Hello
I am taking the practice exams for my COC and I don't seem to understand how I would be able to tell which status indicator goes with a particular cpt/hcpc II code.
For example one of the questions say" Which status indicator would I use for a closed treatment of a distal radial fracture (25600). Keep in mind I will only have access to my books and not the computer while taking the exam, so where could I cross reference cpt/hcpcs in my code books? Any help is appreciated.
Codiologist,
Ok let me try to break it down
status indicators for you. The basic status indicators or
SI is a payment indicator to identify how each CPT and HCPS code is paid and linked to differ dx codes. When the setting is ambulatory and outpatient this applies. This is usually built into your coding grouper program of the encoder software. However as coder you will see audit message flags to you if you code it .Let us say 2 xray same day on same claim...it will reduce one xray by 50%. Or if a patient gets multiple surgeries on same day the reduction will apply when automatically when coded then billed.
Status T modifier will show multiple procedure reduced.
Also
global days surgery guidelines can have indicators too. It is applied per clinical surgery pt receiving. Global surgery indicators are 000, 010, 090, XXX MMM YYY.
000 is endoscopies or minor procedures 010 minor procedures with10 day check up period, 090 major surgery with 90 days check /follow up on care but not charge pt again UNLESS ne new problem or complications develops. Look at CPT 99024 used for these global scenarios. MMM maternity codes not apply XXX concept not apply to certain Eval & Mgt, lab anesthesia or xrays , YYY unlisted codes and subject to pricing ZZZ represent add on codes & included in global services.
Oh yes
modifier indicators(0,1, 9) are used with the NCCI guide by CMS to tell you how many modifiers to use or not use with certain CPT procedure codes to pass the edit. 0 not allowed modifiers 1=one modifier can be used to pass the edit 9= use of modifier not specific . This NCCI edits is to ensure correct coding &linked in most coding software when try transmitting the claim.
Well I hope I helped you a little bit understand these indicators (SI status, T status, modifier indicators, & global day indicators) better.
Lady T