MAP 205 Week 4 Procedural Coding Review

The most frequently used CPT codes are the __________.

• evaluation and management codes

• surgery codes

• anesthesiology codes

• pathology and laboratory codes

Answer explanation

The evaluation and management (E/M) codes are used so frequently that they are placed in the front of the CPT manual for easy reference.

There is a question concerning a claim for a procedure submitted last year. Where will you look to double-check the codes in question?

• the current CPT

• last year's CPT

• ICD-10-CM

• HCPCS Level II codes

Answer explanation

The codes to be used are always based on the date of service, not the date of the claim or the date of the question.

The CPT is updated and new codes are provided for use beginning __________.

• semiannually on January 1 and July 1

• annually on July 1

• annually on January 1

• on the first day of each month

Answer explanation

The CPT manual is updated yearly, and new codes are used for services beginning January 1 of each new year.

Which of the following is not one of the six main sections in the CPT manual?

• Anesthesiology

• Pathology and Laboratory

• Physical Therapy

• Surgery

Answer explanation

Physical Therapy is not a section in the CPT manual.

In order to find information regarding prefixes and suffixes used in the CPT coding manual, you would look in the __________.

• beginning of each section of the manual

• general index for the manual

• Evaluation and Management section of the manual

• Introduction to the manual

For reporting an evaluation and management code, CPT considers a patient to be “new” if the patient has not received professional services from any provider in the medical practice within the past __________ year(s).

• three

• four

• one

• two

Answer explanation

The general rule of thumb is that if a patient has not been seen by a provider in the practice within three years, he or she is considered a new patient.

For coding purposes, which of the following is not a level of patient history?

• comprehensive

• problem-focused

• expanded problem-focused

• expanded detailed

Answer explanation

There is no "expanded detailed" level for describing a patient history.

For coding purposes, which of the following is not a complexity level for medical decision making (MDM)?

• general-purpose MDM

• moderate-complexity MDM

• low-complexity MDM

• high-complexity MDM

Answer explanation

General-purpose is not a complexity level for medical decision making.

Nathan is in the medical office today complaining of a sore throat and fever. After ruling out strep throat, the practitioner diagnoses a common cold and tells Nathan to take over-the-counter medications for symptom relief. In which category does Nathan’s chief complaint fall?

• self-limited complaint

• minimal complaint

• low-severity complaint

• moderate-severity complaint

Answer explanation

The common cold is a self-limiting condition that will run its course; afterward, the patient will recover without medical intervention.

Which of the following statements about surgical coding for the musculoskeletal system is not true?

• Fracture repair assumes and includes cast application.

• A fracture treatment is closed unless stated otherwise.

• Musculoskeletal subheadings begin with the foot and toes and work their way up to the head.

• Cast application is coded only when the practitioner applying the cast did not initially treat the fracture.

Answer explanation

Musculoskeletal subheadings begin with general, and then start with the head and work their way down to the foot and toes.