CRCR - Certified Revenue Cycle Representative Program Charge Capture and Coding Flashcards
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Read the first 7 CRCR - Certified Revenue Cycle Representative Program Charge Capture and Coding flashcards as text
What does the 'global surgical package' concept mean in CPT coding?
Answer: Preoperative, intraoperative, and standard postoperative care included in one surgical code
The global surgical package includes pre-op evaluation, the surgery itself, and routine post-op care within a defined period (0, 10, or 90 days).
Which ICD-10-CM coding guideline applies when a patient is admitted for chemotherapy and also has the malignancy being treated?
Answer: Code the chemotherapy encounter (Z51.11) as the principal diagnosis
When the purpose of admission is chemotherapy, the encounter for antineoplastic chemotherapy (Z51.11) is sequenced as the principal diagnosis, with the malignancy coded additionally.
A hospital bills a service using revenue code 0360 (operating room). Which type of charge does this represent?
Answer: Facility/technical component charge
Revenue code 0360 represents operating room facility charges, which are the technical/facility component billed by the hospital on a UB-04.
When a physician performs two separate, distinct procedures during the same operative session, modifier -51 is appended to:
Answer: The secondary (additional) procedure(s)
Modifier -51 (Multiple Procedures) is appended to the secondary and subsequent procedures, not the primary procedure, to indicate multiple procedures were performed.
What is the correct action when a charge capture team identifies a service that was performed but never entered into the billing system?
Answer: Conduct a late charge entry within the facility's defined timely filing window
A missed charge should be submitted via a late charge process as long as it falls within the payer's timely filing deadline to ensure appropriate reimbursement.
In ICD-10-CM, what does a 7th character 'A' indicate when used with a fracture code?
Answer: The encounter is for active treatment of the fracture
A 7th character 'A' designates the initial encounter, meaning the patient is receiving active treatment for the fracture.
Which type of HCPCS Level II code is primarily used to report durable medical equipment (DME)?
Answer: E codes
HCPCS Level II 'E' codes are specifically designated for durable medical equipment, orthotics, and prosthetics.