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HIM 215 Test 2 Part 1

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rad2329's version from 2017-03-02 15:45

Section 1

Question Answer
The surgery section of CPT if divided by _______.subspecialty (there are 19 subsections with codes ranging from 10021 to 69990
Identify the types of anestesia.General, regional, local, or monitored anesthesia care [MAC])
What is the method of anesthesia through the mouth and when would it be administered?Endotracheal, when general anesthesia is needed; major procedure
Anesthesia application (injected or topical) is called what, and when would it be used?Local, for relatively minor procedures.
What is a key difference between local and general anesthesia? There is no loss of consciousness with local anesthesia as there is when a general is administered.
When is an epidural anesthesia used?To numb certain parts of the body
►◄ Indicates what?text changes from previous edition
What does regional anesthesia involve?Blocking the nerve supply to a part of the body in order to eliminate pain.
What does a field block do?Forms a wall of anesthesia around the site by means of local injections
Explain a nerve block.injection of the nerves close to the site
What does ASA Stand for?The American Society of Anesthesiology
What is MACMonitored Aesthesia Care
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Section 2

Question Answer
What does PCA stand for?Patient-Controlled Analgesia
What is PCA used for?Patient-Controlled Analgesia is administered by the patient and often used to control acute postoperative chronic pain
How is PCA administered?The patient presses a button, a predetermined amount of a prescribed drug is released. The patient controls the amount and frequency of the drug’s administration.
Explain Conscious sedation?It provides a decreased level of consciousness but does not actually put the patient to sleep. The patient can breathe without assistance and can respond to stimulation and verbal commands.
What is the difference between General and Moderate "Conscious" Sedation?General renders the patient unconscious where with Moderate (Conscious) sedation the patient controls his/her airway and can respond to verbal commands.
How are codes divided with Moderate (Conscious) Sedation?Age > or < 5, Time, Provided by physician performing service or other physician.
How are codes organized in the anesthesia section of the CPT?By subdivisions: Anatomical Site, Type of Procedure Performed, Radiologic Procedures, Burn Excisions or Debridement, Obstetrical, and Other Procedures
What four subsections in Anesthesia are not organized by anatomical division?Radiologic Procedures, Burn Excisions or Debridement, Obstetrical, and Other Procedures
What is the Anesthesia Formula?B + T + M (1. Base Units, 2. Time Units, 3. Modifying Units) = payment
What are the key elements that will determine the value of the anesthesiologist's presence during the procedure?The basic service provided, the amount of time spent, and any special circumstances that alter the standard treatment expected for the service delivered.
What does RVG stand for and what does it contain?Relative Value Guide, Codes for anesthesia services, most of which are included in the Anesthesia section of the CPT.
What is Parenthetical information?Notes that provide additional information that will aid the coder in making correct coding decisions (these notes are in parenthesis)
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Section 3

Question Answer
Relating to the Anesthesia Formula, 1. B is for ____ and is published where and by who? Base Unit, RVG (Relative Value Guide), ASA (The American Society of Anesthesiology)
Relating to the Anesthesia Formula, 2. T is for ____, and how is it measured ?Time, Anesthesiologist begins in preop continues throughout intraop (procedure) and ends in postop (Patient no longer under care of anesthesiologist).
Relating to the Anesthesia Formula, 3. M is for ____, and what does it reflect?Modifying Unit, Physical condition indicated by physical status modifier.
When would an Unlisted Procedure Codes be used and what must accompany this type of code?When a more specific category I or Category III code is not found, this type of code ends in 99 and a written report must accompany it.
______ is a designation that follows a code description and is incidental to a more major related procedure. Modifer -59 is most often used with this.Separate procedure
What does the RVG (Relative Value Guide) list?All CPT anesthesia codes
What does a + TM notation refer to?The other two components of the anesthesia formula, time and modifying unit
Anesthesia services paid based on ?Set amount per unit (conversion factor)
National unit values for anesthesia services are based on ?Complexity, Base Unit Value (BUV)
Patient record indicates time, e.g., 15, 30, 60 minutes. Explain minutes conversion to units.Often, 15 minutes = 1 unit, 60 minutes = 4 units.
What is the purpose of the RVG (Relative Value Guide)?To compare the complexity of various anesthesia services so that the relative value of each service, when compared with all services, may be assigned.
Major surgical procedures usually include:Preoperative - Intraoperative - Postoperative - Minor complications
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Section 4

Question Answer
What is PACU?Post-Anesthesia Care Unit
Why does (T) time include periods when the patient is not under anesthesia?It reflects the anesthesiologist’s services, including time spent before [preparation], during, and after surgery
Modifying units (M) reflect what?The circumstances or conditions that change the environment in which the anesthesia service is provided.
What are physical status modifiers an indicator of?The level of complexity of the services required to treat the patient.
When reporting surgery outpatient coders, code ____ payment ?physician (professional)
Why are physical status modifiers necessary?They reflect the added service by the anesthesiologist (and ensures compensation) needed during surgery for patients who have chronic illnesses or other conditions that affect their general health over and above the impact of the condition that led to the surgery.
How are Physical status modifiers payment differentiated?Based on some physical status ratings
P1-P6 and Qualifying circumstances service codes are not reported ?For Medicare
What are qualifying circumstances service codes?CPT codes that begin with the digits 99. These are treated as adjunct codes and must accompany the anesthesia procedure code. They may not stand alone.
When reporting surgery inpatient coders, code _____ payment?hospital (facility)
Where are Modifying Units "Qualifying Circumstances" located?In Anesthesia guidelines and also in Medicin section
What is CF?Conversion Factor
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Section 5

Question Answer
Physical Status Modifier P1Normal, healthy
Physical Status Modifier P2Mild systemic disease
Physical Status Modifier P3Severe systemic disease
Physical Status Modifier P4Severe systemic disease and in constant threat to life
Physical Status Modifier P5Not expected to survive without operation
Physical Status Modifier P6Brain dead
Introduction types of services use what?A needle
Shaving of lesions codes are based on ?size (e.g. 1.1-2.0cm) and location (e.g. arm, hand, nose)
Types of introduction services include ?lesion injections (exp. acne), tattooing (to remove birthmarks), tissue expansion (exp. breast implants), contraceptive insertion/removal, hormone implantation services, insertion/removal of nonbiodegradable drug delivery implant)
Value of 3 would be what Physical Status Modifer?P5
What is the basis for coding subcutaneous injections?The amount of material injected
How are the HCPCS modifiers used in the coding of anesthesia services?Define the types of providers involved in the care of the patient. They provide additional information about the services performed that will be important to third-party payers who are processing claims for reimbursement.
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Section 6

Question Answer
Where is the size of the excision of lesion taken from?Physician's notes not the pathology report because the storage solution shrinks tissue.
Measurements on the lesion’s actual charge are based how ?before the excision (before sending to pathology)
Regarding Lesion's ____ and _____ are included in the excision of a benign or malignant lesion.Local anesthesia, simply or subcutaneous closures.
These codes are used to report services that involve the removal of a benign hyperkeratotic skin lesion such as a callus or corn.Paring or cutting (11055 - 11057)
Paring or cutting lesions may be removed by ?scraping or peeling
A ____ only removes a portion of the lesion and possibly some of the surrounding tissue. An ____ removes the entire lesionbiopsy , excision
What modifier indicates multiple procedures during a single operative session?-51
What are skin tags, and how are they removed?Flaps of skin [benign lesions] that appear most often on the neck or trunk, particularly in older people. They may be removed with use of scissors, blades, ligatures, chemicals, or electrosurgery.
Regarding skin tag removal - Codes indicate number: up to ____ and each additional ____ lesions or part thereof.15 , 10
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