CEHRS Medical Coding in EHR 3

Question 1

Which modifier is appended to a CPT code to indicate that a procedure was performed bilaterally?

Accepted Answer

-50

Answer

Modifier -50 indicates that the same procedure was performed on both sides of the body during the same operative session.

Question 2

What is the primary function of the National Correct Coding Initiative (NCCI) edits?

Accepted Answer

To prevent improper payment of procedures that should not be billed together

Answer

NCCI edits are CMS-developed guidelines that identify pairs of codes that cannot be billed together because one is considered bundled into the other.

Question 3

A patient is admitted for pneumonia and also has COPD. Which condition is the principal diagnosis?

Accepted Answer

Pneumonia, because it is the reason for admission after study

Answer

The principal diagnosis is defined as the condition established after study to be chiefly responsible for causing the admission.

Question 4

Which CPT code range covers Evaluation and Management (E/M) services for office or outpatient visits?

Accepted Answer

99201–99215

Answer

CPT codes 99202–99215 (new and established patients) represent E/M services provided in office or outpatient settings.

Question 5

What does 'medical necessity' mean in the context of insurance reimbursement?

Accepted Answer

Services that are appropriate, reasonable, and necessary for the diagnosis or treatment of an illness or injury

Answer

Medical necessity requires that the service is appropriate for the patient's condition and consistent with accepted standards of medical practice for coverage and reimbursement.

(CEHRS) Certified Electronic Health Records Specialist Practice Test

(CEHRS) Certified Electronic Health Records Specialist Practice Test

CEHRS Medical Coding in EHR 3