ER Facility coding Interview Questions

1.      Which Procedures are bundled in Critical Care?

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2.    What are the Procedures separately billed from Critical Care?

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3.      CPT code for 75 minutes Critical Care?

Ans:  99291, 99292

4.      For 2^nd Degree burn MD applied Silvadene Cream, Give correct CPT code?

Ans: 16020

5.      Definitive Fracture Care guidelines?

Ans: To report Definitive fracture care we need X-ray with non displaced Fracture Confirmation, any Immobilization (ex: splint,sling, etc.), Pain management and Follow up more than 3days.

6.      Injections & Infusions Hierarchy?

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7.      Code correct CPT codes for below Scenario:

Zofran IVP given at 10:00

Morphine IVP given at 10:00

Vancomycin IVPB given from 10:00 to 12:31

Hydration given from 10:00 to 14:30

Ans: 96365, 96366*2, 96375*2, 96361*2

8.      CPT code for Hydration given from 13:00 to 14:31 and Zofran IM at 14:00?

Ans: 96360, 96361, 96372-59

9.      ET Tube insertion CPT Code? (OR) Intubation Performed in ER Report correct CPT code?

Ans: 31500

10.  30 years patient came to ER and Received 30 minutes Conscious sedation from ER MD and admitted in OR for Surgery, Report Correct CPT code for sedation?

Ans: 99149

11.  Patient came to ER with Cardiac Arrest, MD performed CPR and 45 minutes Critical care Documented. Report Correct CPT & ICD 10 CM codes?

Ans: 99291-25, 92950 & I46.9

12.  As per 2017 ICD 10 Guidelines code below Scenario:

Patient diagnosed with CHF, Hypertension and ESRD.

Ans: I13.2, I50.9, N18.6

13.  What is Modifier and give some Examples?

Ans: A modifier is a two character code that provides the means by which the reporting physician can indicate that a service or procedure that has been performed has been altered by some specific circumstance but has not changed in its definition or code.

Modifier 25: Significant, Separately Identifiable E/M Service by Same Physician on Same Day of Procedure or Other Service.

Modifier 50: Bilateral Procedure

Modifier 51: Multiple Procedures

Modifier 52: Reduced Services

Modifier 59: Distinct Procedural Service

Modifier 76: Repeat Procedure by same Physician

Modifier 77: Repeat Procedure by another Physician

14.  What are the new Distinct Procedure modifiers?

Ans: We have four new distinct procedural service modifiers

Modifier XE: Separate Encounter, A Service That Is Distinct Because It Occurred During A Separate Encounter.

Modifier XS: Separate Structure, A Service That Is Distinct Because It Was Performed On A Separate Organ/Structure.

Modifier XP: Separate Practitioner, A Service That Is Distinct Because It Was Performed By A Different Practitioner.

Modifier XU: Unusual Non-Overlapping Service, The Use Of A Service That Is Distinct Because It Does Not Overlap Usual Components Of The Main Service.

15.  What are CCI edits?

Ans: Correct Coding Initiative (CCI) edits are pairs of Current Procedural Terminology (CPT) or Healthcare Common Procedure Coding System (HCPCS) Level II codes that are not separately payable except under certain circumstances. The edits are applied to services billed by the same provider for the same beneficiary on the same date of service.