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When was the Health Information and Accountability Act (HIPAA) created?

1996

What are Medical Ethics?

Standards of conduct based on moral principals.

What are the two provisions of HIPPA?

1. Insurance Reform
2. Administrative Simplification

What is the False Claims Act (FCA)

A Federal law that prohibits submitting a false claim or making a false statement or representation in connection with a claim.

What is the National Correct Coding Initiative (NCCI)?

Initiative developed by CMS to promote national correct coding methods and control improper coding that leads to wrong payments of Part B health claims.

What are the two types of edits that the NCCI implements?

1. Column 1/ Column 2; identified unbundled codes.
2. Mutually Exclusive Edits: Codes that are unlikely to be performed on the same patient in the same day.

Who investigates and prosecutes Health Care fraud?

Office of Inspector General (OIG)

When can a provider share PHI without specific permission from the patient?

1. For treatment (discussing the case with another professional)
2.Payment (When providers submit claims on the patient's behalf).
3. Operations: Staff training and Quality Improvement.

What is Employer Liability?

Physicians are legally responsible for their actions and their employee's actions. a.k.a Respondant Superior. (Let the master answer.)

What is Employee Liability Insurance?

Protection against loss of money caused by failure through error or unintentional omission of the individual or service submitting the claim.

What is in a Medical Record?

-Social and Medical History
-Family History
-Physical Exam Findings
-Progress Notes
-Lab/Rad Results
-Consultation Reports
-Correspondence to the patient

When billing an insurance company, what information must be included?

-Date of Service (DOS)
-Place of Service (POS)
-Type of Service (TOS)
-Diagnosis
-Procedure(s)

How long should Medical Records be retained?

Governed by State and Local laws; should be retained indefinitely. For deceased patients, they should be kept at least 5 years.

-algia

Pain

-emia

Blood Condition

-itis

Inflammation

-megaly

-Enlargement

-meter

Measure

-osis

Abnormal condition

-pathy

Disease Condition

-rrhagia

Bursting forth blood

-rrhea

Discharge, Flow

-sclerosis

Hardening

-scopy

To view

-centisis

Surgical Puncture

-ectomy

Removal, Excision, Resection

-gram

Record

-lysis

Separation, Breakdown

-pexy

Surgical Fixation

-plasty

Surgical Repair

-rrhaphy

Suture

-scopy

Visual Examination

-stomy

Opening

-therapy

Treatment

-tomy

To cut into

a, an

Without

ante-

before

anti-

Against

brady-

Slow

dys-

Painful, difficult

endo-

Within

epi-

Above

ex-

out, out of

hemi-

Half

Hypo-

Below, deficient

Infra-

Below

inter-

Between

oglio-

Little, scanty

para-

Beside

per-

Through

poly-

Many

pre-

Before, in front of

pseudo-

False

sub-

Under

supra-

Above

tetra-

Four

arth/

cartilage

cephal/

head

cardi/

heart

cholecyst/

gall bladder

chondro/

cartilage

colp/

vagina

derm/

skin

enter/

intestine

episi/

vulva

gastro/

stomach

gloss/

tongue

hepato/

liver

hyster/

uteris

lapar/

abdomen

lact/

milk

lith/

stone

mast/

breast

myo/

muscle

nat/

birth

oophor

ovary

oste/

bone

pneum/

lung

rhin/

nose

salping/

fallopian tubes

stomat/

mouth

Anterior/Ventral

Front part of the body.

Posterior/Dorsal

Back part of the body.

Proximal

Near the point of attachment to the trunk.

Distal

Far from the point of attachment of the trunk.

Medial

Middle of the body.

Lateral

Side

Frontal, Coronal

Vertical plane dividing the body into Anterior and Posterior sections.

Sagittal

Vertical plane dividing the body to the left and the right sides.

Transverse/Cross Sectional

Horizontal plane dividing the upper and lower parts of the body.

What are the 2 types of glands on the skin?

1. Sebaceous (oil) glands
2. Suddiferous (sweat) glands

What are the 3 layers of skin?

1. Epidermis (Top layer)
2. Dermis (Middle layer)
3. Subcutaneous Layer

What is hair made of?

Karatin

What is the moon like white area at the base of the nail called?

Lunula

What are the 2 types of sweat glands?

1. Eccrine (secrete odor)
2. Apocrine (odorless sweat)

What hormones do the adrenal glands secrete?

Epinephrine and Steriods

Collagen

Structural protein found in skin and connective tissue.

Melanin

major skin pigment

Lipocyte

Fat cell

Macule

discolored, flat lesion

Vesicle

small collection of clear fluid; blister

Wheal

smooth, slightly elevated swollen area that is redder or paler than the surrounding skin

Alopecia

Absence of hair

Gangrene

Death of tissue due to loss of blood supply

Impetigo

Bacterial inflammatory skin disease with lesions, pustules and vesicles

Multigravida

A pregnant woman who has had at least one pregnancy.

What are bones connected together with?

fibrous bands of ligaments

What are bones made of?

Osseous

What are the insides of bones comprised of?

hematopoietic tissue

How are bones categorized?

The Axial Skeleton and the Appendicular Skeleton

What is the Axial Skeleton comprised of?

Skull, Ribcage and Spine.

What is the Appendicular Skeleton comprised of?

Shoulder, collar, pelvic, arms and legs.

Long Bones

Strong, broad and have large surfaces for muscles to attach to.

Short Bones

Small with irregular shapes (ie wrist and ankle)

Flat Bones

Bones covering body parts (ie shoulder blades, ribs, pelvic bones)

Sesamoid Bones

Small, rounded bones that resemble sesame seeds that are found near joints. (ie knee cap)

Frontal Bone

Forms the front part of the skull and the forehead.

Parietal Bones

Forms the sides of the cranium

Occipital Bone

Forms the back of the skull

Temporal Bones

Forms the two lower sides of the cranium

Ethmoid Bone

Forms the roof of the nasal cavity

Sphenoid Bones

In front of the temporal bones

Zygoma

Cheek Bone

Lacrimal Bones

Bones at the corner of each eye that cradle the tearducts

Maxilla

Upper Jawbone

Mandible

Lower Jawbone

Vomer

Bone that forms the wall between the nostrils

Palatine Bones

Upper roof of the mouth

Inferior nasal conchae

Interior of the nose

How many regions is the spinal/vertebral column divided into?

5

How many bones are in the spine?

26

What are the 5 regions of the spine?

1. Cervical
2. Thoracic
3.Lumbar
4. Sacral
5. Coccygeal

Cervical

Neck Bones

Thoracic

Upper Back

Lumbar

Lower Back

Sacral

Sacrum

Coccygeal

Coccyx (Tailbone)

Humerus

Upper Arm bone

Ulna

Lower medial arm bone

Radius

Lower arm bone in line with the thumb

Carpals

Wrist bones

Metacarpals

Bones the palm of the hand

Phalanges

Finger Bones

Tibia

Shin

Fibula

Smaller, lateral leg bone

Malleolus

Ankle

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