LEVEL UP
As of January 1, 2023, these are the two ways you can select an E/M code level for hospital visits.
What is MDM or total time?
This modifer is used for significant, separately identifiable evaluation & management service by the same physician or other qualified health care professional on the same day of teh procedure or other service.
What is modifier 25?
The abbreviation "MAC(s)" refers to these.
What are Medicare Administrative Contractor(s)?
This long bone is found in the upper leg.
What is the femur?
This is the number of digits that are included in a standard CPT code.
What is five?
This E/M component includes interpreting lab results, reviewing records, and ordering tests.
What is Amount and/or complexity of data reviewed/analyzed?
This modifier is used for the professional component.
What is modifier 26?
In the medical coding world, what does LCD stand for and who issues it?
What is Local Coverage Determination, issued by Medicare Administrative Contractors.
This muscle helps you breathe by moving your chest up and down.
What is the diaphragm?
This place of service is represented by the two digit code: 21.
What is inpatient?
These 3 elements determine medical decision making.
What are "number & complexity of problems addressed at the encounter; data reviewed/analyzed; risk of management"?
Modifier 50 is used when this happens.
What is a bilateral procedure?
The abbreviation HCPCS is pronounced "hick-picks". It stands for this.
"What is Healthcare Common Procedure Coding System".
The radius and ulna are bones found in this part of the body.
What is the forearm?
Use this CPT code range for the initial visit when a patient is admitted to the hospital as an inpatient.
The updates in 2021/2023 did away with these two components of documentation being used to determine level of service.
What are history and exam?
This modifier is used when the procedure has to be discontinued (started but is not completed).
What is modifier 53?
Pronounced "Hip-ah", this is the correct abbreviation and name for this law.
What is HIPAA - Health Insurance Privacy and Portability Act?
This organ system includes the skin.
What is the integumentary system?
This code is used for aspiration and/or injection of a major joint or bursa, such as a knee or shoulder.
What is 20610?
This kind of discussion, when documented appropriately, can boost the data element of MDM to a higher level.
What is "Discussion of management or test interpretation with an external physician or healthcare professional"?
Modifier 78 describes this scenario.
What is "an unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the post-operative period"?
Medicare Severity Diagnosis-Related Group - The amount Medicare will reimburse the hospital for the inpatient stay.
This section of the spine contains 12 vertebrae and connects to the ribs.
What is the thoracic spine?
When evaluating a possible fracture, this code is used for a two-view x-ray of the foot.
What is 73630?