COBGC Reimbursement and Billing 3

Question 1

Which modifier indicates that a significant, separately identifiable E/M service was provided on the same day as a minor procedure by the same physician?

Accepted Answer

-25

Answer

Modifier -25 is appended to the E/M code to show it was a significant, separately identifiable service from the procedure performed on the same day.

Question 2

For a pregnant patient covered by both her own employer plan and her spouse's plan, which plan is primary for her maternity services?

Accepted Answer

The patient's own insurance plan

Answer

Under coordination of benefits (COB) rules, a patient's own insurance is always primary for services she personally receives.

Question 3

A patient at 34 weeks gestation is hospitalized for management of severe preeclampsia. How are these inpatient services billed?

Accepted Answer

Separately from the global OB package as a complication

Answer

Complications of pregnancy requiring inpatient hospital care are billed separately from the global OB package using appropriate hospital visit codes.

Question 4

Which HCPCS Level II code category is used to report injectable drugs administered in the OB/GYN office, such as Rho(D) immune globulin?

Accepted Answer

J codes (drugs administered other than oral method)

Answer

HCPCS Level II J codes represent drugs administered other than by the oral method, including injections given in a physician's office.

Question 5

Which of the following services is typically BUNDLED within the global obstetric delivery package and cannot be billed separately?

Accepted Answer

Routine episiotomy performed during vaginal delivery

Answer

Routine episiotomy repair is considered an integral part of vaginal delivery and is included in the global obstetric delivery package.

(COBGC) Certified Obstetrics Gynecology Coder Practice Test

(COBGC) Certified Obstetrics Gynecology Coder Practice Test

COBGC Reimbursement and Billing 3