Appendixes CPT copyright 2020 American Medical Association. All rights reserved. =New code ▲=Revised code #=Re-sequenced code +=Add-on code 530 ||||||||||| APPENDIX V. TEST YOUR KNOWLEDGE! ANSWER KEY V. Test Your Knowledge! Answer Key Chapter 1 1. d. The medical record should be complete and legible. 2. c. The code assigned for the condition chiefly responsible for the services provided 3. b. Do not report codes for conditions that have been previously treated but no longer exist. 4. d. Extremely low birth weight newborn, unspecified weight (P07.00) indicates that either the birth weight was undocu- mented or the wrong code was selected. 5. a. Three categories are included in the Current Procedural Terminology (CPT®) (Healthcare Common Procedure Coding System Level I) code set. Certain codes may be updated more frequently than the annual update. Chapter 2 1. a. Modifiers add context to how or when the service was provided. 2. d. Modifier 24 is appended to a code for an unrelated E/M service during the postoperative period of a procedure pro- vided by the physician or other qualified health care professional. 3. b. XS, separate structure (site/organ), is a potential substitute for modifier 59, as are modifiers XE, XP, and XU. 4. a. Modifier 66 is appended to the basic procedure code when highly complex procedures are carried out under the surgi- cal team concept. 5. a. A code pair identifies services that should not normally be billed by the same physician for the same patient on the same date of service. Chapter 3 1. c. When the period for which information is needed overlaps with the period for which the patient is or was enrolled in the health plan 2. b. The percentage of children 2 years of age who had 1 or more capillary or venous lead blood test for lead poisoning on or by their second birthday would not apply to a child who turns 3 years old during the measurement year. 3. b. False. Modifier 8P allows the reporting of circumstances when an action described in a measure’s numerator is not performed and the reason is not otherwise specified. 4. c. The Alphabetical Clinical Topics Listing does not provide a complete description of each measure. The listing directs the reader to the measure developer’s website to access the complete description of the measure. Chapter 4 1. d. Physician work, practice expense, and professional liability are components of the Resource-Based Relative Value Scale. 2. c. International Classification of Diseases, 10th Revision, Clinical Modification codes selected in the electronic health record for an encounter should be placed in the order of responsibility for the service(s) provided. 3. a. Place of service 11 designates that services were provided in a physician’s office. 4. b. Review claim adjustment reason and remittance advice remark codes. 5. c. The practice shares either reward or loss depending on actual total costs versus budgeted costs. Chapter 5 1. a. Coding all services at the same level is an abusive billing practice. Answers b, c, and d are examples of fraudulent ­ practices. 2. a. Privacy concerns and federal and state regulatory requirements should be taken into consideration. 3. d. A desired attribute or qualification of a compliance officer is experience in billing and coding. 4. d. Contact legal counsel as soon as possible. Make sure the attorney or legal practice has experience with audits. Coding_2021.indb 530 Coding_2021.indb 530 9/15/20 2:24 PM 9/15/20 2:24 PM
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