CPR Codes & ICD-10 Codes

Question 1

Treatment Codes

Answer 1

• Common Procedural Terminology
• CPT Codes
• Timed: Treatment-related codes
• Untimed: Evaluation & Re-evaluation

Question 2

Must always bill the CPT code that

Answer 2

best describes the interventions provided

Question 3

Timed Units

Answer 3

1 Unit = 15 minutes of treatment
2 Units = 30 minutes of treatment

Question 4

What is a “Unit”

Answer 4

between the window of 8 - 22 minutes
- 1 Unit: 8 - 22 minutes
- 2 Units: 23 - 37 minutes
- 3 Units: 38 - 52 minutes
- 4 Units: 53 - 67 minutes

Question 5

PT- Evaluation - Stable ( Low complexity)

Answer 5

• No personal factors or co-morbidities
• Addressing 1-2 elements
• subacute

Question 6

PT - Evaluation - Evolving (moderate complexity)

Answer 6

• 1 -2 personal factors
• addressing 3 or more elements
• evolving clinical presentation with changing characteristics

Question 7

PT - Evaluation - Unstable (high complexity)

Answer 7

• 3 or more personal factors
• addressing 4 or more elements
• unstable presentation
• acute

Question 8

Three 7th characters

Answer 8

• ” A” Initial encounter (acute), someone comes to you without haven’t seen a doctor
• “D” Subsequent encounter (healing/recovery)
• “S” Sequela

Question 9

‘A” - Active Treatment

Answer 9

• Initial encounter
• in a direct access state where the patient is evaluated by a therapist prior to any other medical profession

Question 10

“D” - Subsequent Encounter

Answer 10

• Healing or recovery
• More common for therapists to use this 7th character

Question 11

“S” - Sequela

Answer 11

• a condition that is the consequence of a previous disease or injury
• example: scar formation after a burn
• clavicle example: Difficulty with shoulder elevation/ flexion

Question 12

Code has less than 7 characters and the 7th character extension is required

Answer 12

“X” is assigned

Question 13

ICD- 10, the codes billed by PTs have to do with

Answer 13

• what problem we are addressing, not the medical diagnosis
• example: difficulty walking, not parkinsons
• Code the problem you are addressing first, followed by the injury code

Question 14

External cause codes, place of occurrence codes, and activity codes

Answer 14

• report only once at the initial encounter