Billing And Coding Simulation > Medicine Coding > Flashcards

Medicine Coding Flashcards

(95 cards)

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1
Q

Allergy testing units

A

Units = number of tests performed

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2
Q

Cardiac Cath codes with intervention

A

Cardiac Cath only codable to determine need for intervention if patient’s condition changed significantly

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3
Q

EKG/stress test codes

A

One code for global component, one for technical, one for professional, modifier 26 not necessary

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4
Q

Hierarchy for infusions

A

For physicians, determined by most significant service for treatment of chief complaint, only ONE initial service may be coded per encounter

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5
Q

Hydration services

A

Use for infusion of prepackaged fluids that are medically necessary, not for fluids containing medication

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6
Q

Immunization/medicine guidelines

A

Require two codes per administration and substance administered

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7
Q

Selective/non selective wound care

A

Assigned when non excisional debridement performed

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8
Q

Time for infusion services

A

1/2 or more of time listed for code must be documented for each unit

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9
Q

Medicine section

A

Pertains to services that are diagnostic or therapeutic

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10
Q

Definitive, restorative, and/or invasive procedures

A

Located in surgery section

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11
Q

E/M services

A

May be reported when a “significantly, separately identifiable” service is performed, append modifier 25

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12
Q

Immune globulin, serum, recombinant products

A

Report products in addition to the administration code

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13
Q

Vaccines/toxoids

A

Identify vaccine product only, additional code needed for administration

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14
Q

Interactive complexity code 90785

A

Add on code used when specific communication factors complicate the delivery of psychiatric procedures

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15
Q

Psychiatry evaluation codes 90791 and 90792

A

Can only be reported once per day

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16
Q

Time driven codes

A

Must have time documented

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17
Q

Psychotherapy for crisis codes

A

Not assigned in conjunction with regular psychotherapy codes

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18
Q

Biofeedback

A

Codes 90912-90913 when performed to perineal muscles, anorectal, or urethral sphincter, use 90901 for all other

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19
Q

Hemodialysis services

A

90935-90940

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20
Q

Dialysis services other than hemodialysis

A

90945-90947

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21
Q

End stage renal services

A

Assign based on monthly/daily, # of face to face visits, age

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22
Q

ESRD service units

A

When daily use units for number of days

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23
Q

Gastroenterology

A

Diagnostic and therapeutic services only, definitive, invasive, or restorative code from surgery section

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24
Q

Ophthalmology E/M codes

A

When encounter focuses on history, exam, and medical decision making

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25
General ophthalmological services
When encounter focuses on diagnostics
26
Ophthalmology specialized services
Contact lens/spectacle services, prescription/fitting/provision, aphakia/nonaphakia
27
Otorhinolaryngological (ENT) tests
General, vestibular function, audiologic function, evaluation/therapeutic services, special diagnostic procedures
28
Cardiovascular subcategories
Other, coronary, cardiography, cardiovascular monitoring, implantable and wearable device evaluations, echocardiography, cardiac catheterization, intracardiac electrophysiological procedures/studies, peripheral arterial disease rehab, noninvasive physiologic studies/procedures, home and outpatient international normalized ratio (INR) monitoring services
29
Coronary therapeutic services and procedures
Includes Accessing, selective catheterization, radiological supervision and interpretation, imaging, and closure
30
Codes specified for major coronary arteries
Include left main coronary, left anterior descending, left circumflex, right main coronary, and ramus intermedius arteries
31
Major coronary artery branch
Code for initial then each additional
32
Lesion revascularization
One intervention - one code, two interventions - two codes
33
Modifier LC
Left circumflex artery
34
Modifier LD
Left anterior descending coronary artery
35
Modifier LM
Left main coronary artery
36
Modifier RC
Right coronary artery
37
Modifier RI
Ramus intermedius artery
38
Cardiography procedures
Professional, technical, or complete
39
EKG monitoring for cardiovascular stress testing
Inherent in codes
40
Telemetry strip reviewing only
Use code from cardiovascular medicine
41
Holter monitors
Should include 48 hours continuous monitoring
42
Mobile telemetry monitors
Transmit at any time to an attended transmission center
43
Event monitors
Record segments of EKGs triggered by either patient activation or internal program
44
Implantable/wearable cardiac device evaluation period
Established by date of initiation of remote monitoring or the 91st day for pacemakers/defibrillators, 31st day for implantable loop recorders
45
Programming device codes and remote interrogation device evaluation
Codes may be reported in the same period
46
Pacemaker and defibrillator interrogation codes
May not be reported during the same period as insertion/revision service codes by same provider
47
Echocardiography techniques
Transthoracic, transesophageal, stress, Doppler
48
Echocardiography procedures
Specified as limited or complete, complete must document “unable to visualize” if unable to visualize
49
Modifier 26
Use if only professional component (interpretation and report) is performed
50
Catheterization (left vs right)
Determined by vessel accessed, not which extremity
51
Heart catheterization in conjunction with a revascularization
Only reportable if performed to determine need for revascularization
52
Code 93503
Do not report in conjunction with other diagnostic catheterization procedures
53
Contrast injection to image access site for closure device and closure device
Not separately reportable
54
Intracardiac electrophysiological procedures/studies
Includes insertion/positioning of catheters, stimulation of multiple locations, analysis, and reporting. May include evaluation, mapping, and/or ablation
55
Multiple procedures (Intracardiac electrophysiological)
Append modifier 51 for subsequent procedures
56
Peripheral arterial disease rehab
Use code 93668 per rehab session
57
Training for home INR monitoring
Code 93792
58
INR Management
Code 93793, do not bill E/M with code
59
Use of a handheld Doppler device that doesn’t produce a hard copy/record
Included in E/M code
60
Ankle brachial index services
Reportable with codes 93922 and 93923
61
Duplex scans
Performed using ultrasonic scanning equipment
62
Physiological scans
Use equipment other than ultrasound
63
Ventilation management
Assign codes based on hospital inpatient/observation, nursing facility or home, domiciliary or rest home (initial/subsequent day or minutes)
64
Spirometry or pulmonary function test
Code 94010
65
Bronchodilation responsiveness
Code 94060
66
Demonstration/evaluation of use of nebulizer/inhaler
Code 94664, can only be used once per day
67
Allergy testing
Categorized by percutaneous scratch, puncture, prick, intradermal, and patch techniques
68
Allergy testing codes
Assigned units based on number of tests performed
69
Ingestion challenge testing
Code 95076 for first 120 minutes, code 95079 for each additional 60 minutes
70
Neurology/neuromuscular procedure categories
Sleep medicine procedures, routine electroencephalography, muscle/range of motion testing, electromyography, ischemic muscle testing/guidance for chemodenervation, nerve conduction tests, intraoperative neurophysiology, autonomic function tests, evoked potentials/reflex tests, special EEG tests, neurostimulators/analysis programming, motion analysis, functional brain mapping, monitoring and long term EEG set up, and other
71
EEG sleep studies
Assigned based on time
72
Muscle testing
Assigned based on body region
73
Electromyography
Assigned based on # extremities or body regions
74
Intraoperative neurophysiology
Assigned as add on code during surgical procedures
75
Codes for administration of fluids/medicines
Include codes for the administration/injection and actual medication
76
Fluid/medication administration
Only one initial code, unless 2 IV sites are medically necessary, use modifier 59
77
Initial administration code determination
Determine by chief reason/primary treatment for encounter and not by medication/fluid given
78
Append E/M with modifier 25
Only if a significantly, separately identifiable service is performed in addition to injection/infusion
79
Subsequent units of drug/fluid administration
Report in units
80
Drug/fluid administration codes
Driven by time, greater than half of stated time must be documented
81
Hydration codes
Used for reporting prepackaged fluids, not used for fluids containing medications
82
Sequential infusion code
Use for administration of a new substance following initial medication/substance
83
Concurrent infusion code
Administration of a new fluid at the same time as another medication/substance, use only once per encounter
84
Physical medicine/rehab subcategories
Physical therapy, occupational therapy, athletic training, modalities, therapeutic procedures, active wound care management, tests/measurements, orthotic/prosthetic management and training, other
85
Physical therapy evaluations
History, exam, MDM, plan of care
86
Occupational therapy evaluation
History, assessment of occupational performance, MDM, plan of care
87
Athletic training evaluation
History and physical activity profile, exam, MDM, plan of care
88
Athletic training evaluation
History and physical activity profile, exam, MDM, plan of care
89
Modality codes
Based on supervised vs constant attendance, time
90
Active wound care management
Selective/non selective, sq cm treated
91
Osteopathic manipulation treatment body areas/regions
Head, cervical, thoracic, lumbar, sacral, pelvic, lower extremities, upper extremities, rib cage, abdomen/viscera
92
Spinal regions
Cervical, thoracic, lumbar, sacral, pelvic
93
Extraspinal regions
Head, lower extremities, upper extremities, rib cage, abdomen
94
Category II codes
Tracking performance measurement only, 4 numerical followed by letter F
95
Category III codes
Temporary codes for emerging technology, services, and procedures, 4 numerical followed by letter T
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