Exam 6: Procedural Coding

Mrs. Burke is a 54-year-old patient seen by her physician for an annual routine physical examination. She has no complaints or symptoms. A nonautomated urinalysis with microscopy and bilateral screening mammography were done. Code for the office visit, urinalysis, and mammography.

When coding for x-ray films taken of both knees, list

If you are billing services for an assistant surgeon, use modifier ____________________ after the surgery procedure number.

Included in a global surgery policy and a surgical package is/are

The E/M code 99203 is considered a level ____________________ code.

When counseling and coordination of care dominate ____________________% of face-to-face physician/patient encounters, then time is considered the key to qualify for a particular level of E/M service.

What code is used for an intramuscular injection of prochlorperazine (Compazine)?

When multiple lacerations of the same classification are repaired in the same body area

The Medicare global surgery policy for major operations is similar to the surgical package concept.

Deliberate manipulation of CPT codes for increased payment is called ____________________.

A patient appears at an outpatient medical facility with extensive lacerations. Simple repair of wounds measuring 2.5, 4.6, and 3.5 cm on the hands, along with complex repair of a 1.5-cm wound on the nose and intermediate repair of wounds measuring 7.3 and 4.6 cm on the scalp, are performed. List the code(s) required for the repairs.

In coding a surgical procedure, postoperative care and follow-up visits may not be coded separately if they fall within the global period for the procedure.

Some private insurance companies may or may not accept HCPCS codes.

Insurance companies go by the rule: "If it is not documented, then it was not ____________________."

Private health insurance plans using the UCR system may pay a physician's full charge if it does not exceed UCR charges.

When there is a choice of two or three somewhat similar codes, the insurance claims examiner will choose the highest-paying code.

In a UCR system, payment can be extremely high for a rarely performed but highly complex procedure because there may be no history of billed charges from other physicians on which to base payment.

A patient required arthroplasty of the tibial plateaus of both knees. Code this procedure for the surgeon.

What does bundling mean?

A listing of accepted charges or established allowances for specific medical procedures is called a/an ____________________.