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CHAPTER 4 CPMA QUESTIONS WITH CORRECT ANSWERS
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CHAPTER 4 CPMA QUESTIONS WITH CORRECT ANSWERS
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CHAPTER 4 CPMA QUESTIONS WITHCORRECT ANSWERS
Calculation sanesthesia sunits sfor sMedicare. s- sans--Base sunit svalue s+ stime sunits s= sTotal
sunits s
Does snote sgive sadditional sunits sfor smodifying sfactors.
Calculation sof sanesthesia sunits sfor scommercial spayers s(depending son scontract) s- sans--
Base sunit svalue s+ stime sunits s+ smodifying sfactor sunits s= sTotal sunits.
A spatient sreceives sgeneral sanesthesia sfor sa stotal sknee sreplacement. sthe sanesthesia
sprovider sstarts sanesthesia sat s8 sAM. sthe ssurgery sbegins sat s8:15 sAM sand sends sat s9:45
sAM. sThe sanesthesia sprovider stakes sthe spatient sto srecovery sand sturns scare sover sto
sthe srecovery sroom snurse sat s9:55 sam. sWhat sis sthe stotal sanesthesia stome? s- sans--115
sminutes. sAnesthesia stime sstarts sduring sthe sprep stime snot sthe ssurgical stime.
what scode scan s62326 sbe sreported swith san san samentias scode? s- sans--Continuous
sepidural scatheter splace sfor spost sop spain smanagement sthat sis snot sused sas sthe smode
sof sanesthesia.
Surgical ssteps sfor sauditing. s- sans--1- sDetermine sthe sscope sof sthe saudit
2-Varify sthe sdocumentation sis scomplete s
3- sreview sthe soperative snote sin sits sentirely s
4-varify sthe sprocedure shave snot sbeen sunbundled swhen smore sthan sone sprocedure
scode sis sreported
5-review sMUEs sfor sthe scodes sto sprevent sreporting sexcessive sunits. s
6-when ssequencing smultiple scodes, smake ssure sit sis sdone sin sRVU sorder. s
7. sVerify smedical snecessity
8- swhen scoding sfor san sassistant ssurgery smake ssur sethe sassistant ssturgeon sis
sapproved sfor ssurgery. s
9- sVerify sproper smodifier suse. s
10-Make ssure sall scharges sare scaptured.
MUE smedical sunlikely sedits. s- sans--is sthe smaximum samount sof sunits sthat sshould sbe
sreported sfor sHCPSC/CPT scodes.
Bullet sSymbol s- sans--A sbullet ssymbol slocated sto sthe sleft sof sa scode sindicates snew
sprocedures sand sservices sadded sto sthe sCPT® scode sbook. sIt sis simportant sto sreview sall
sthe snew scodes seach syear. sWhen sauditing, suse sthe scorrect scodes sfor sthe sdate sof
sservice saudited. sFor sexample, san saudit sis sperformed sin sMarch s2022 sfor sdates sof
sservice sfrom sOctober s2021. sIn sthis scase, suse sthe scodes sfrom s2021 sthat swere svalid
swhen sthe sprocedure swas sperformed.
,A striangle ssymbol s- sans--A striangle ssymbol slocated sto sthe sleft sof sa scode sindicates sthat
sthe sdescription sof sthe scode shas sbeen srevised. sDetails sof sthe srevision sare sfound sin
sAppendix sB sof sthe sCPT® scode sbook. sReview sthe scode srevisions seach syear. sAs swith
sthe snew scodes, smake ssure sto suse sthe scodes sand sdescriptions sthat swere svalid sfor sthe
sdates sof sservice sincluded sin sthe saudit.
Opposing shorizontal striangles s- sans--Opposing shorizontal striangles sindicate snew sand
srevised stext, sother sthan sin sprocedure sdescriptors. sThese ssymbols sindicate sCPT®
sEditorial sPanel sactions. sInformation sis sadded sor srevised sto sclarify scode suse sto sprevent
scoding serrors. sThe scodes smay snot schange, sbut sthere swas sa sneed sto sclarify scode suse
sto sprevent sunbundling sor sto salert sthe scoder sthat sadditional sservices smay salso sbe
sreported. sAn sauditor smust sstay sup sto sdate son schanges sto scoding sguidelines sand
sparenthetical snotes.
EXAMPLE
The sforbidden ssymbol s- sans--The sforbidden ssymbol sidentifies scodes sthat sare sexempt
sfrom sthe suse sof smodifier s51 s(See sCPT® sAppendix sE). sThese scodes sare salso sexempt
sfrom sthe smultiple sprocedure spayment sreduction. sMonitor sfor sproper sreimbursement.
The sstar s- sans--The sstar sidentifies sCPT® scodes swhich scan sbe sreported swhen susing
ssynchronous stelemedicine susing sboth saudio sand svideo stelecommunications. sWhen
sperformed sby ssynchronous stelemedicine, smodifier s95 sis sappended sto sthe sCPT® scode.
sThese scodes sare salso slisted sin sAppendix sP.
The saudio sicon s- sans--The saudio sicon sidentifies sCPT® scodes swhich scan sbe sreported
swhen stelemedicine sservices sare sfurnished susing saudio-only scommunications. sWhen
sperformed sby ssynchronous stelemedicine, smodifier s93 sis sappended sto sthe sCPT® scode.
sThese scodes sare slisted sin sAppendix sT.
EXAMPLE
Which sprocedure sis sexempt sfrom sModifier s51?
A.93612
B.92228
C.90673
D.90666 s- sans--Answer: sA. s93612
Rationale: sTo squickly sdetermine sif sa sprocedure sis smodifier s51 sexempt srefer sto
sAppendix sE sin sthe sCPT® scode sbook, swhich sincludes sa slist sof sall sprocedures sthat sare
sexempt sfrom sModifier s51.
Which sof sthe sfollowing scode scombinations sare sNOT ssubject sto sa smultiple sprocedure
spayment sreduction?
A.21433, s21401
B.31255, s31287
C.32666, s32674
D.48150, s49440 s- sans--Answer: sC. s32666, s32674
, Rationale: sAdd-on scodes sare snot ssubject sto sthe smultiple sfee sreduction. sYou scan salso
sdetermine sthe scorrect sanswer sby saccessing sthe s2014 sNational sPhysician sFee
sSchedule sRelative sValue sFile sfound sat shttp://www.cms.gov/Medicare/Medicare-Fee-
for-Service-Payment/PhysicianFeeSched/PFS-Relative-Value-Files.html. sCodes snot
ssubject sto sthe smultiple sfee sschedule sreduction shave sa s0 sin sthe smultiple sprocedure
scolumn.
In sFebruary s2023, san sauditor sis sasked sto sreview s10 srecords sfor sdate sof sservice
s12/1/2022 sto smake ssure sthe sclaims swere spaid scorrectly. sThe sclaims sincluded scode
s99224, swhich swas sdenied son sall sthe sclaims. sThe sdenial swas sfor san sinvalid scode.
sWhat sshould sthe sauditor sadvise sthe sprovider?
A.Code s99224 swas sdeleted seffective s1/1/2023. sDetermine sthe scorrect snew scode sand
shave sstaff sresubmit sclaims.
B.If sdocumentation ssupports sthe sservice, shave sthe sstaff scontact sthe scarrier sto
sreprocess sthe sclaims. sCode s99224 swas svalid sfor sthe sdate sof sservice sbilled.
C.Code s99224 swas sdeleted seffective s1/1/2023. sThis sis sa svalid sdenial. sAdvise sthe sstaff
sto swrite soff sthe sbalance.
D.Code s99224 swas seffective sfor sthe sdate sof sservice. sAdvise sthe sstaff sto sadd smodifier
s59 sand sresubmit sthe sclaim. s- sans--Answer: sB. sIf sdocumentation ssupports sthe sservice,
shave sthe sstaff scontact sthe scarrier sto sreprocess sthe sclaims. sCode s99224 swas svalid sfor
sthe sdate sof sservice sbilled.
Rationale: sThe seffective sdates sof scodes sare sdate sof sservice sdriven. sNew sCPT® scodes
sbecome seffective sJanuary s1st sof severy syear. sWhen sauditing, sverify scodes sbased son
sthe scodes sthat swere svalid sduring sthe sdate sof sservice.
Which scode scombination sis sappropriate sto sreport?
A.16020, s16036
B.17312, s17313
C.19083, s76942
D.10160, s76942 s- sans--Answer: sD. s10160, s76942
Rationale: sReview sparenthetical snotes sto sdetermine sthe sappropriate sadd-on scode swith
sthe sprimary scode. sCoding sguidelines sand sparenthetical snotes sprovide sinstruction sfor
swhen sradiological sguidance scan sbe sreported sseparately.
How sare srevisions sto scoding sguidelines sidentified sin sthe sCPT® scode sbook?
A.A sbullet sicon
B.A spound s(#) sicon
C.Green sfont swith sunderlined stext
D.Green stext swith sopposing sarrows s- sans--Answer: sD. sGreen stext swith sopposing
sarrows
Rationale: sThe srevisions sto sthe scoding sguidelines sfrom sone syear sto sthe snext sare
sidentified sby sgreen stext sand sopposing sarrows senclosing sthe srevised stext.
Provider sModifiers s- sans--AA—Anesthesia sservices spersonally sperformed sby san
sanesthesiologist
AD—A sphysician swho sis smedically ssupervising smore sthan sfour sconcurrent sprocedures
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