Question

ked Ie bsite include E/M codes by specialty, Iab procedue, /M c lbwest allowed charge and allowed services. The types of data by specialty, lab procedures, level Il codes, level 1 codes, and type of t, ranked He data are presented in table es, level 1 codes INSTRUCTIONS Refer to the Top 10 the following questions. TR1 Current Procedural Terminology (CPT) Codes (Table 9-1). Analyze the data table, and answer Table 9-1 Top 10 Current Procedural Terminology (CPT Codes Current Medicare Part B Top 10 Current Procedural Terminology (CPT) Codes National Data CPT Code 99214 99213 99232 99223 66984 99233 99285 88305 99204 99215 Allowed Chaages $ 8,174,871,557 $ 6,789,770,914 $3,572,583,474 $ 2,309,147,150 $ 2,254,500,991 Rank by Charges Number of Services 81,303,417 100,262,062 50,943,179 11,770,703 $ 2,253,815,789 22,283,347 9,879,083 $1,674,265887 $ 1,377,477,046 $1,339,445,0048,569,205 $ 1,316,510,822 19,853,914 9,691,728 317,660,010 10 TOTALS$31,062,388,634 634/ 1. What CPT level I code is ranked first according to number of services? 42582 What was the total allewed-charges for CPT code 99285 3. What is the percentage of non E/M codes in the top 10 ranking? 4. In his annual meeting, a CFO at a local hospital stated that CMS paid $2.2 million for service in the emergency department under CPT code 99285. Is this correct? 5. List the highest ranking CPT surgical code and allowed charges. What was the average per- service charge? Current Procedural Terminology published by the American Medical Association 20

Answer 1

Solution :

1. According to the number of services, CPT level I code that ranked first is code 99214. The number of services provided is 81, 303,407.

2. By looking at the above table, The total allowed charges for the code 99285 is $1,674,265,887.

3. The non E/M codes are code 5 and 8. Code 66984 is surgical code and the code 88305 is laboratory and pathology code. The percentage of nonE/M codes are 2/10 X100 = 20%.

4.No, it is not correct. Based on the above table, the CMS paid for the emergency department services is approximately 1.6 million.

5. Highest ranking CPT surgical code is 66984. It allowed charges was $2,254,500,991. The average per service charge is

2,254,500,991 / 3,103,372 = $726.46