Exam 38176000 Med Billing & Coding

Aortic valve stenosis , Coronary circulation , Cardiac catheterization

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Ashley Kailian
1800 N.Hills Rd Apt 406
York, Pa, 17406
Student Number: 21648849

Examination: 38176000

1.List the three goals of Physician Payment Reform.
1. Decrease Medicare expenditures, Re-Distribute physicians payments more equitibly, Ensure quality health care at a reasonable rate.

2. Mr. Jones is admitted to the hospital by the orthopedic surgeon for severe hip pain. The ortho surgeon provides an
initial hospital visit during which it’s determined that Mr. Jones has a fractured hip that will require surgical intervention. Mr. Jones is taken later that day to the OR, where the
doctor performs the surgical procedure to repair Mr. Jones’ hip. Which modifier would you use for the hospital visit?
2. Modifier-57

3. List and define the three components of the relative value unit.
3.Physician work, Practice expense, and Malpractice.

4.List the three types of persons eligible for Medicare.
4 Elderly, Disabled by Social Security Administration and Renal Failure patients (ESRD).

5. Name the six basic location methods to locate main terms in the index of CPT
5. procedure/service
anatomic site
condition of disease

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6. An initial inpatient consultation with a detailed history, detailed exam, and MDM of low complexity would be coded to what E/M code?
6. 99253 is the E/M code of the initial impatient consultation.

7. What are the four elements of history?
7. Problem focused, Expanded problem focused ,Detailed & Comprehensive

8. The complexity of medical decision making is based on what three elements? 8. Number of diagnoses, Risk of morbidity(complication or death., Amount of data (complexity)

9. 9. Provide the CPT code(s) for the following scenario.
A 7-year-old female established patient presents to the pediatrician complaining of ear pain for the last three days. A detailed history is then taken. She had associated fever of 101° F yesterday....
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