FREE COBGC Coding Guidelines and Conventions Questions and Answers

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What does the “*” symbol in ICD-10-CM indicate?

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In ICD-10-CM, the “*” symbol is used as a placeholder in some codes to indicate the need for additional characters or to provide further specificity. This is different from codes requiring specific modifiers or additional detail about the condition or service.

In CPT coding, what is the purpose of using a “modifier”?

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Modifiers are used in CPT coding to provide additional information about the service performed, such as indicating special circumstances or variations in how the service was provided. They do not change the base code completely, delete codes, or create new codes.

Which coding guideline helps determine whether a procedure should be bundled or separately coded?

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The National Correct Coding Initiative (NCCI) guidelines are used to determine whether a procedure should be bundled with another service or coded separately. These guidelines help prevent inappropriate coding and ensure that the services are billed correctly. CPT, ICD, and HCPCS are coding systems rather than guidelines for bundling.

How are “excludes1” and “excludes2” notes used in ICD-10-CM coding?

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In ICD-10-CM, “excludes1” notes indicate that the code cannot be used with another specified code because the two codes are mutually exclusive. “Excludes2” notes indicate that a code is not included in the category but that another code may be used if it is present in addition to the primary code.

What is the main purpose of using the “add-on” codes in CPT coding?

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“Add-on” codes in CPT are used to report services that are performed in conjunction with a primary procedure. They are meant to be used in addition to the primary code and cannot be reported alone. They do not replace primary codes, modify codes, or indicate bundled sets of services.

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