Questions and Answers
What does the acronym HCPCS stand for?
Healthcare Common Procedure Coding System
What temporary HCPCS Level II codes are required for use by Outpatient Prospective Payment System (OPPS) Hospitals?
C codes
What agency maintains and distributes HCPCS Level II codes?
CMS
When procedures are 'mandated' by third party payers, what modifier would you use?
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What publications does the AMA copyright and maintain?
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How often are HCPCS Level II permanent national codes updated?
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What does 'non-facility' describe when calculating Medicare Physician Fee Schedule payments?
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What is the correct anesthesia CPT® code for surgery performed on the frontal lobe of the brain?
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What is the correct code for a total ankle arthroplasty with an implant?
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What code represents a secondary rhinoplasty where a small amount of work is performed on the tip of the nose?
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What modifier is used to report the termination of a surgery following induction of anesthesia due to extenuating circumstances?
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What is the correct HCPCS Level II code for a removable metatarsal foot arch support that is pre-molded?
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A patient is seen for a 2,400,000 U injection of Bicillin L-A. What code represents this drug and the units given?
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What is the correct CPT® code for a complicated nephrolithotomy on a patient with a congenital kidney abnormality?
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What is the correct CPT® code to report a microscopic urinalysis?
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Study Notes
HCPCS Overview
- HCPCS stands for Healthcare Common Procedure Coding System.
- C codes (C1713-C9899) are required for Outpatient Prospective Payment System (OPPS) hospitals to report new technology procedures and devices.
- CMS (Centers for Medicare & Medicaid Services) is responsible for maintaining and distributing HCPCS Level II codes.
- HCPCS Level II permanent national codes are updated annually in January.
Modifier Usage
- Modifier 32 indicates mandated services required by third-party payers.
- Modifier 53 is used when a surgery is terminated due to circumstances threatening patient well-being.
AMA Publications
- The AMA copyrights and maintains the CPT® code book and CPT® Assistant, covering all three categories of procedures.
Medicare Physician Fee Schedule
- "Non-facility" refers to private physician practices, which receive higher reimbursement compared to hospital-owned practices.
Anesthesia and Surgical Codes
- The CPT® code for anesthesia during surgery on the frontal lobe of the brain is 00210.
- A total ankle arthroplasty with an implant is coded as 27702.
- Secondary rhinoplasty involving minor work on the nose tip is represented by code 30430.
- A complicated nephrolithotomy due to a congenital kidney abnormality is coded as 50070.
Diagnostic and Treatment Codes
- A microscopic urinalysis is reported using CPT® code 81015.
- The HCPCS Level II code for a removable pre-molded metatarsal foot arch support is L3050.
- For a 2,400,000 U injection of Bicillin L-A, the correct coding is J0561 x 24 (where one unit equals 100,000 U).
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Description
This set of flashcards covers key concepts from Chapter 6 of the AAPC's Introduction to CPT. Test your knowledge on HCPCS standards and temporary coding systems for outpatient hospitals. Perfect for those studying coding practices and procedures.
