Read this information from a Medicare carrier and answer the questions that follow.
E&M services rendered in a private residence are correctly billed with CPT codes 99341–99345 (new patients) and CPT codes 99347–99350 (established patients), home services. These CPT codes are payable only in home settings, that is, place of service 12.
National Government Services has seen many instances of providers billing outpatient/office codes in home set¬tings. Home visits should not be reported with E&M codes 99201–99215, which represent office and outpatient services.
A. LO 13.3 Based on Table 13.2, what claim adjustment reason code will result if this code is billed 99201, POS 12?
B. LO 13.3 Which Remark Code would appear, N210 or N211?
Home visit CPT codes should be reported from 99341-99350. E/M service in a private residence can not be used if the patient resides in a shared living facility. The home visit includes average time for coordinating care that is face to face visit patient and provider spend the times. It includes patients residing in their own residence and qualifies for medical necessity to meet the ongoing need for health issues. That can be a new patient or establishes a patient.
Case 13.3 Using Insurance Terms Read this information from a Medicare carrier and answer the questions that follow. E&M services rendered in a private residence are correctly billed with CPT codes 99341–99345 (new patients) and CPT codes 99347–99350 (established patients), home services. These CPT codes are payable only in home settings, that is, place of service 12. National Government Services has seen many instances of providers billing outpatient/office codes in home set¬tings. Home visits should not be reported with E&M codes 99201–99215, which...
Case 13.3 Using Insurance Terms Read this information from a Medicare carrier and answer the questions that follow. E&M services rendered in a private residence are correctly billed with CPT codes 99341–99345 (new patients) and CPT codes 99347–99350 (established patients), home services. These CPT codes are payable only in home settings, that is, place of service 12. National Government Services has seen many instances of providers billing outpatient/office codes in home set¬tings. Home visits should not be reported with E&M...
QUESTION 1 Which modifier would a radiologist append to the CPT code to reflect that charges were only for "interpretation and report?" A. 53 B. TC C. 22 D. 76 E. 26 F. 25 10 points QUESTION 2 Any CPT code designated as a "separate procedure" is only coded and billed when? A. When bills are not submitted to Medicare B. When it is not considered a component of another procedure C. When the physician demands separate payment for...
QUESTION 1 Physicians and mid-level practitioners (NPs and PAs) use which coding system to capture their professional fees? A. DSM-5 B. CPT/HCPCS C. ICD-10-PCS D. ICD-10-CM 10 points QUESTION 2 Choose the best answer. Because each CPT/HCPCS code has its own separate fee, are coders allowed to code all services separately? A. Yes. In order to properly capture all charges, every CPT and HCPCS code should be coded separately to optimize reimbursement. B. No. A coder can only choose...
QUESTION 4 On the day of Max's discharge from the hospital, the attending physician asked him questions and provided information such as Max's final diagnosis, prognosis, the results of various diagnostic tests, and necessary follow-up in the outpatient setting. The provider created two medical records for this same date of service. A progress note for the day of discharge records the physicians review of diagnostic tests, assessment of the patient's condition, and decision to discharge home. The discharge summary provides...
1. Which of the following is PROBABLY a case of medical malpractice? I. A doctor neither monitors nor diagnoses cerebral bleeding in a patient with a head injury, resulting in the patient's death. II. A doctor does not examine a person with an eye injury, resulting in vision loss. II. An incorrect diagnosis of cancer on a biopsy (pathology) inspection, leading to unnecessary surgery. A. III only B. I only C. II only D. I, II, III 2. Margaret was...
QUESTION 21 Using the table below, select which code(s) should be reported for a Medicare patient receiving follow-up mammogram imagery on the right breast, following abnormal screening mammogram the prior week. This service is provided in a physician-owned freestanding imaging center. HCPCS Code Descriptor G0202 Screening mammography, digital images, bilateral, all views G0204 Diagnostic mammography, digital images, bilateral, all views G0206 Diagnostic mammography, digital images, unilateral, all views R0070 Transportation of portable x-ray equipment and personnel to home or nursing...