Medicare
General Coding
Procedures
Abbreviations
Definitions
100
How many PQRI codes would you have on the chart if a patient had pneumonia and chest pain?
5 (4 for pneumonia and 1 for chest pain)
100
What is the time span for after hours?
2200-0800 (10:00pm-8:00am)
100
What makes an I&D complex instead of simple
packing or multiple simple abscesses
100
What does CHF stand for?
Congestive Heart Failure
100
What does "circumferential" mean?
goes all the way around
200
If MC is listed as the secondary insurance do we still follow MC billing rules?
Yes
200
Do we bill separately for splints?
No, at this time they are included in the level of service
200
What is the procedure code if a patient is intubated?
31500
200
What does AMS stand for?
Altered Mental Status
200
What is a DVT or Deep vein thrombosis?
blood clot in the legs
300
Will you always have a level of service when a procedure is performed on a MC patient?
No, only if the level of service is "separately identifiable"
300
What level of service would be the lowest level if a lab or x-ray is done?
99283
300
How do you code multiple complex I&D abscesses?
List each procedure code separately. Use modifier 59
300
What does SVT stand for?
Supraventricular tachycardia
300
What is Abduction?
Movement of the limbs (arms or legs) away from the body
400
What statement needs to be on the chart if a PA/NP is involved in the patient's care in order to bill the chart to the doctor?
That the doctor "personally saw" the patient.
400
Can you bill the moderate sedation codes if a procedure is not done in conjunction with it?
No (this code is only billable with a procedure)
400
What are the 3 elements needed in order to determine a laceration repair code?
1. location 2. length 3. complexity
400
What does ACLS stand for?
Advanced Cardiac Life Support
400
What is a pneumothorax?
Air trapped on the outside of the lung
500
If a PA or NP (mid-level provider) is involved in the patient's care and performs the procedure is that procedure billable to the doctor?
No, it must be billed to the PA
500
Are nerve blocks billable when a procedure is done on that same area?
No, they are included in the procedure
500
What is the criteria needed to charge for a foreign body removal (subcutaneous tissue) code?
An incision must be made 1st.
500
What does AAA stand for?
Abdominal Aortic Aneurism
500
What is an opthamologic burr
Removal of a rust ring from the eye
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