ch 13 HCPCS Level 2 Questions and Answers 2024;full solution pack

Durable medical equipment carrier (DMERC) - A company designated by the state or region to act as the Medicare Administrative Contractor (fiscal intermediary) for all DME claims. Parenteral - by way of anything other than the gastrointestinal tract, such as intravenous, intramuscular, intramedullary, or subcutaneous Not otherwise specified (NOS) - an indication that more detailed information is not available from the physician's notes Orthotic - a device used to correct or improve an orthopedic concern durable medical equipment (DME) - apparatus and tools that help individuals accommodate physical frailties, provide pharmaceuticals, and provide other assistance that will last for a long time and/or be used to assist multiple patients over time enteral - within,or by way of, the gastrointestinal tract prosthetic - fabricated artificial replacement for a damaged or missing part of the body chelation therapy - the use of chemical compound that binds with metal in the body so that the metal will lose its toxic effect. it might be done when a metal disc or prosthetic is implanted in a patient, eliminating adverse reactions to the metal itself as a foreign body The symbol of a circle with a line through it means - The symbol of a circle with a line through it means The little box with a check mark in it ☑ indicates a code description that - includes a quantity measurementThe J codes are used to bill insurance carriers for - drugs administered by a health care professional. HCPCS Level II codes are used, most often, to report all except - anesthesia administered by an anesthesiologist. The acronym DME stands for - durable medical equipment. HCPCS Level II codes are presented as - one letter followed by four numbers. HCPCS is an acronym that stands for - Health care Common Procedure Coding System. The code D1110 is an example of a - HCPCS Level II code. The D0000-D9999 codes are created and maintained by the - American Dental Association. HCPCS Level II Appendix 5 provides additional information on - new, changed, deleted, and reinstated HCPCS codes The E codes shown in the HCPCS Level II book are - used to identify DME provided to a patient An example of DME is - a three-prong cane A line through the center of a code and its description means - the code has been deleted and may no longer be used Alcohol intervention treatment might be coded from - H0001-H2037 A code with an A next to it means that - the service is limited to a specific age groupSee Also Code - This notation cross-references this code with another code that may be similar in description. The notation serves as a reminder for you to double-check that you are using the most accurate code. Clarifications of Coverage - This notation indicates when to use or not use the code. Report in Addition to Code - When one code is to be reported with other codes, this notation will identify those circumstances. It not only tells you the circumstances but also tells you which code to use. See Code(s) - Refers you to a CPT code for a description that is potentially better and may be more specific for reporting what was actually done or given to the patient. Determine if an Alternative HCPCS Level 2 or a CPT Code Better Describes - Serves as a warning to you to make certain that there is no better or more specific code in either the CPT or elsewhere in this HCPCS Level II book that correctly reports the services or procedures performed. Use this code for - Provides you with alternative names, brand names, and other terms that are also represented by the code's description. Pertinent Documentation to Evaluate Medical Appropriatness should be - Warns you up front that you should include the proper documentation along with the claim the first time you submit it, rather than wait to be asked by the third-party payer, which would delay payment. do not use this code to report - Warns you of circumstances when you are not permitted to use a code. medicare covers - This notation gives you information about coverage, particularly Medicare and Medicaid coverage. code with caution - This notation warns that you need to go back and double-check the provider's notes carefully. If this is what was actually done, then be certain to attach documentation explaining why that method was used instead of the newer technique because it is surely going to be s report concurrent to the xxx procedure - This notation directs you to always report this code with a code for another specific procedure. a large bullet, or solid circle - Indicates that it is the first year that the code is included in this code set. a solid triangle - Let's you know that the code's description has been changed or adjusted since last year or that a rule or guideline regarding the code has changed. an open circle - Identifies that the code had been deleted but now has been restored (reinstated). a circle with a slash through it - in the HCPCS Level II book, identifies a code that is not covered under the skilled nursing facility (SNF) prospective payment system (PPS). a check mark inside a square box marks - A code description that identifies a specific quantity of material or supply "A" symbol - Highlights the fact that a code is used only for procedures, services, and equipment performed or used on a patient of a certain age group "M" symbol - Reminds you that the code describes maternity procedures, services, and equipment performed or used on a pregnant female 12-55 years of age.