American Health Information Management Association (AHIMA) Certification Practice Exam

What action should a coder take with remaining test codes that are not included in a panel, based on CPT guidelines?

1. Report the remaining tests using individual test codes, according to CPT.

2. Do not report the remaining individual test codes.

3. Report only those test codes that are part of a panel.

4. Do not report a test code more than once regardless of repetition.

The correct answer is: Report the remaining tests using individual test codes, according to CPT.

A coder should report the remaining test codes using individual test codes, according to CPT guidelines. When tests are organized into panels, it is common that some specific tests might not be included in the panel. If these tests are ordered and performed, it is essential to report them separately to ensure accurate billing and maintain compliance with coding standards. CPT guidelines support reporting individual codes for tests that are not bundled together in a panel. This not only provides a complete picture of the services rendered but also helps in proper reimbursement for those services. Failing to report these individual codes could lead to underbilling and loss of revenue, as it would not reflect the full scope of work that was performed. In contrast, the other options do not align with CPT guidelines, which encourage transparency and accuracy in reporting all performed tests. The choice to not report remaining individual test codes disregards the guidance that allows for detailed representation of a patient's care and appropriately reflects the physician’s intent.