10 Questions
Which type of denials occur when the payment of one CPT is included in the payment of another CPT?
Inclusive denials
What action should be taken if a CPT is found to be inclusive according to the CCI Edit?
Send the claim for coding review
Which modifier is used when CPT 71048 is inclusive with 71101?
59-Distinct Procedure Service
When should modifier 25 be used?
When separate ENM and Non ENM services is performed in same session by same doctor
What additional documents can be used for appealing inclusive denials?
Medical record and screenshots of CCI Edit
Which type of expenses are included in the Global denial?
All of the above
What is the global period for major surgery?
90 days
What is the global period for minor surgery?
10 days
Which modifier is used when a patient comes for Evaluation and Management Service under a global period that is not related to surgery?
Modifier 24
What action should be taken if the Date of Service (DOS) falls under the global period and the Diagnosis (DX) code is different?
Send the claim to coding to append a modifier
Test your knowledge on how to handle denials related to inclusive CPT codes and the steps to take for coding review or claim reprocessing. Learn about CCI Edit and turnaround time in this informative quiz.
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