What is the purpose of reimbursement edits?
A) to prevent overpayment associated with incorrect coding
B) to check for inconsistencies of coding submitted in claims
C) to scan claims for compliance with the rules of coding
D) to allow for changes in physician reimbursement rates
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Q. 2) Coders must ensure that each CPT code reported is linked to:
A) a provider query.
B) the appropriate fees for services.
C) a medical necessity.
D) one or more diagnosis codes.
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Q. 3) In the Tabular List, the shared portion of the code listed before the semicolon convention is the:
A) common descriptor.
B) add-on code.
C) indented code description.
D) standalone code.
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Q. 4) What is the purpose of CPT codes?
A) to collect payment from individual patients
B) to provide a diagnosis during patient encounters
C) to identify billable services provided to patients
D) to explain procedures and services rendered to patients
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Q. 5) What is the first step in locating a preliminary code in the Index?
A) refer to the Tabular List
B) identify the Main Term
C) review the modifying terms
D) read the instructional notes
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Q. 6) Category III codes are used for:
A) emerging technology.
B) disease-specific assessments.
C) certain types of care plans.
D) all of the above.
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Q. 7) Which does NOT need to be identified to abstract procedures from the patient's medical record for CPT coding?
A) primary services or procedures
B) secondary services or procedures
C) quantities of each procedure
D) planned services or procedures
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Q. 8) Descriptive words in the Index that appear indented under the Main Term to further describe the service or procedure are:
A) conversion factors.
B) instructional notes.
C) modifying terms.
D) special instructions.
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Q. 9) How many appendices does the CPT manual contain?
A) 5
B) 10
C) 15
D) 20
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Q. 10) What type of procedure is reported when a physician provides a unique service that is not adequately described by an existing CPT code?
A) unknown
B) unlisted
C) unnamed
D) unreported
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