Term
a. 69799
b. 29999
c. 43499 |
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Definition
For Surgery, give unlisted code for:
a) unlisted procedure; middle ear
b) unlisted procedure; arthroscopy
c) unlisted procedure; esophagus |
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Term
a. 88299
b. 81099
c. 84999 |
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Definition
For Pathology and Laboratory, give unlisted code for:
a) unlisted procedure; cytogenetic study
b) urinalysis procedure
c) chemistry procedure |
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Term
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Definition
For Medicine, give the unlisted code for:
unlisted special service, procedure, or report |
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Term
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Definition
For Radiology, give the unlisted code for:
a) unlisted procedure; clinical brachytherapy
b) unlisted miscellaneous procedures; diagnostic nuclear medicie |
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Term
| Physicians Quality REporting Initiative |
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Definition
| What does PQRI stand for? |
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Term
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Definition
| a program within Medicare that pays physicians a bonus for reporting quality measures, which usually addresses at risk ailments that will develop as a result of a patient's illness |
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Term
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Definition
With PQRI, there is a:
a) bundled code for systolic and diastolic blood pressure
b) systolic blood pressure code
c) diastolic blood pressure code
d) bundled systolic and diastolic code if normal, separate systolic and diastolic if abnormal
e) b and c
f) PQRI uses ICD-9-CM codes |
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Term
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Definition
| Four modifier codes that can only be used with Category II codes, and they report the reason the performance measure was not performed with PQRI reporting |
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Term
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Definition
| PQRI modifier that states the performance measure was not performed due to medical reasons--such as a contraindicated due to adverse drug interaction |
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Term
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Definition
| PQRI modifier that states a performance measure was not performed because of personal reasons of the patient--like religious beliefs |
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Term
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Definition
| PQRI modifier that states performance measure not performed because of systemic reasons, such as equipment was not available |
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Term
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Definition
| PQRI modifier that states a performance measure was not performed for an unspecified reason |
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Term
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Definition
| PQRI measures state that an ____ code from the CPT or a ___ code from HCPCS are the two types of codes permissible with Category II codes |
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Term
False
Some ICD-9-CM codes can be submitted with PQRI codes |
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Definition
| T or F: ICD-9-CM codes are never used with Category II codes |
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Term
| National Provider Identification |
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Definition
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Term
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Definition
| a number that is assigned to a physician and tracks their quality measure submissions for PQRI |
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Term
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Definition
| codes that report emerging technology and are temporary codes for up to five years |
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Term
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Definition
| There is a new technology with a Category III code. Do you use the Category III code or the Category I code? |
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Term
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Definition
| codes that are used to describe services and procedures that have been approved by the FDA and have been proven to have clinical effectiveness |
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Term
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Definition
Category III codes:
a) may not be approved by the FDA
b) may not be widely offered
c) may not have been proven clinically effective
d) identify emerging trends in health care
e) all of the above |
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Term
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Definition
When do you need to submit a special report with a claim?
a) when you use an unusual, new, or seldom used procedure
b) use Category I unlisted code
c) use a Category III code
d) all of the above
e) all but a |
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Term
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Definition
Special report submitted for a claim should include:
a) definition or description of the nature, extent, and need for procedure or service
b) time, effort, and equipment necessary to provide the service
c) skill of the physicians involved
d) all of the above |
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Term
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Definition
| A comma between numbers in the Index indicates that there are a _______ of codes |
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Term
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Definition
| A hyphen between numbers in the Index indicates that there is a ______ of codes |
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Term
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Definition
| T or F: A coder codes from the Index |
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Term
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Definition
You can locate main terms in the index by:
a) service or procedure
b) anatomic site
c) condition or disease
d) synonym
e) eponym
f) abbreviation
g) numeric code
h)all of the above
i) all but g
j) all but d and f |
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Term
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Definition
Use the index to find the code for:
Repair Abdomen Suture |
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Term
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Definition
Use the index to find the code for:
Femur Abscess Incision |
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Term
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Definition
Use the index to find the code(s) for:
Fracture Ankle Lateral |
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Term
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Definition
Use the index to find the code for:
Emergency Department Services, Physician Direction of Advanced Life Support |
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