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Health Data Classification Systems Part 1

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rootootie's version from 2017-02-07 18:39

Section 1

Question Answer
What are the three levels of CPT Codes and description (name) of the level?Level I CPT Codes (Current Procedural Terminology) These are used for Physician services and procedures. Level II HCPCS Codes (Healthcare Common Procedure Coding System) National Codes, These are used for Drugs, Equipment, Supplies. Level III Local codes - phased out due to HIPAA
What type of code ends with 99?Unlisted Code
What type of information are modifiers used to indicate?Bilateral Procedures, Multiple Procedures, Service greater than usually required
What are G codes used to identify?Professional procedures and services that would otherwise be reported with a CPT code but no CPT code has been established
What are K codes used to identify?Durable Medical Equipment
What level of Evaluation & Management (E/M) based on?Documentation, Key Components, Contributing Factors
Guideslines will _____ Contain information that you will need to know in order to code correctly from that section, Not repeated elsewhere in the section, Describe how and when to report supplies
An Unlisted Procedure Code is ____ A procedure or service not found in the CPT Manual, Located in the Section Guidelines, Located at the end of a Subsection or Subheading
The CPT manual was developted by ____ in the year _____.AMA (American Medical Association), 1966
Pulse, temperature, & blood pressure are all part of which examination element?Constitutional (OS)
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Section 2

Question Answer
Modifiers can be found in which CPT appendix?A
The CPT Manual has how many "main" sections?Six
A patient who has not been seen by a physician or the same physician group within _____ years would be considered a new patientThree
CPT codes have how many digits?Five
Which punctuation mark between codes in the CPT Manual index indicates a range of codes?Hyphen ( - )
Which punctuation mark is used with a stand alone code to save space?Semicolon ( ; )
What act mandated the adoption of a national uniform standard for electronic transmission of financial and administrative health information and elimiated the usage of LEVEL III codes.HIPAA
What is HIPAA?Healthcare Insurance Portability and Accountability Act
This type of code has all of the words that describe the code that follows?Stand alone
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Section 3

Question Answer
HCPCS alphanumeric codes are known as ?Level II codes
A hyphen ( - ) in the index of the CPT manual indicates what?A range of codes is available
What function does an add on code do?Identifies a code that is never used alone
What must accompany the claim when using an unlisted code?A special report
What does CPT stand for?Current Procedural Terminology
What does HCPCS stand for?Healthcare Common Procedure Coding System
There are two types of codes, but only _____ codes have the full descriptionStand-alone
What does a modifier do?Provides additional information to the third-party payor
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Section 4

Question Answer
Modifer -52 A service was reduced without changing the definition of the code
Modifer -59Services that are usually bundled into one payment that were provided as separate services
Modifier -25Provided on the same day as a minor procedure performed by the same individual
Modifier -50For Medicare patients which modifier is required for bilateral procedures
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Section 5

Question Answer
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Section 6

Question Answer
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