Mod B Unit 2 Theory

Front 1

Modifiers can indicate

Back 1

only part of a service, a bilateral procedure, unusual service

Front 2

modifier 22

Back 2

unusual services (increased procedural services)

Front 3

modifier 25

Back 3

significant, separately identifiable

Front 4

modifier 50

Back 4

bilateral procedure

Front 5

modifier 51

Back 5

multiple procedures at the same visit

Front 6

Name of the book that contains a coded list of procedures with unit values that indicate the relative value of various services

Back 6

healthcare common procedure coding system (HCPCS)

Front 7

What should be done when a service rendered is not listed in the coding book

Back 7

use a code with a description stating unlisted and attach appropriate documentation to the claim

Front 8

bundling

Back 8

to group codes together that are related to a procedure

Front 9

unbundling

Back 9

coding and billing numerous CPT codes to identify procedures usually described by a single code

Front 10

downcoding

Back 10

refers to a code that is changed by and insurance carrier because it is not recognized by the system

Front 11

upcoding

Back 11

the deliberate manipulation of CPT codes for increased payment

Front 12

CPT is divided into 6 code sections

Back 12

evaluation and management, anesthesia, surgery, radiology nuclear medicine diagnostic ultrasound, pathology and laboratory, medicine

Front 13

when coding for a claim that involves a surgery, the coder should have

Back 13

a copy of the operative report

Front 14

coding procedure that involve repairs need to use the main term that specifies the

Back 14

length and depth of the repair performed

Front 15

when coding a claim for a procedure that involved a biopsy, the coder needs to have

Back 15

a pathology report to code the diagnosis properly

Front 16

elements of evaluation and management codes

Back 16

history, examination, medical decision making, nature of presenting problem, counseling, coordination of care, time

Front 17

when coding for procedures it is vital that the billing specialist ensure

Back 17

that the medical record contains the appropriate documentation of the procedure that was performed

Front 18

fee schedule

Back 18

method of payment that is similar to a price list

Front 19

relative value scales or schedules

Back 19

service performed+time+skill+overhead=payment formula

Front 20

neoplasms

Back 20

benign or malignant new growth

Front 21

before coding a claim for HIV/AIDS, it is necessary to have

Back 21

an authorization for release of HIV status form signed by the patinet

Front 22

when coding a diagnosis, you need to first use

Back 22

volume 2 and then read about the code in volume 1

Front 23

it is necessary to have an understanding of anatomy and physiology to be a good medical coder

Back 23

true

Front 24

sequencing of diagnostic codes

Back 24

primary diagnosis (first listed), main reason for the encounter

Front 25

V codes are

Back 25

a supplementary classification of coding and may be used in four primary circumstances

Front 26

classification of factors influencing health status and contact with health service

Back 26

v01 -v89

Front 27

E codes are

Back 27

supplenentary diagnosis in which you look for external causes of injury rather than disease

Front 28

For what situation would an E code be used for

Back 28

an allergic reaction due to a medication

Front 29

Codes E800-E999 are

Back 29

classification of external causes of injury and poisioning

Front 30

the 4th or 5th digit added to an ICD-9 code provides more information regarding, etiology, site or manifestations

Back 30

true

Front 31

which of the following describes a primary diagnosis

Back 31

the main reason for an encounter

Front 32

which of the following type of codes is not listed in the ICD-9 CM coding book

Back 32

medications

Front 33

which of the following is not part of the relative value studies formula

Back 33

diagnosis

Front 34

e codes may be used as a primary diagnosis or as a supplementary diagnosis

Back 34

false

Front 35

whic of the following is a method of payment that is similar to a price list

Back 35

FEE SCHEDULE

Front 36

THE KEY COMPONENTS OF EVALUATION AND MANAGEMENT ODES ARE WHICH OF THE FOLLOWING

Back 36

history, examination, and medical decision making

Front 37

which of the followuing is not part of the relative studies formula

Back 37

time, skill, overhead cost