MA 300 STUDY OUTLINE 1 QUESTIONS AND ANSWERS
Who created the first comprehensive disease classification system in the United States in 1869? -
CORRECT ANSWER✅✅the American Medical Association (AMA) as the American Nomenclature of
Disease.
What are the main reasons to use procedure coding? - CORRECT ANSWER✅✅1. To justify medical
services to insurance companies by correlating procedures to diagnosis
2. To collect statistics about the outcome and effectiveness of treatments
3. To help physicians and hospitals set fees based on the amount of time and skill required to provide a
specific service
How often are level I codes updated? - CORRECT ANSWER✅✅Updated Annually
Who updates and publishes the CPT manual? - CORRECT ANSWER✅✅American Medical Association
(AMA)
HCPCS level II codes include what services that are not in the PT system and may not be covered by
insurance? - CORRECT ANSWER✅✅procedures, injections, and durable medical equipment covered by
Medicare Part B
How often should updated code books be purchased? - CORRECT ANSWER✅✅every year.
CPT manual contains codes which are usually how many digits long? - CORRECT ANSWER✅✅5-digits
What is a modifier? - CORRECT ANSWER✅✅is an addition to a procedure code that indicates unusual
circumstances related to the procedure, such as a more extensive procedure or two procedures
performed in the same session
How many digits are in a Modifier? - CORRECT ANSWER✅✅2
, What pieces of information may be significant when choosing the correct code for a procedure? -
CORRECT ANSWER✅✅• Location
• Size of lesion or repair
• Method of performing the procedure, test, or surgery
• Number of minutes allotted for a treatment (e.g., acupuncture)
• Complexity of the procedure or service
What are the two types of CPT codes? - CORRECT ANSWER✅✅Stand-alone & Indented
If a patient comes in for an exam and has an electrocardiogram done, per the physician's orders, is this
billed under the examination or separately, under its own code? - CORRECT ANSWER✅✅The code
93005 would be used if the ECG tracing is made in one office, but insurance should not be billed for the
interpretation because it will be done by another physician and billed from another office
What type of services and providers would find their appropriate codes in the E/M section? - CORRECT
ANSWER✅✅primary care practitioners and specialists.
Define established patient. - CORRECT ANSWER✅✅one who has been seen in the previous 3 years
Define new patient. - CORRECT ANSWER✅✅one who has not had services performed by any provider
in the medical office in the previous 3 years
Define inpatient. - CORRECT ANSWER✅✅a patient who has been formally admitted to a health care
facility'
Define outpatient - CORRECT ANSWER✅✅one who has not been admitted to a health care facility
What is problem-focused history? - CORRECT ANSWER✅✅is one that addresses the chief complaint,
with a brief history of the illness or problem.
It would be used for a straightforward problem, such as a sore throat.
Who created the first comprehensive disease classification system in the United States in 1869? -
CORRECT ANSWER✅✅the American Medical Association (AMA) as the American Nomenclature of
Disease.
What are the main reasons to use procedure coding? - CORRECT ANSWER✅✅1. To justify medical
services to insurance companies by correlating procedures to diagnosis
2. To collect statistics about the outcome and effectiveness of treatments
3. To help physicians and hospitals set fees based on the amount of time and skill required to provide a
specific service
How often are level I codes updated? - CORRECT ANSWER✅✅Updated Annually
Who updates and publishes the CPT manual? - CORRECT ANSWER✅✅American Medical Association
(AMA)
HCPCS level II codes include what services that are not in the PT system and may not be covered by
insurance? - CORRECT ANSWER✅✅procedures, injections, and durable medical equipment covered by
Medicare Part B
How often should updated code books be purchased? - CORRECT ANSWER✅✅every year.
CPT manual contains codes which are usually how many digits long? - CORRECT ANSWER✅✅5-digits
What is a modifier? - CORRECT ANSWER✅✅is an addition to a procedure code that indicates unusual
circumstances related to the procedure, such as a more extensive procedure or two procedures
performed in the same session
How many digits are in a Modifier? - CORRECT ANSWER✅✅2
, What pieces of information may be significant when choosing the correct code for a procedure? -
CORRECT ANSWER✅✅• Location
• Size of lesion or repair
• Method of performing the procedure, test, or surgery
• Number of minutes allotted for a treatment (e.g., acupuncture)
• Complexity of the procedure or service
What are the two types of CPT codes? - CORRECT ANSWER✅✅Stand-alone & Indented
If a patient comes in for an exam and has an electrocardiogram done, per the physician's orders, is this
billed under the examination or separately, under its own code? - CORRECT ANSWER✅✅The code
93005 would be used if the ECG tracing is made in one office, but insurance should not be billed for the
interpretation because it will be done by another physician and billed from another office
What type of services and providers would find their appropriate codes in the E/M section? - CORRECT
ANSWER✅✅primary care practitioners and specialists.
Define established patient. - CORRECT ANSWER✅✅one who has been seen in the previous 3 years
Define new patient. - CORRECT ANSWER✅✅one who has not had services performed by any provider
in the medical office in the previous 3 years
Define inpatient. - CORRECT ANSWER✅✅a patient who has been formally admitted to a health care
facility'
Define outpatient - CORRECT ANSWER✅✅one who has not been admitted to a health care facility
What is problem-focused history? - CORRECT ANSWER✅✅is one that addresses the chief complaint,
with a brief history of the illness or problem.
It would be used for a straightforward problem, such as a sore throat.
