Final Review

Created by normaibarra2 

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24 terms · Step by Step & Health Insurance Today

The removal of a lesion by transverse incision that did not require sutured closure is reported by using codes from which subsection?

SHAVING OF EPIDERMAL OR DERMAL LESIONS

What is intermediate?

Layered closure of one or more of deeper layers of subcutaneous tissue and superficial fascia with skin closure

What is a specialist?

A physician whose practice is limited to a particular branch of medicine or surgery, especially one who is certified by a board of physicians:

What is a staff model?

A Health Maintenance Organization ( HMO) that delivers health care through a physician group owned and controlled by the HMO unit.

What is the NCQA?

A private, non-profit organization, that accredits health care plans based on careful evaluation of the quality of care members receive as well as member satisfaction rates

What is Arthrocentesis?

Joint aspiration, a procedure whereby a sterile needle and syringe are used to drain fluid from a joint

What is the full thickness of the skin?

Dermis

What is the term used when a Physician sends his/her patient to be evaluated by another physician?

Referral

What subcategories are incision and drainage codes divided?

11300-11313 Integumentary System - Skin, subcutaneous and Accessory Structures

What is intermediate?

Layered closure of one or more of deeper layers of subcutaneous tissue and superficial fascia with skin closure

List the fracture type?

Open, closed, or percutaneous

What is segmental instrumentation?

The attachment of a fixative device at each end of the area being repaired and at least one other attachment in the spinal area being repaired.

What is modifier -79 for?

Unrelated procedure or service by the same physician during the postoperative period

What is external fixation?

The application of a device that holds a bone in place

What does open mean?

Surgically opened to view or remotely opened to place nail across fracture

What two items are needed to correctly code a local treatment of burns?

Percent and depth

What is a PPO?

A group of hospitals and Physicians that agree to render particular services to a group of people, generally under contract with a private insurance.

What is another name for a bunionectomy?

Hallux Valgus

What is a lifetime insurance cap?

An insurance cap limits the amount of money the policyholder has to pay out of pocket for any one incident or in any one year.

When a business entity pays for insurance it is known as what?

Commercial Health Insurance

What is a Fiscal Intermediary?

Part A Contractor Medicare A private company that has a contract with Medicare to pay part A and some part B bills.

Reduction is also known as?

Manipulation

What are margins when excisions are being performed?

Narrow Margins

What two items are needed to correctly code a local treatment of burns?

Percent and depth

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