CPT BASICS NEW EAM REVIEW SOLUTION
CPT stands for: - current procedural terminology
what kind of code ends with 99? - unlisted procedure and service codes end in 99
codinginformation that pertains to an entire section is locatd in the _________. - guidelines that are
printed a tthe beginning of a section pertain to the entire section
when using an unlisted or category III code, third party payors usually require the submission of what? -
special report
modifiers are listed in appendix _____ - appendix A
additional numbers or letters (2 digits or characters) used with cpt codes to provide greater specificity
about the delivery of services or procedures are called _____ - modifiers - if the modifiers are
alphanumeric thenthey are specifically hcpcs modifiers but the cpt modifeiers can also be digits
whenno code exists for a procedure or service, the appropriate ______ ______ code should be used. -
unlisted procedure
when a written report is required to document a procedure or service it must include a description of
the nature, extent and need for the procedure and the _____, ______, and _____ required to deliver it. -
time, effort, and equipment
what type of code has the full code description? - stand-alone code
what type of code has only a portion of the code description? - indented code
can modifier 22 (increased procedural services) be assigned to cpt codes 99291 or 99292? yes or no -
No. Modiffier 22 should not be appended to an e/m service
, what modifier is used for repeat procedure or service by same physician? - 76 is used to indicate to third
party payers that the services are not duplicate services and the bill isnot a duplicate bill.
what modifier is used for 2 surgeons? - 62
what modifier is used to identify only the professional component of a service? - 26 - 26 is used to
designate a physician component of procedures that have a professional and technical component such
as ultrasounds or xrays. Mod 26 is usually used with radiology service b/c radiology services often have
two components - professinal and tecnical.
An example of the technical component is an dindependent radiology facility that takes the xrays
(technical comp) and send s them to a private radiologist who read sthe xrays writes a a report
(professional component).
what modifier is used for multiple modifiers? - 99 - this is when more than one modifier is required to
adequately explain the seervices or procedures.
Mod 51 is used for multiple procedures and is not correct to indicate multiple modifiers are being used.
whatmodifier is used for a distinct procedural service? - 59 - indicate that services that are usually
bundled into one payment were provided as separate services. As the code description notes, mod 59 is
used to identify the following:
different session
different procedure or surgery
different site or organ system
separate incision/excision
separate lesion
separate injury or area of injury in extensive injuries
59 is reported with codes from all sections of the cpt manual EXCEPT e/m codes
CPT stands for: - current procedural terminology
what kind of code ends with 99? - unlisted procedure and service codes end in 99
codinginformation that pertains to an entire section is locatd in the _________. - guidelines that are
printed a tthe beginning of a section pertain to the entire section
when using an unlisted or category III code, third party payors usually require the submission of what? -
special report
modifiers are listed in appendix _____ - appendix A
additional numbers or letters (2 digits or characters) used with cpt codes to provide greater specificity
about the delivery of services or procedures are called _____ - modifiers - if the modifiers are
alphanumeric thenthey are specifically hcpcs modifiers but the cpt modifeiers can also be digits
whenno code exists for a procedure or service, the appropriate ______ ______ code should be used. -
unlisted procedure
when a written report is required to document a procedure or service it must include a description of
the nature, extent and need for the procedure and the _____, ______, and _____ required to deliver it. -
time, effort, and equipment
what type of code has the full code description? - stand-alone code
what type of code has only a portion of the code description? - indented code
can modifier 22 (increased procedural services) be assigned to cpt codes 99291 or 99292? yes or no -
No. Modiffier 22 should not be appended to an e/m service
, what modifier is used for repeat procedure or service by same physician? - 76 is used to indicate to third
party payers that the services are not duplicate services and the bill isnot a duplicate bill.
what modifier is used for 2 surgeons? - 62
what modifier is used to identify only the professional component of a service? - 26 - 26 is used to
designate a physician component of procedures that have a professional and technical component such
as ultrasounds or xrays. Mod 26 is usually used with radiology service b/c radiology services often have
two components - professinal and tecnical.
An example of the technical component is an dindependent radiology facility that takes the xrays
(technical comp) and send s them to a private radiologist who read sthe xrays writes a a report
(professional component).
what modifier is used for multiple modifiers? - 99 - this is when more than one modifier is required to
adequately explain the seervices or procedures.
Mod 51 is used for multiple procedures and is not correct to indicate multiple modifiers are being used.
whatmodifier is used for a distinct procedural service? - 59 - indicate that services that are usually
bundled into one payment were provided as separate services. As the code description notes, mod 59 is
used to identify the following:
different session
different procedure or surgery
different site or organ system
separate incision/excision
separate lesion
separate injury or area of injury in extensive injuries
59 is reported with codes from all sections of the cpt manual EXCEPT e/m codes
