -Answer-Current Procedural Terminology What is a panel -Answer-A series of test that are grouped together because they are usually used together What is a block? -Answer-Frozen piece of a sample What is a section? -Answer-Slice of frozen block Who is the one who requires a special report when you use unlisted codes? -Answer- The company, insurance company, or 3rd party payer that is processing the claims. Which code does the pathology section include test only? -Answer-Laboratory Test Only What are the descriptive components for the emergency departments? -Answer-Time is not the descriptive component in the emergency department What does Appendix B cover? -Answer-Additions to, deletion from and revisions What are J codes? -Answer-Drugs What does appendix A contain? -Answer-List Of MODIFIERS that are used to ALTER or MODIFY Codes What is an add on code? -Answer-Identifies a code that is used in combination with a primary procedure What is a hyphen? -Answer-A range of Codes; the symbol used between two code numbers to indicate that a range is available What is the range of codes for a surgery procedure? -Answer- What is the reason for the CPT Coding System? -Answer-Health care providers to communicate both effectively & efficiently with the third party payer (To describe Health care Services) What is contained in the guidelines? -Answer-Provide specific information about coding in that section & contain valuable information for the coder What are the 6 elements that a special report must contain? -Answer-Nature, extent, need, time, effort and equipment What is a tracer? -Answer-An identifiable substance, such as a dye or a radioactive isotope What is the CPT codebook? -Answer-compilation of guidelines, codes and descriptions used to report health care services What does HCPCS stand for? -Answer-Healthcare Common Procedure Coding System Who maintains the HCPCs coding system? -Answer-American Medical Association The CPT code set includes how many categories of medical nomenclature (choosing names for things) and descriptors? -Answer-3 Name these 3 categories? -Answer-1. Category I CPT Codes- utilizes 5 digit numerical code. updated by the AMA, mandatory to use these codes for reporting and reimbursement. 2. Category II CPT Codes- are optional performance measurement tracking codes. They are used for Physician Quality Reporting System (PQRS), an incentive based program developed by CMS to record evidence based measures These codes are alphanumeric with the letter F in the last position (eg, 0001F) These codes are reported in addition to EM services or clinical service CPT Category I codes 3. Category III CPT Codes- these are temporary codes. Category III codes are alphanumeric with the letter T in the last position. (eg, 0075T) Unlike category II codes, Category III codes can be reported alone without an additional Category I code What does ; mean in the CPT book? -Answer-Words before the ; are considered the "common procedure" in the code descriptor indented descriptor is dependent on the preceding "common procedure" code descriptor not necessary to report the main code when reporting the indented code What does + mean? -Answer-add on code...these must b