Ophthalmic Coding Specialist Study Questions

Category - Opthalmological Coding Certification Practice Test

Which of the following steps is NOT needed before an unlisted services procedure code can be included on a claim?
  1. Review the CPT manual to make sure a more appropriate code does not exist
  2. Review Category II codes to make sure an appropriate code does not exist
  3. Review Category III codes to make sure an appropriate code does not exist
  4. Check to see if a modifier is appropriate to include with your code
Explanation
Answer: B - Before you include an unlisted services procedure code on a claim, you do NOT have to review Category II codes to make sure an appropriate code does not exist. In order to assign an unlisted procedures code, you first must review all of the CPT codes in that section to make sure a more appropriate code does not exist. You must also check to see a modifier is available to include on the claim. Lastly, before assigning an unlisted procedure code, you must check if a Category III code is more appropriate.
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