E&M
Altering States
Why
Payers
Random
100
Office visits, preventative visits, hospital visits are all included here.
What are Evaluation and Management Codes
100
These 2 digit codes are used to show when a particular service has been alter in some way that does not change the service defined by the CPT code
What are modifiers
100
These codes describe why a service was rendered.
What are ICD-10 codes
100
The government agency that administers Medicaid and Medicare
What is the Center for Medicaid and Medicare Services: CMS
100
The AAPC
What is the American Academy of Professional Coders
200
The three key components of an E&M service are
What are History, Exam, Medical Decision-making
200
This altering code means that an E&M service happened in addition to something else
What is the modifier 25
200
This code describes a well adult
What is Z00.00
200
Group Health was an example of this kind of healthcare organization and this kind of insurance
What is an HMO?
200
This modifier indicates that a service has been reduced by the provider of service.
What is modifier 52
300
The overarching criteria for code selection is
What is Medical Necessity
300
When reporting only the professional component of a service this modifier is used
What is 26
300
R codes
What are codes for symptoms
300
The payers who audit providers of medical care
Who are All of Them.
300
The code W57.XXXA should be used as the primary diagnosis in the case of
What is Never
400
Time can be the controlling factor in choosing an E&Mcode when this has occurred
What is when it is that counseling/coordination of care has dominated the visit.
400
This is sed to identify procedures/services that are commonly bundled together but are appropriate to report separately under some circumstances.
What is modifier 59
400
E11.32
What is Diabetic retinopathy
400
This the claim form used by providers to report services to payers
What is CMS 1500
400
The person who codes the services is responsible for the codes reported: True or False.
What is False. The providers of service are responsible for the codes reported under their names.
500
It is permissible to report code 99205 when these things have been documented.
What are a comprehensive history, a comprehensive exam and medical decision-making of high complexity OR that the visit took at least 60 minutes, that the visit was dominated, greater than 50% of the visit was spent counseling/coordinating care and that the extent of the counseling was documented.
500
P5 is this kind of code and means
What is a physical status code and means that the patient is moribund or likely to die without the procedure
500
S82.001A
What is the initial encounter for the treatment of a closed fracture of the L patella
500
These are the clients of insurance payers
The employer groups who purchase insurance for their employees
500
Payment for services rendered is evidence that the codes were reported correctly
What is false.