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ANSWER KEY

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  1. (a) annually
  1. (d) late fall
  1. (b) January 1st

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  1. ANSWER = Medical Services Procedures
  2. ANSWER = An ICD-9-CM code that justifies the need for the service or procedure.
  1. (c) five-digit
  2. (d) seven
  1. Six sections of Category I procedures and services of the CPT:

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  1. Evaluation & Management
  2. Anesthesia
  3. Surgery
  4. Radiology
  5. Pathology

f. Medicine

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  1. (c ) altered
  2. Describe the contents of the following:
  1. APPENDIX “A” = Detailed descriptions for each CPT modifier
  2. APPENDIX “B” = Annual CPT coding changes.
  3. APPENDIX “C” = Clinical examples for codes in E & M
  4. APPENDIX “D” = Add-on codes
  5. APPENDIX “E” = Codes exempt from modifier – 51 reporting rules

MATCHING: Match the CPT term or symbol in the first column with its definition or description in the second column:

  1. bullet (B) = a new code added to CPT
  2. triangle (F) = code description revision
  3. horizontal triangles (E) = surround revised guidelines and notes
  4. asterisk (D) = indicates variable preoperative and postoperative services
  5. circle with slash (A) = the code is not to be used with modifier - 51
  6. plus symbol (C) = add-on codes
  7. boldface type (H) = main terms in the CPT
  8. See ( I ) = directs coders to an index entry
  9. italicized type ( G ) = used for the cross reference term, See, in the CPT index
  10. inferred words ( J ) = used to save space in the CPT index.
  1. (b) Two-digit
  2. Describe the function of the guidelines located at the beginning of each section in the CPT code book:

ANSWER = Carefully reviewed before attempting to code.

  1. When would an unlisted procedure or service code be assigned ?

ANSWER = When the provider performs a procedure or service for which there is no CPT code.

  1. The CPT index is organized by ?

ANSWER = Alphabetical main terms printed in boldface.

TOTALS = 35

PART II:

  1. Describe what “main terms” represent ?

ANSWER = Procedures or services, organs, anatomic sites, conditions, eponyms or abbreviations.

  1. Assign codes and modifiers to the following:
  1. Bilateral partial mastectomy CODE: ____19301 [50 ]___
  1. Vasovasostomy discontinued after anesthesia due to heart CODE: _____55400[ 73 ]__

arrhythmia, hospital outpatient.

  1. Decision for surgery during initial office visit, comprehensive . CODE: _____99205______
  1. Expanded office visit for follow-up mastectomy, new onset diabetes CODE: _____99232______

was discovered and treated.

  1. Cholecystectomy, postoperative management only. CODE: _____47600_[55]_

f. Difficult and complicated resection of external cardiac tumor. CODE: ______33130_____

  1. Hemorrhoidectomy by simple ligature discontinued prior to anesthesia CODE: ______46221_____

due to severe drop in blood pressure, hospital outpatient.

  1. Assistant surgeon, modified radical mastectomy. CODE: ______19307 [80]_
  1. Total abdominal hysterectomy, preoperative management only. CODE: ______58150 [56 ]_
  1. Total urethrectomy, including cystostomy, female, surgical care only. CODE: ______53210 [54]_
  1. Simple repair of a 2-inch laceration on the right foot discontinued CODE: ______892.2_____

due to severe dizziness, physician’s office.

  1. List the seven basic steps for coding procedures:

STEP#1: Read the introduction located in the CPT coding manual.

STEP#2: Review the guidelines located at the beginning of each CPT section.

STEP#3: Review the procedure or service listed on the office source document.

STEP#4: Refer to the CPT index and locate the main term for the procedure or service.

STEP#5: Locate the necessary subterms and cross references listed in the index.

STEP#6: Review the description of the procedure /service codes listed in the index.

STEP#7: Assign the applicable primary code number, any add on (+) or additional codes needed, and finally

accurately classify the statement being coded.

  1. Medicare pays only a portion of a patient’s acute care hospitalization expenses and the patient’s out-of-pocket expenses are calculated on a _____BENEFIT______PERIOD______basis.
  1. General Medicare eligibility requires individuals or spouses to ?
  1. Have worked at least ___10__years in medicare covered employment.
  1. Be a minimum of ___65___years old.
  1. Be a citizen or permanent resident of the ____UNITED______STATES______.
  1. (b) 60
  2. (c ) 190

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  1. Assign codes and modifiers to the following:
  1. Tonsillectomy and adenoidectomy, age 10, and a wart CODE#1:__42820___ CODE#2:__28.3_

removed from the patient’s neck while in the OR.

  1. Excision, malignant lesion 0.6 to 1.0 cms., face and layer CODE#1:__17281__ CODE#2:__M8000__

closure of wounds of face, 2.0 cms.

  1. incision and drainage, perianal abscess, superficial and CODE#1:__10160__ CODE#2:__49.1___

puncture aspiration of abscess, hematoma, cyst.

  1. Muscle repair of forearm and suture of major peripheral CODE#1:__64856__ CODE#2:__83.65__

nerve, arm, without transposition.

  1. (a) Health care providers
  1. (c ) Transplant center
  1. (b) A malignancy

TOTALS = 38