What does CPT stand for - ✔️✔️Current Procedural Terminology
What is CPT used for? - ✔️✔️Outpatient services
Physician offices
HCPCS - stands for? - ✔️✔️Healthcare Common Procedure Coding System
What is HCPCS? - ✔️✔️standardized coding system developed by the federal government that is
used primarily to identify products, supplies, and services not include in CPT.
Category I CPT codes include: - ✔️✔️-Evaluation and Management
-Anesthesia
-Surgery
-Radiology
-pathology and Laboratory
-Medicine
Who publishes CPT? - ✔️✔️AMA (American Medical Association)
What are the three types of supplementary codes? - ✔️✔️Category II codes
Category III codes
Modifiers
What are Category II codes? - ✔️✔️provides supplementary tracking codes that are designed for
use in performance assessment and quality improvement activities.
-composed of 4 numbers and an alphabetic character
-example: 1000F
What is a CPT modifier? - ✔️✔️Modifiers is a two digit numeric or alphanumeric character
designed to give Medicare and other third-party payers additional information needed to process
a claim. A physician or facility uses a modifier to flag, a service provided to a patient that has
been altered by some special circumstances but for which the basic code description itself has
not changed.
When are modifiers used? - ✔️✔️to indicate that a particular event modified the service or
procedure, but with no change in its. basic definition.
HIPAA - ✔️✔️Health Insurance Portability and Accountability Act
What does HIPAA do? - ✔️✔️The HIPAA legislation of 1996 provides, in part, more widespread
access to health insurance and the protection and privacy of health information, and legal
requirements for appropriate sharing of client's information.
What organization is responsible for updating CPT codes? - ✔️✔️AMA
What does a semicolon signify in CPT? - ✔️✔️the main entry applies to, and is part of all intended
entries that follow their codes.
What does the # symbol mean? - ✔️✔️Resequenced code
What does the + symbol mean? - ✔️✔️This means this is an add on code and cannot be used
alone.
Which symbol indicates that a procedure code is new in CPT? - ✔️✔️CPT uses "bullets" before a
code to identify that it is a new code.
The surgeon documents surgical removal of metatarsophalangeal joint. What is the correct code?
- ✔️✔️Amputation, toe - 28820
Which category of CPT codes is reserved for emerging technology? - ✔️✔️Category III
Refer to codes 11730 and 11732. Assume that a physician performs a complete avulsion of the
nail plates of the thumb and index finger. What would be the correct code assignment? - ✔️✔️Both
codes would be used.
11732 is the add one code for each additional nail plate avulsed.
Refer to codes 40840-40844. Assume that a surgeon performed a unilateral, posterior
vestibuloplasty. Which code should be assigned? - ✔️✔️40842
Refer to codes 56630. What documentation in the operative report wold be needed to support the
use of this code? - ✔️✔️Removal of less than 80 percent of vulvar area, and there was removal of
skin and deep subcutaneous tissue
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