CMRT CMRT Coding & Classification Systems 2 — Questions and Answers
Question 1: What is the purpose of HCPCS Level II codes?
- Code supplies, equipment, and non-physician services not covered by CPT (Correct answer)
- Replace ICD-10-PCS for outpatient procedures
- Code dental procedures
- Classify drugs by therapeutic category
Correct answer: Code supplies, equipment, and non-physician services not covered by CPT
HCPCS Level II codes are alpha-numeric codes used to bill for supplies, durable medical equipment, ambulance services, and certain drugs not covered by CPT.
Question 2: In outpatient coding, what is the 'first-listed diagnosis' equivalent to in the inpatient setting?
- Principal diagnosis (Correct answer)
- Primary chronic condition
- Chief complaint
- Admitting diagnosis
Correct answer: Principal diagnosis
The first-listed diagnosis in outpatient coding is the condition established after study as the reason for the visit, analogous to the inpatient principal diagnosis.
Question 3: Which coding concept describes assigning additional codes to fully describe a condition that requires more than one code?
- Multiple coding / Code also / Use additional code (Correct answer)
- Etiology/manifestation convention
- Excludes 1 note
- Default code assignment
Correct answer: Multiple coding / Code also / Use additional code
Multiple coding directives like 'use additional code' instruct coders to assign secondary codes to capture the full clinical picture of a condition.
Question 4: What does the ICD-10-CM Excludes1 note mean for a coder?
- The excluded condition cannot be coded together with the code it appears under (Correct answer)
- The excluded condition is included in the code
- The excluded condition should be coded as an additional code
- The note is informational only and has no coding impact
Correct answer: The excluded condition cannot be coded together with the code it appears under
Excludes1 means the two conditions cannot occur together; if both are present, query the physician because one may be incorrectly documented.
Question 5: Which coding system is used specifically for dental procedures in the US?
- CDT (Code on Dental Procedures and Nomenclature) (Correct answer)
- CPT Category III
- HCPCS Level I
- ICD-10-PCS
Correct answer: CDT (Code on Dental Procedures and Nomenclature)
CDT codes, maintained by the American Dental Association, are used to report dental procedures for insurance billing.
Question 6: What is the purpose of the CC/MCC subclassification in the MS-DRG system?
- Adjust payment to reflect increased resource use due to complications or comorbidities (Correct answer)
- Identify the admitting diagnosis
- Group cases by age and sex
- Classify hospital-acquired conditions
Correct answer: Adjust payment to reflect increased resource use due to complications or comorbidities
CC (Complication or Comorbidity) and MCC (Major Complication or Comorbidity) designations increase MS-DRG weight and reimbursement when present as secondary diagnoses.
CMRT CMRT Coding & Classification Systems 2
What is the purpose of HCPCS Level II codes?