HIT 235 - UNIT 1 EXAM QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026

HIT 235 - UNIT 1 EXAM QUESTIONS WITH VERIFIED SOLUTIONS LATEST UPDATE 2026 How is CPT maintained, changed and updated? - Answers It is updated annually w/ changes effective on Jan 1st; No grace period for using the updated codes Who developed CPT and for what purpose? - Answers AMA - to meet reporting and communication needs of physicians In 1983, who adopted CPT to report physician and non-physician services provided to Medicare and Medicaid pts. - Answers CMS What are the multiple purposes of CPT? - Answers 1.Reimbursement in outpt settings 2.Trending - what px are being used more 3.Planning 4.Benchmarking - comparing w/other providers 5.Measuring Quality These are referred to as "CPT codes"; each px or service is identified w/ a five digit numeric code - Answers Category I codes These are referred to as "tracking codes"; alpha-numeric (4 numbers and the letter F) - Answers Category II codes used to track certain things in the facility that they find important. Ex) Assessment of tobacco use - Answers Category II codes These are referred to as "temporary codes"; Will be 4 numbers and the letter T. B/c of emerging technology they are added so quickly but are yet to be FDA approved - Answers Category III codes Documents use of unconventional surgical methods; tracks efficacy and outcomes - Answers Category III codes Appended to Category I codes and indicates some change in the procedure - Answers CPT Modifiers What codes are used for diagnoses of Inpatient services? - Answers ICD-9-CM What codes are used for procedures for Outpt and Physician services? - Answers CPT/HCPCS What codes are used for procedures of Inpatient services? - Answers ICD-9-CM What codes are used for diagnoses of Outpt and Physician services? - Answers ICD-9-CM Combines CPT and National Codes; provides a way for us to report and code our supplies and screening px - Answers HCPCS - Healthcare Common Procedure Coding System HCPCS - Answers Healthcare Common Procedure Coding System CMS recommendation date for ICD-10-CM/PCS? - Answers Oct. 1, 2015 What claim form is used in Physician offices? - Answers Claim 1500 How many dx and px can a Claim 1500 have? - Answers 4 diagnoses 6 procedures CMS 1500 is used to submit claims to whom? - Answers Medicare Part B Most other ins. co. Medicaid What claim form is used in Hospitals? - Answers CMS 1450/ UB-04 How many dx and px can a CMS 1450 have? - Answers 18 diagnoses 6 procedures CMS 1450/UB-04 is used to submit claims to whom? - Answers Medicare Part A used to conserve space in descriptions of procedures - Answers Semicolon ; indicates new procedure - Answers Bullet (symbol) codes with a substantially altered description will have this symbol beside it - Answers Triangle Coders need to review what appendix each year to see if any of their most common codes have been affected by changes? - Answers Appendix B This symbol represents new and revised text - Answers Facing Triangles Go here to see a complete list of additions, deletions, and revisions of codes and text - Answers Appendix B If a code has this symbol, you can never assign the code by itself, but only put it with another code - Answers (+) - Add on codes This symbol indicates that conscious sedation is included if provided by physician doing the procedure - Answers Circled bullet This is when a pt. can still follow commands but they won't remember anything; monitored by physician performing px and no additional code would be assigned, unless an anesthesiologist is needed - Answers conscious sedation This symbol indicates a code that is out of numerical sequence; allows for relocation of codes w/o unnecessarily deleting codes - Answers # This symbol indicates a code that is being recycled or reinstated - Answers O - Hollowed Circle used in CPT to give additional detail and instructions on how to assign a particular code - Answers Notes