CPT Procedure Coding Flashcards

CPT codes are organized into how many main sections?

Answer: 6

CPT is organized into 6 main sections: Evaluation and Management, Anesthesia, Surgery, Radiology, Pathology/Laboratory, and Medicine.

Which CPT modifier indicates a procedure was performed bilaterally?

Answer: -50

Modifier -50 is used to indicate that a procedure was performed bilaterally during the same operative session.

What does the CPT modifier -25 indicate?

Answer: Significant, separately identifiable E/M service on the same day as a procedure

Modifier -25 indicates a significant, separately identifiable E/M service was provided on the same day as a procedure or other service.

In CPT E/M coding for office visits (2021 guidelines), what two components determine the level of service?

Answer: Medical decision making and time

Under 2021 revised guidelines, office/outpatient E/M levels are based on medical decision making (MDM) or total time.

What is an 'add-on code' in CPT?

Answer: A code that is always reported in addition to a primary procedure code

Add-on codes are designated with a '+' symbol and must always be reported with a primary procedure code; they are never reported alone.

Which CPT modifier is used when a physician performs only part of a procedure and another physician performs the rest?

Answer: -56

Modifier -56 is used when the physician performed the preoperative care only.

In CPT, what does the term 'bundling' refer to?

Answer: Including multiple related services within one procedure code

Bundling means that related services are included within a single procedure code and should not be billed separately.

CPT code 99213 is an example of which type of service?

Answer: Office or other outpatient visit

99213 is a Level 3 established patient office or outpatient visit code.