CDIP CPT and HCPCS Code Assignment

Question 1

What does CPT stand for in the context of medical procedure coding?

Accepted Answer

Current Procedural Terminology

Answer

Clinical Protocol Terminology

Answer

Certified Physician Taxonomy

Answer

Comprehensive Procedural Terminology

Question 2

HCPCS Level II codes are alphanumeric codes maintained by CMS primarily used to report which of the following?

Accepted Answer

Durable medical equipment, prosthetics, orthotics, supplies, and services not found in CPT

Answer

Inpatient diagnoses and hospital complications

Answer

MS-DRG weights and reimbursement categories

Answer

Surgical procedures performed in the operating room

Question 3

In the outpatient hospital facility setting, CPT codes drive reimbursement under which Medicare payment system?

Accepted Answer

Ambulatory Payment Classifications (APCs)

Answer

Inpatient Prospective Payment System (IPPS)

Answer

All Patient Refined DRGs (APR-DRGs)

Answer

Resource-Based Relative Value Scale (RBRVS)

Question 4

An operative report documents 'excision of a 2.3 cm benign lesion of the back,' but the coder assigned a CPT code for destruction of the lesion. What is the most appropriate action for the CDI specialist?

Accepted Answer

Communicate with the coding/HIM staff to review the documentation and resolve the discrepancy

Answer

Correct the code directly in the EHR coding module

Answer

Contact the surgeon to amend the operative report language to match the code

Answer

Submit the claim as coded since excision and destruction are clinically equivalent

Question 5

A physician documents 'intravenous infusion of therapeutic drug' without specifying the drug name or infusion duration. Why does this documentation gap matter for CPT coding?

Accepted Answer

CPT infusion codes require the drug identity and total infusion time to select the correct code, making a query to the physician appropriate

Answer

CPT infusion codes do not require drug specificity — the route of administration is sufficient

Answer

Infusion documentation is exclusively the nurse's responsibility and cannot be queried

Answer

Drug specificity only matters for ICD-10-CM adverse effect coding, not CPT

Question 6

Which of the following statements correctly distinguishes CPT Category I codes from Category III codes?

Accepted Answer

Category III codes are temporary, five-digit T-codes for new and emerging technologies and services that may lack sufficient data for permanent Category I status

Answer

Category I codes are for emerging technologies only; Category III codes are for established high-volume procedures

Answer

Category III codes are maintained by CMS, while Category I codes are maintained by the AMA

Answer

Category I and Category III codes are interchangeable for outpatient facility billing