Medical Administrative Assistant Hi-1011 Chapter 16

The given answer is true. To determine an E/M (Evaluation and Management) level, three components are taken into consideration. These components include history, examination, and medical decision-making. Each component has specific criteria that are used to assign a level to the E/M service provided by a healthcare professional. By assessing these three components, healthcare providers can accurately document and code the level of complexity and resources involved in a patient's visit.

Modifiers are indeed numeric and alphanumeric. Modifiers are used to provide additional information or clarification about a concept or object. They can be in the form of numbers or a combination of numbers and letters. Numeric modifiers provide quantitative information, such as size or quantity, while alphanumeric modifiers can include both numbers and letters to provide more specific or detailed information. Therefore, the statement that modifiers are numeric and alphanumeric is correct.

HCPCS (Healthcare Common Procedure Coding System) codes are used to identify and classify medical supplies, equipment, and services provided by healthcare professionals. These codes are used for billing and reimbursement purposes by insurance companies and government healthcare programs such as Medicare and Medicaid. Therefore, the statement that HCPCS codes are used for supplies is true.

Arthroscopy is a type of procedure that would be found in the surgery section. Arthroscopy is a minimally invasive surgical procedure that allows doctors to visualize, diagnose, and treat problems inside a joint. It involves inserting a small camera called an arthroscope into the joint through a small incision. This procedure is commonly used for diagnosing and treating various joint conditions, such as torn ligaments, cartilage damage, and inflammation. Therefore, arthroscopy is the correct answer for the given question.

CPT stands for Current Procedural Terminology

PT codes have a dollar value associated with them and diagnosis codes give medical reason for those services to be paid.

Coders do not only use category I codes for billing. Category I codes are used for reporting services and procedures performed by healthcare professionals. However, coders also use category II codes for performance measurement and category III codes for emerging technologies. Therefore, the statement that coders only use category I codes for billing is false.

Stand alone codes have a full description of the procedure done.

The CPT book is published every year in the fall (October).

Unlisted procedure codes can be used if necessary. A report will need to go with the claim.

In the given options, "date" is not an E/M (Evaluation and Management) factor. E/M factors typically refer to elements that are considered when determining the level of evaluation and management services provided to a patient, such as the complexity of the medical case, the type of service provided, the location or place where the service is rendered, and the status of the patient (e.g., new or established). However, "date" does not fall under any of these factors and is not directly related to the evaluation and management of a patient.

A modifier can be used if the service performed was reduced from the original description.

Notes are found in the Guidelines in front of each section of the CPT book.

The term "alternative physician" does not modify a procedure. It refers to a different doctor who could potentially perform the procedure, but it does not describe or change the procedure itself. The other options, such as "alternative anatomic site," "alternative procedure," and "extent of service," all describe different aspects or variations of the procedure being performed.

Unbundling codes is not a method used to show the insurance company the extent of procedures performed by the physician. Instead, it refers to the practice of billing separately for components of a bundled procedure, which is considered fraudulent and can result in penalties.