Wiki Need help on STATUS INDICATORS, Please.

codiologist

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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.
 
I'm studying for the COC as well. I'm not sure what they mean by what status indicator to use for a code. Under OPPS a status indicator is assigned to each code by Medicare I believe

I would assume based on this being a surgical procedure the SI for that code under APC would be T - Significant procedure subject to multiple procedure discounting
 
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Hi, Thanks for your reply. I assumed it was either status indicator S or T, so I googled it for the answer. But looking it up on the internet will not help me in the actual exam, since that isn't allowed. This has been the 2nd question in the practice exams about asking what status indicators I would choose for a specific cpt...

Thanks again for any help.
 
When Inwas working in outpatient facility, the procedures in the range 10000-69999 were all status S.. Everything else was a T with a few exceptions for some of the radiology like CT and MRI and a few interventional radiology. There was a Medicare release at that time that stated this and it made it so much easier.
 
If i could only use findacode on the exam. I looked it up afterwards and its a T. I just assumed since it would be reduced under MPFS that the same reduction would apply to the facility. I thought maybe S were add-on codes but those are N as they roll up into the APC of the primary procedure. So back to the drawing board for me due to that finding.

I'd probably suggest the first thing you do is find a blank page in CPT book and write in all the status indicators and their meaning. That's a good way to disregard the most obviously incorrect ones in case you need to guess on the exam. I think i am going to look for a list of the CPT codes and their status indicators and see if I can find patterns.
 
Status Indicators, along with Payment Indicators are located in your HCPCS book.

I wish I went front to back. I just skimmed through all the Pub 100 references (good stuff in there) only to realize SI's are at the beginning of my book. I guess that saves me from writing them down. Now if the test really asks you to guess what the status indicator is on a specific CPT code, I'm in some trouble.
 
I knew the status indicators were in the hcpc book and yes the indicator for 25600 is T, multiple proc disc applies. But I just hope this questions isn't on the exam, as there isn't an option to look up the OCE.

Thanks to all who replied, I'll keep investigating and coming back to check for more replies.
Have a great day Y'all.
 
I pulled an OPPS file from my APC pricing software. Under status S, Not very many Surgery codes came up. Lots of casting and strapping, Radiology, Blood products, Nuclear Medicine, Radiation Therapy, Dental, Chemo admin, Sleep studies, nerve conduction studies, Psychotherapy, Apheresis/Stem Cell and Related Services, transfusions, Audiology, Cardiac rehab etc.

Only 92 Codes in the 10000-69999 range came up as S. Most were T
I don't see how they could ask this on the test. Surgery section really is all over the place:


Count of CPT

T 2720
C 1630
J1 796
E 341
N 229
M 157
Q1 116
S 92
Q2 75
B 26
A 2
Q3 2
Q4 1
Grand Total 6187
 
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Yes I think I had it backwards. Sorry it has been a could of years. The T were surgical and the S was for the services typically not subject to discounting.
 
Update on Status Indicator cross reference w/ CPT codes on CoC exam.

FYI, Incase anyone else wants to know, I just found out that the COC exam might ask specific questions re: what status indicators go with certain cpt or hcpc codes. The proctor of the test should supply us with the CMS addendum B 1589-FC which we can find the info in the material supplied to us.

Thanks everyone...
 
I hope that's true. I did buy the COC practice tests and All 3 had at least one question about what status indicator goes with code XXXXX
 
Where do you find the CMS global period status indicators and in which code book?

Having trouble figuring this one out. The question I have is, What is the CMS global period status indicator for endoscopies?
Just need to know where to start to find an indicator so I can learn where to look.
Thanks!
 
Where do you find the CMS global period status indicators and in which code book?

Having trouble figuring this one out. The question I have is, What is the CMS global period status indicator for endoscopies?
Just need to know where to start to find an indicator so I can learn where to look.
Thanks!
Hey Manda! Did you ever get an answer on this? I got stuck on this as well & can’t find where to locate them at.
 
Do you know where to find this in the CPT book? Im stuck. Please help.
Status indicators are published by payers, not by CPT. Some versions of the code books will include the indicators as a reference, but not all. If you're looking for the Medicare payment status indicators, I'd recommend getting them from the CMS Medicare website. There are different sets of status indicators depending on the type of provider you are billing for (hospital, ASC, physician), but the current versions of all of them are available there.
 
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(y)
 
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