CDEO Chapter 7 Questions With Answers Graded A+ Assured Success
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Course
CDEO
Institution
CDEO
Modifiers - provide addtional info about the service/procedure indicating service/procedure has
been altered but the definition of the code has not changed.
Global Surgery Package - The time, effort, and services required to complete a procedure are
bundled together to form a surgery package . P...
CDEO Chapter 7
Modifiers - provide addtional info about the service/procedure indicating service/procedure has
been altered but the definition of the code has not changed.
Global Surgery Package - The time, effort, and services required to complete a procedure are
bundled together to form a surgery package . Payment is made for a package of services and not each
individual service provided within the package.
Using RBRVS - CMS annually publishes Physician Fee Schedule information on its website and
posts the formula for calculating physician fee schedule amounts.
RBRVS - Resource-Based Relative Value Scale
RBRVS System - Established by Medicare to reimburse physicians based on CPT code submitted for
reimbursement
RVU - Each CPT code has an assigned relative value unit which, when multiplied by conversion
factor and a geographic region allowance , creates the reimbursement for the medical service the CPT
code represents
RVU Components - 1) Physician work- time, skill, training, and intensity of service provided
2) Practice Expense - reflects the cost of ancillary personnel, supplies, and overhead
3) Professional Liability Malpractice Insurance
Physician Fee Amounts - vary depending on facility vs non-facility
, Facility Practice RVU - expenses include services performed in emergency rooms , hospitals, SNFs,
nursing homes, ASC.
Non Facility RVUs - include services performed in non-hospital owned physician practices and
privately owned practices.
GPCI - Geographic Practice Cost Index
Geographic Prctice Cost Index - is used to realize the varying cost based on geographic location
CF - Converstion Factor
Conversion Factor - this is a fixed dollar amount used to translate the RVUs into fees
Other Health Plans - other than Medicare may choose not to use the CMS calculations to
determine provider reimbursement
CPT Surgery Package Description - * Subsequent tot he decision for surgery, E?M Services on the
date immediately prior to or on the date of the procedure including H&P
*Local Anesthesia: defined as local infiltration, metacarpal/metatarsal/digital block, or topical anesthesia
* Operation Itself
* Immediate Post-Operative Care, including dictation of operative notes, talking with family and other
physicians
* Writing Orders
* Evaluation of patient post-anesthesia recovery
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