Coding Guidelines & Conventions Flashcards
7 cards from real CMC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Coding Guidelines & Conventions flashcards as text
Which CPT modifier is used to report a service performed by two surgeons of different specialties working together?
Answer: -62
Modifier -62 is used when two surgeons of different specialties each perform distinct portions of a procedure requiring unique skills.
In ICD-10-CM, what does a code listed as the 'default code' in the Alphabetic Index represent?
Answer: The most common or unspecified condition when no further detail is provided
The default code is the most frequently associated code for a condition when the record lacks sufficient detail to assign a more specific code.
When a patient has both a related complication and the underlying condition, how should they generally be coded?
Answer: Code both, with sequencing based on reason for the encounter
Both the complication and the underlying condition should be reported, sequencing the one chiefly responsible for the encounter as the principal diagnosis.
What is the correct approach when a CPT code description includes the phrase 'each additional' (add-on code)?
Answer: Report it only with its designated primary procedure code
Add-on codes are always reported with their primary procedure code and are exempt from the multiple procedure modifier -51.
In outpatient coding, what term describes the primary condition after study that is chiefly responsible for the visit?
Answer: First-listed diagnosis
In outpatient settings, the term 'first-listed diagnosis' is used instead of 'principal diagnosis,' which is an inpatient term.
Which ICD-10-CM table is used when coding adverse effects and poisonings?
Answer: Table of Drugs and Chemicals
The Table of Drugs and Chemicals provides codes for poisoning, adverse effects, and underdosing of medications and chemical substances.
When coding a neoplasm, what information from the medical record is most critical for selecting the correct code?
Answer: Behavior (malignant, benign, uncertain, unspecified) and site
The Table of Neoplasms requires both the anatomical site and behavior classification to assign the correct code.