Medical Coding Systems Flashcards
7 cards from real CPC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medical Coding Systems flashcards as text
When coding fractures in ICD-10-CM, which 7th character extension indicates the initial encounter for a closed fracture?
Answer: A
The 7th character 'A' designates the initial encounter for active treatment of a fracture, regardless of whether it is the patient's first visit.
The National Correct Coding Initiative (NCCI) edits are used to:
Answer: Prevent improper payment of procedures that should not be billed together
NCCI edits are CMS-developed policies that bundle certain procedure code pairs to prevent incorrect unbundling and overpayment.
In CPT, which modifier is used when a procedure or service is reduced or eliminated at the physician's discretion?
Answer: -52
Modifier -52 indicates that a service was reduced or partially eliminated and is appended to the procedure code to reflect the lesser service.
Which ICD-10-CM code is used when a patient is seen specifically for a screening examination with no signs or symptoms?
Answer: A Z code (Z00-Z99)
Z codes capture encounters for reasons other than illness or injury, including routine screenings, preventive care, and health supervision visits.
The coordination of CPT code assignment for outpatient hospital facility claims is governed by:
Answer: APC payment methodology and OPPS
Hospital outpatient services are reimbursed under the Outpatient Prospective Payment System (OPPS) using Ambulatory Payment Classifications (APCs).
Which ICD-10-CM convention is used to identify manifestation codes that must always be sequenced after the etiology code?
Answer: Italicized type and brackets
In ICD-10-CM, manifestation codes appear in italics in the Tabular List and the etiology/manifestation pair is shown in brackets in the Index.
When a patient undergoes a procedure and an adverse effect occurs due to a correctly administered drug, the coder should:
Answer: Sequence the nature of the adverse effect first, then add a code for the drug
For adverse effects of correctly administered drugs, ICD-10-CM guidelines require sequencing the nature of the adverse effect (the condition) first, followed by the T-code identifying the drug.