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CPT Coding Test Questions with
100% Correct Answers| Verified |
Latest Update 202 5
CPT coding system ✔✔Descriptive terms and identifying codes for reporting medical services and procedures Provides uniform language that describes medical, surgical, and diagnostic services Published by the American Medical Association (AMA) CPT codes ✔✔Five digits in length Descriptions reflect health care services and procedures performed in modern medical practice. Reviewed by AMA to update codes and descriptions annually Category I CPT codes ✔✔Five-digit CPT code and descriptor nomenclature Organized in six sections
Category II CPT codes ✔✔Reported to track performance measurements
CPT Category II Codes ✔✔Tracking codes used for performance measurement in compliance with PQRS Assigned for certain services or test results that support performance measures Alphanumeric and consist of four digits followed by alpha character F Reporting is optional. CPT Category III Codes ✔✔Allow for utilization tracking of emerging: Technology Procedures Services Facilitate data collection/assessment about new services/procedures during FDA approval process Alphanumeric and consist of four digits followed by the alpha character T
CPT Appendices ✔✔Appendix A—CPT modifiers/descriptions Appendix B—Added/deleted/revised codes Appendix C—E/M clinical examples Appendix D—Summary list of add-on codes Guidelines ✔✔define and explain assignment of codes, procedures, and services in a particular CPT section Unlisted Procedures/Services ✔✔Assigned for procedure or service for which there is no CPT code Special report (e.g., copy of procedure report) is attached to claim to describe: Nature Extent Need for procedure or service Time, effort, and equipment necessary
Synonyms, eponyms, and abbreviations Modifying Terms ✔✔Main term may be followed by subterms that modify main term and/or terms they follow. Subterms may also be followed by additional subterms that are indented Single Codes and Code Ranges ✔✔Index code numbers are represented by: Single code number Range of codes, separated by: Dash Series of codes separated by commas Combination of single codes and ranges of codes Note: Review all listed codes before assigning a code for the procedure or service.
Boldface type ✔✔Main terms in the CPT index are printed in boldface type. Note: CPT categories, subcategories, headings, and code numbers are also printed in boldface type. Cross-reference term See ✔✔Directs coders to index entry under which code is listed Italicized type is used for cross-reference term See. Inferred words ✔✔used to save space when referencing subterms CPT Modifiers ✔✔Modifiers indicate that description of service or procedure performed has been altered. Clarify services and procedures performed by providers. CPT code and description remain unchanged.
Procedure or service documented Organ or anatomic site Condition documented in the record Substance being tested Synonym Eponym Abbreviation Step 5—Locate subterms, and follow cross-references. Step 6—Review descriptions of codes, and compare qualifiers to descriptive statements. Step 7—Assign code number, applicable add-on or additional codes, and/or modifiers. Evaluation and Management Section ✔✔Located at beginning of CPT because these codes describe services most frequently provided by physicians
Accurate assignment is essential to success of physician practice because most revenue is generated by these services. E/M Level of Service ✔✔Reflects amount of work involved in providing care to patient: Extent of history performed Extent of examination performed Complexity of medical decision making Three to five levels of service are included in E/M categories. Documentation in chart must support level of service Accurate Assignment of E/M Codes ✔✔Identify place of service (POS). Identify type of service (TOS). Determine whether patient is new or established. Review documentation for level of service components.
Concurrent care ✔✔provision of similar services to same patient by more than one provider on same day Transfer of care ✔✔physician who is managing some or all of patient's problems releases patient to another provider's care Key components ✔✔history, examination, and medical decision making Contributory components ✔✔components— counseling, coordination of care, nature of presenting problem, and time Must be focus of visit to be used in selection of E/M code Complexity of Medical Decision Making ✔✔Complexity of establishing diagnosis and/or selecting management option Measured by:
Number of diagnoses or management options Amount and/or complexity of data to be reviewed Risk of complications and/or morbidity or mortality Types of medical decision making: Straightforward Low complexity Moderate complexity High complexity Counseling Contributory Components ✔✔Counseling—discussion with patient and/or family concerning one or more of the following areas: Diagnostic results Impressions Recommended diagnostic studies Prognosis Risks and benefits of management options Instructions for management/follow-up
The same Anesthesia section code is often reported for different surgical procedures that share similar anesthesia requirements. Qualifying Circumstances for Anesthesia ✔✔Anesthesia services provided during situations or circumstances that make anesthesia administration more difficult, as follows: 99100 (Anesthesia for patient of extreme age, younger than one year and older than 70) 99116 (Anesthesia complicated by utilization of total body hypothermia) 99135 (Anesthesia complicated by utilization of controlled hypotension) 99140 (Anesthesia complicated by emergency conditions) Surgery Section ✔✔Organized by body system Subsections are subdivided into categories by specific organ or anatomic site.
To code surgeries properly, ask the following questions: What body system was involved? What anatomic site was involved? What type of procedure was performed? global surgery ✔✔Global period—number of days associated with surgical package; designated as 0, 10, or 90 days Unbundling ✔✔Not allowed Defined as assigning multiple codes to procedures/services when just one comprehensive code should be reported Separate Procedure ✔✔Parenthetical note following code description Identifies procedures that are an integral part of another procedure or service Reported if procedure or service is:
Review radiology report or charge slip and code descriptions to select appropriate code. Complete—reference to number of views required for full study of designated body part Complete Procedure ✔✔When complete is found in code description, one code is reported to "completely" describe procedure performed. When complete is found in parenthetical note below code, it may be necessary to report more than one code to "completely" describe the procedure performed. Professional vs. Technical Component ✔✔Professional component—covers supervision of procedure and interpretation/ documentation of report describing examination and findings Technical component—covers use of equipment, supplies provided, and employment of radiologic technicians
Moderate (Conscious) Sedation Subsection ✔✔Reported for drug-induced depression of consciousness that requires no interventions to maintain airway patency or ventilation Does not include minimal sedation (e.g., anxiolysis), deep sedation, or monitored anesthesia care (MAC) National Correct Coding Initiative (NCCI) ✔✔Promotes national correct coding methodologies Controls improper assignment of codes that results in inappropriate reimbursement of Medicare Part B claims Home Health Procedures/Services Subsection ✔✔Reported by nonphysician health care professionals who perform procedures and provide services to patient in patient's
