General Practical Application Tips

This is a list of common mistakes we find students make in the Practical Application assignments.

The PAs are fill-in-the blank assignments that require a very specific answer in each field. Many of the errors you receive are simply based on not entering the “exact match” criteria set up for the PA answer. Follow these instructions for all chapter PAs and you will see lower error rates.

Remember, the PAs are meant to be a learning tool. Don’t be too critical of the score – DO YOUR BEST and learn from them!

Most important is to review the PA Tips and Hints before you enter your code(s). These are great tools to help guide you in the right direction. We recommend to work the questions out in the workbook first, and then open the online assignment. You may find this helpful as some of the questions will take a good deal of time and you only have one (1) attempt at each Chapter PA assignment.

1. Always place a dash (-) between a CPT® and a modifier and between multiple modifiers.
   Example: 30115-50, 01400-QK-QS-P3, 71100-26-LT
   • No Spaces
   
   
2. Use modifiers on CPT® (procedure) codes not on ICD-10-CM (diagnosis) codes.
   Example: S42.293B-RT would be inappropriate, but 24515-RT is appropriate.
   • Never put a modifier on an ICD-10-CM level I and II (diagnosis) code.
   
   
3. Report modifiers that affect payment first.
   Example: 26, 78, 22, 50, and 51
   
   
4. Report informational modifiers such as right and left last.
   Example: 71100-26-LT
   • Review Chapter 6 in the text book when assigning modifiers to help you determine modifier order.
   
   
5. Check your answers before you SUBMIT the assignment.
   Example: O9A.22 not 09A.22, I67.43 not 167.43 or L03.2 not I03.2 or 103.2
   • Make sure you place the CPT® and ICD-10 code in the correct field.
   • Check for data entry errors such as transposed numbers and letters for numbers.
   • Make sure to always use capital letters in your ICD-10 diagnosis code
   
   
6. Code the procedure with the highest complexity first unless otherwise specified in the guidelines.
   Example: Repairs are more complex than excision of lesions — 12032, 11406-51.
   • Check the chapter PA Tips for instructions on the order.
   
   
7. List the ICD-10-CM codes in order based on the ICD-10-CM Official Guidelines.
   • If no guideline exists, use the order as they appear in the Assessment/Impression.
   
   
8. When coding CPT® and ICD-10-CM codes, the first diagnosis must give medical necessity to the procedure code.
   Example: 33512, I25.10, 110, E11.9
   
   
9. External Cause codes are never coded in the first position
   Example: S09.8XXA, Y36.450A
   
   
10. For bilateral procedures use modifier 50.
    Example: 30115-50
    
    
11. Modifier 51 is appended to additional procedures performed during the same session.
    • This is never used on the first CPT® code