Chapter 15 medical coding

Question 1

CPT codes are used for documenting…

Answer 1

procedures

Question 2

ICD-10-CM codes are used for documenting…

Answer 2

diagnoses

Question 3

assigning lower level CPT codes

Answer 3

downcoding

Question 4

what are the different parts of an ICD code?

Answer 4

1. first 3 digits - category
2. decimal point
3. 4-7 following digits - to be more specific
4. sometimes a placeholder after the 4th character

Question 5

the cause of a disorder

Answer 5

etiology

Question 6

the primary condition for which a patient is receiving care

Answer 6

principal diagnosis

Question 7

what are combination codes used for?

Answer 7

for external causes of disease

Question 8

what are expanded codes used for?

Answer 8

for greater detail

Question 9

what are the 3 levels of HCPCS codes?

Answer 9

1. procedures & services
2. supplies/materials
3. local carrier codes - used only by insurance companies that process medicare

Question 10

the connection between the diagnostic and procedural info

Answer 10

code linkage

Question 11

changing a code to match what the insurance company will pay for rather than what accurately reflects the procedure

Answer 11

coding for coverage

Question 12

using a code that indicates a higher level of service than what was actually perfomred

Answer 12

upcoding

Question 13

how many volumes are in the ICD-10 manual?

Answer 13

3

Question 14

how many digits is CPT codes?

Answer 14

5

Question 15

what are the 6 sections of CPT codes?

Answer 15

1. evaluation and management
2. anesthesia
3. surgery
4. radiology
5. pathology
6. lab and medicine

Question 16

what codes use modifiers and what do they do?

Answer 16

• CPT and HCPCS level 2
• indicates the procedure was different from the standard description

Question 17

reporting codes for signs and symptoms as well as diagnosis

Answer 17

overcoding