1.
ICD-10, CPT, E/M, DRG, RVU…What does it all mean?
2.
What are billing modifiers and why are they used? List 5 common modifiers and describe a clinical scenario for the use of each.
3.
What are the 3 different groups of evaluation and management codes? What elements are necessary for each E/M level?
4.
What is a global period? Give examples of procedures with 0, 10 and 90 day global periods.
5.
What are upcoding and unbundling?
6.
If you list three CPT codes which one goes first? Why?
7.
What are facility charges? Which patients are billed for facility charges?
8.
How does documentation of complications and co-morbidities during a hospitalization affect billing for the physician and for the hospital?
9.
A 60-year old smoker presents for evaluation of hoarseness. You perform a level 3 office visit. On PE, you are not able to visualize the larynx and proceed with an FFOL. How would you bill this visit
10.
Your tonsillectomy patient bleeds on post-operative day #10 and requires an OR visit for control of hemorrhage. How would you code this procedure (include ICD-9 and CPT codes)?
11.
You are called to the ER for evaluation of an epistaxis. You perform a detailed H&P. After determining the source is from the anterior septum, you cauterize the lesion and d/c the patient. An hour later, the ER calls to say the patient has re-bled. Upon return to the ER, you place an anterior pack. Four hours later, the patient has recurrent bleeding. Now you are fed up and take him to the OR for nasal endoscopy and definitive cautery. How would code these events?
12.
A laryngectomy patient presents for evaluation of otorrhea during the global period. What modifier would you attach to the E/M visit? Can you bill for any procedures performed during this visit?
13.
You excise a 1 cm basal cell cancer from the forehead and close the defect in layers. List the appropriate ICD-9 and CPT codes. What if you can’t close this primarily and perform a rhomboid flap instead?
14.
How would you bill for a septoplasty, SMR of inferior turbinates, endoscopic bilateral maxillary antrostomies, total ethmoidectomies, and frontal sinus exploration? List the procedures in the proper order and don’t forget your modifiers!
15.
The above patient needs a sinus debridement in the office, one week after surgery. How would you bill for this visit?