PREFACE |
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1 | (20) |
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1 | (1) |
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2 | (2) |
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KEY POINTS REGARDING CPT & HCPCS |
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3 | (1) |
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PREPARING FOR CPT & HCPCS CODING |
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4 | (7) |
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4 | (1) |
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REVIEW PROCEDURE STATEMENTS AND CODES |
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5 | (1) |
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6 | (1) |
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7 | (1) |
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8 | (3) |
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11 | (6) |
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FORMAT AND CONVENTIONS OF CPT |
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12 | (1) |
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12 | (1) |
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13 | (1) |
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13 | (1) |
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13 | (2) |
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15 | (2) |
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17 | (3) |
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FORMAT AND CONVENTIONS OF HCPCS |
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17 | (1) |
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18 | (1) |
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18 | (1) |
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18 | (1) |
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MEDICAL AND SURGICAL SUPPLIES |
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19 | (1) |
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19 | (1) |
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19 | (1) |
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EXERCISE 1: CODING BASICS |
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20 | (1) |
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21 | (34) |
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21 | (1) |
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SPECIAL MEDICARE CONSIDERATIONS |
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22 | (1) |
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22 | (1) |
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UNLISTED PROCEDURES OR SERVICES |
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23 | (1) |
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CPT CHANGES, ADDITIONS AND DELETIONS |
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23 | (2) |
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HCPCS CHANGES, ADDITIONS AND DELETIONS |
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25 | (1) |
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25 | (1) |
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NEW PATIENT VERSUS ESTABLISHED PATIENT |
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26 | (1) |
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NEW PATIENT OR INITIAL VISIT |
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26 | (1) |
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ESTABLISHED PATIENT/FOLLOW-UP VISITS |
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26 | (1) |
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PLACE (LOCATION) OF SERVICE |
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26 | (1) |
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27 | (2) |
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28 | (1) |
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EXERCISE 2: CODING & BILLING ISSUES, PART 1 |
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29 | (1) |
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30 | (1) |
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SEPARATE OR MULTIPLE PROCEDURES |
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30 | (1) |
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MULTIPLE SURGICAL PROCEDURES |
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30 | (1) |
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30 | (1) |
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31 | (1) |
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CONFIRMATORY CONSULTATIONS |
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31 | (1) |
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31 | (1) |
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SUPPLIES AND MATERIALS SUPPLIED BY PHYSICIAN |
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31 | (2) |
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33 | (2) |
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34 | (1) |
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DUE TO LACK OF DOCUMENTATION |
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34 | (1) |
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PURCHASED DIAGNOSTIC SERVICES |
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35 | (1) |
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36 | (7) |
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43 | (10) |
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43 | (8) |
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HCPCS AMBULANCE SERVICE MODIFIERS |
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51 | (1) |
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52 | (1) |
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EXERCISE 3: CODING & BILLING ISSUES, PART 2 |
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53 | (2) |
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EVALUATION & MANAGEMENT SERVICES |
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55 | (92) |
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GUIDELINES/CLASSIFICATION OF EVALUATION AND MANAGEMENT SERVICES |
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55 | (1) |
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56 | (1) |
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MATERIALS SUPPLIED BY PHYSICIAN |
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56 | (1) |
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DEFINITIONS OF COMMONLY USED TERMS |
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57 | (4) |
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NEW AND ESTABLISHED PATIENTS |
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57 | (1) |
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57 | (1) |
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57 | (1) |
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58 | (1) |
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58 | (1) |
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HISTORY OF PRESENT ILLNESS |
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59 | (1) |
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59 | (1) |
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59 | (1) |
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SYSTEM REVIEW (REVIEW OF SYSTEMS) |
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60 | (1) |
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LEVELS OF EVALUATION AND MANAGEMENT SERVICES |
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61 | (1) |
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61 | (4) |
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61 | (1) |
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62 | (2) |
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64 | (1) |
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65 | (2) |
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65 | (1) |
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NATURE OF THE PRESENTING PROBLEM |
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65 | (2) |
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67 | (2) |
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68 | (1) |
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68 | (1) |
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DIAGNOSTIC TESTING OR STUDIES |
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69 | (1) |
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69 | (1) |
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69 | (1) |
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69 | (1) |
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70 | (1) |
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CHOOSING EVALUATION AND MANAGEMENT CODES |
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70 | (3) |
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73 | (1) |
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WHAT IS DOCUMENTATION AND WHY IS IT IMPORTANT? |
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74 | (1) |
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WHAT DO PAYERS WANT AND WHY? |
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74 | (1) |
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GENERAL PRINCIPLES OF MEDICAL RECORD DOCUMENTATION |
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75 | (1) |
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DOCUMENTATION OF E/M SERVICES |
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76 | (1) |
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77 | (2) |
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79 | (1) |
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HISTORY OF PRESENT ILLNESS |
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79 | (1) |
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80 | (1) |
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PAST. FAMILY AND/OR SOCIAL HISTORY |
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81 | (1) |
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DOCUMENTATION OF EXAMINATION |
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82 | (4) |
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GENERAL MULTI-SYSTEM EXAMINATIONS |
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84 | (1) |
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SINGLE ORGAN SYSTEM EXAMINATIONS |
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85 | (1) |
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GENERAL MULTI-SYSTEM EXAMINATIONS |
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86 | (5) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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90 | (1) |
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CARDIOVASCULAR EXAMINATION |
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91 | (3) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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93 | (1) |
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EAR. NOSE AND THROAT EXAMINATION |
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94 | (4) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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97 | (1) |
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98 | (3) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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100 | (1) |
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GENITOURINARY EXAMINATION |
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101 | (4) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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103 | (2) |
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HEMATOLOGIC/LYMPHATIC/IMMUNOLOGIC EXAMINATION |
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105 | (3) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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107 | (1) |
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MUSCULOSKELETAL EXAMINATION |
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108 | (3) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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110 | (1) |
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111 | (3) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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113 | (1) |
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114 | (3) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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116 | (1) |
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117 | (3) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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119 | (1) |
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120 | (3) |
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CONTENT AND DOCUMENTATION REQUIREMENTS |
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122 | (1) |
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DOCUMENTATION OF THE COMPLEXITY OF MEDICAL DECISION MAKING |
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123 | (5) |
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NUMBER OF DIAGNOSIS OR MANAGEMENT OPTIONS |
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123 | (1) |
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AMOUNT AND/OR COMPLEXITY OF DATA TO BE REVIEWED |
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124 | (1) |
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RISK OF SIGNIFICANT COMPLICATIONS. MORBIDITY AND/OR MORTALITY |
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125 | (2) |
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127 | (1) |
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DOCUMENTATION OF AN ENCOUNTER DOMINATED BY COUNSELING OR COORDINATION OF CARE |
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128 | (1) |
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OFFICE AND OTHER OUTPATIENT SERVICES |
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129 | (1) |
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CLINICAL EXAMPLES FOR OFFICE EVALUATION AND MANAGEMENT SERVICES |
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129 | (4) |
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HOSPITAL OBSERVATION SERVICES |
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133 | (1) |
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HOSPITAL INPATIENT SERVICES |
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134 | (1) |
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135 | (1) |
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136 | (1) |
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137 | (1) |
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138 | (1) |
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NURSING FACILITY SERVICES |
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139 | (1) |
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DOMICILIARY, REST HOME OR CUSTODIAL SERVICES |
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140 | (1) |
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140 | (1) |
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140 | (1) |
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141 | (1) |
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CARE PLAN OVERSIGHT SERVICES |
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141 | (1) |
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PREVENTIVE MEDICINE SERVICES |
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142 | (1) |
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142 | (1) |
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SPECIAL SERVICES AND REPORTS |
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143 | (1) |
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143 | (1) |
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SERVICES RENDERED AFTER REGULAR HOURS |
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143 | (1) |
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SERVICES RENDERED AT SPECIAL LOCATION |
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143 | (1) |
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OFFICE EMERGENCY SERVICES |
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143 | (1) |
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EXERCISE 4: EVALUATION & MANAGEMENT SERVICES |
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144 | (3) |
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147 | (6) |
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147 | (1) |
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148 | (1) |
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149 | (1) |
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149 | (1) |
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MATERIALS SUPPLIED BY PHYSICIAN |
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149 | (1) |
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SEPARATE OR MULTIPLE PROCEDURES |
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149 | (1) |
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149 | (1) |
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149 | (1) |
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PHYSICAL STATUS MODIFIERS |
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150 | (1) |
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150 | (1) |
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QUALIFYING CIRCUMSTANCES ANESTHESIA |
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151 | (2) |
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153 | (22) |
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153 | (1) |
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153 | (1) |
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LISTED SURGICAL PROCEDURES |
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153 | (1) |
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153 | (1) |
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FOR DIAGNOSTIC PROCEDURES |
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153 | (1) |
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FOR THERAPEUTIC PROCEDURES |
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153 | (1) |
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MATERIALS SUPPLIED BY PHYSICIAN |
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154 | (1) |
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MULTIPLE SURGICAL PROCEDURES |
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154 | (1) |
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154 | (1) |
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BILLING FULL VERSUS REDUCED FEES |
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155 | (1) |
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155 | (1) |
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156 | (1) |
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UNLISTED SERVICE OR PROCEDURE |
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156 | (1) |
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157 | (1) |
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157 | (2) |
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159 | (2) |
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161 | (1) |
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161 | (1) |
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161 | (1) |
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161 | (1) |
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161 | (1) |
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STEPS FOR CODING WOUND REPAIRS |
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161 | (1) |
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162 | (1) |
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163 | (1) |
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163 | (1) |
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RECONSTRUCTION OF ORAL AND FACIAL DEFORMITIES |
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164 | (1) |
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164 | (1) |
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164 | (1) |
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164 | (1) |
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165 | (1) |
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VASCULAR INJECTION PROCEDURES |
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165 | (1) |
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HEMIC AND LYMPHATIC SYSTEMS |
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166 | (1) |
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MEDIASTINUM AND DIAPHRAGM |
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166 | (1) |
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166 | (1) |
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166 | (1) |
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166 | (1) |
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CYSTOSCOPY, URETHROSCOPY AND CYSTOURETHROSCOPY |
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167 | (1) |
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167 | (1) |
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168 | (1) |
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MATERNITY CARE AND DELIVERY |
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168 | (2) |
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168 | (1) |
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169 | (1) |
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169 | (1) |
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COMPLICATIONS OF PREGNANCY |
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169 | (1) |
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PARTIAL MATERNITY SERVICES |
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169 | (1) |
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170 | (1) |
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170 | (1) |
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SURGERY OF THE SKULL BASE |
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170 | (1) |
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170 | (1) |
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171 | (1) |
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EXERCISE 5: ANESTHESIA AND SURGERY |
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172 | (3) |
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175 | (6) |
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175 | (1) |
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175 | (1) |
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SEPARATE OR MULTIPLE PROCEDURES |
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175 | (1) |
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175 | (1) |
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176 | (1) |
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SUPERVISION AND INTERPRETATION ONLY |
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176 | (1) |
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176 | (1) |
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BILATERAL PROCEDURE CODES |
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177 | (1) |
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SPECIAL MEDICARE CONSIDERATIONS |
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177 | (1) |
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177 | (1) |
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178 | (1) |
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CONSULTATION OR CLINICAL MANAGEMENT |
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178 | (1) |
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CLINICAL TREATMENT PLANNING |
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179 | (1) |
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CLINICAL TREATMENT MANAGEMENT |
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179 | (1) |
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179 | (2) |
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HCPCS RADIOLOGY EQUIPMENT TRANSPORTATION CODES |
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180 | (1) |
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181 | (4) |
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181 | (1) |
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SERVICES IN PATHOLOGY AND LABORATORY |
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181 | (1) |
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181 | (1) |
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182 | (1) |
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182 | (1) |
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183 | (1) |
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183 | (1) |
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EXERCISE 6: RADIOLOGY AND LABORATORY |
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184 | (1) |
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185 | (24) |
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185 | (1) |
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185 | (1) |
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185 | (1) |
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185 | (1) |
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186 | (1) |
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UNLISTED SERVICE OR PROCEDURE |
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187 | (1) |
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187 | (1) |
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188 | (1) |
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MATERIALS SUPPLIED BY PHYSICIAN |
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188 | (1) |
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188 | (1) |
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THERAPEUTIC OR DIAGNOSTIC INFUSIONS |
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189 | (1) |
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THERAPEUTIC OR DIAGNOSTIC INJECTIONS |
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189 | (1) |
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DRUGS ADMINISTERED OTHER THAN ORAL METHOD |
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190 | (1) |
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190 | (1) |
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PSYCHIATRIC CONSULTATIONS |
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191 | (1) |
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191 | (1) |
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192 | (1) |
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192 | (4) |
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INTERMEDIATE OPHTHALMOLOGICAL SERVICES |
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192 | (1) |
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COMPREHENSIVE OPHTHALMOLOGICAL SERVICES |
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193 | (1) |
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SPECIAL OPHTHALMOLOGICAL SERVICES |
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194 | (1) |
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DETERMINATION OF THE REFRACTIVE STATE |
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194 | (1) |
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195 | (1) |
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195 | (1) |
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HCPCS CODES FOR VISION SERVICES |
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196 | (1) |
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OTORHINOLARYNGOLOGIC SERVICES |
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196 | (1) |
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AUDIOLOGIC FUNCTION TESTS WITH MEDICAL DIAGNOSTIC EVALUATION |
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196 | (1) |
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HCPCS CODES FOR HEARING SERVICES |
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197 | (1) |
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197 | (1) |
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SPECIAL MEDICARE CONSIDERATIONS |
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197 | (1) |
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NON-INVASIVE VASCULAR STUDIES |
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197 | (1) |
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SPECIAL MEDICARE CONSIDERATIONS |
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198 | (1) |
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198 | (1) |
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SPECIAL MEDICARE CONSIDERATIONS |
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198 | (1) |
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198 | (1) |
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OTHER ALLERGY MEDICAL SERVICES |
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199 | (1) |
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199 | (1) |
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NEUROLOGY AND NEUROMUSCULAR PROCEDURES |
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199 | (1) |
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SPECIAL MEDICARE CONSIDERATIONS |
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199 | (1) |
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CHEMOTHERAPY ADMINISTRATION |
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200 | (1) |
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201 | (1) |
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PHYSICAL MEDICINE AND REHABILITATION |
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201 | (1) |
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SPECIAL PHYSICAL MEDICINE CODING ISSUES |
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201 | (1) |
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201 | (1) |
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202 | (1) |
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DOCUMENTATION OF TREATMENT PHASE |
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202 | (1) |
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203 | (1) |
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SPECIAL SERVICES AND REPORTS |
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203 | (3) |
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204 | (1) |
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SERVICES RENDERED AFTER REGULAR OFFICE HOURS |
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204 | (1) |
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SERVICES RENDERED AT SPECIAL LOCATION |
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205 | (1) |
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OFFICE EMERGENCY SERVICES |
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205 | (1) |
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205 | (1) |
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206 | (1) |
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206 | (1) |
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MISCELLANEOUS/EXPERIMENTAL |
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206 | (1) |
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206 | (1) |
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207 | (1) |
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207 | (1) |
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EXERCISE 7: MEDICINE SERVICES |
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208 | (1) |
APPENDIX A: ANSWERS TO CODING EXERCISES |
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209 | (8) |
INDEX |
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217 | |