Practice Test Geeks(CCS) Certified Coding Specialist Practice Test
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Outpatient & Ambulatory Coding (CPT/APC) Flashcards

6 cards from real CCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 Outpatient & Ambulatory Coding (CPT/APC) flashcards as text

  1. In hospital outpatient coding, what is the OPPS 'packaging' concept?

    Answer: Certain ancillary services (labs, minor drugs, supplies) are packaged into the APC payment for the primary service and not separately payable

    Under OPPS packaging, certain ancillary items and services - such as minor laboratory tests, low-cost drugs, and supplies - are bundled into the APC payment for the primary procedure and are not separately reimbursed.

  2. According to CPT coding guidelines, what is the definition of a 'new patient' for E/M office visits?

    Answer: A patient who has not received professional services from the physician or another physician of the same specialty in the same group practice within the past 3 years

    CPT defines a new patient as one who has not received professional services from the physician, or another physician of the same exact specialty and subspecialty in the same group practice, within the past 3 years.

  3. Under the 2023 CPT E/M guidelines for outpatient office visits, what are the two elements used to select the level of service?

    Answer: Medical decision making (MDM) or total time on the date of encounter

    The revised CPT 2021+ E/M guidelines for office/outpatient visits base code selection on either Medical Decision Making (MDM) or total time spent on the date of service - history and exam are no longer separately scored.

  4. Which modifier is appended to a CPT code to indicate a service was a distinct procedural service separate from another procedure performed the same day?

    Answer: Modifier -59

    Modifier -59 (Distinct Procedural Service) indicates that a procedure or service is distinct or independent from other services performed on the same day - overriding bundling edits when the services are truly separate.

  5. In hospital outpatient coding, the 'significant, separately identifiable E/M service' performed the same day as a procedure is reported with which modifier?

    Answer: -25

    Modifier -25 is appended to the E/M code to indicate that a significant, separately identifiable E/M service was performed by the same physician on the same day as a procedure or other service.

  6. Under OPPS, which type of service is assigned to 'APC status indicator V'?

    Answer: Clinic or emergency department visit - paid under the visit APC

    Status indicator V denotes clinic and emergency department visit codes (CPT E/M codes for hospital outpatient) that are paid under visit APCs under OPPS.