Chapter 5&6 Insurance HB Chaper 6 Medical Terminology

45 terms by ellemireles 

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true

proper coding can mean financial success or failure of a medical practice

true

although diagnostic coding is important in medical insurance billing, payment is never based on it

true

coding from an out-of-date ICD-9-CM code book can delay payment, result in denied claims, or cause costly mistakes that can lead to financial disaster

false

V codes should always be listed in the second position

false

fractures are coded as open if there is no indication of whether the fracture is open or closed

excluded

diagnoses that relate to a patient's previous medical problem that have no bearing on the patient's present condition should be ____when coding

at the beginning of the chapter, at the beginning of a section, and at the beginning of a three-digit category.

five digit codes can appear when?

locate the main term in the alphabetic index, verify the code in the tabular list, read any instructions in the tabular list, check for exclusion notes, and assign the code

which of the following is the correct order of steps to take in ICD-9-CM coding?

"suspected" ACL tear, "likely" ACL tear, "rule out" ACL tear

a patient is being evaluated in the office for an anterior cruciate ligament (ACL) tear. Which term should not be used to code the diagnosis

cancer that is confined to the site of origin

carcinoma in situ is used to describe...

three to five

diagnostic codes have how many digits?

true

the use of five digits is not optional

presenting symptoms

when the patient's medical record states a "versus" diagnosis such as "tendinitis versus synovitis" code the...?

the acute is first

how should an insurance billing specialist list the diagnostic codes on an insurance form when a specific condition is stated as both acute and chronic?

tracking diseases, medical research, evaluate hospital services, classifications of causes of mortality

for what four reasons was diagnostic coding developed?

false

UCR (usual, customary, reasonable) is used mostly in reference to managed care services

true

private health insurance plans using the UCR system may pay a physician's full charge if it does not exceed UCR charges

true

when a new CPT code is used, it may take long as 6 months before an insurance company has a mandatory value assignment

true

in coding a surgical procedure, postoperative care and follow-up visits may not be coded separately if they fall within the global period for the procedure

true

the medical global surgery policy for major operations is similar to the surgical package concept.

false

the CPT code book includes a description of the number of follow-up days that are allowed after surgery at no additional charge

annually

the CPT publication is updated and revised when?

the physician

the key components that determine an evaluation and management code are documented by who?

operation,local infiltration, digital block or topical anesthesia, and normal uncomplicated postoperative care.

the surgical package includes...

decision for surgery

the two digit modifier-57 means...

surgery section

the largest section in the CPT book is...

5;2

CPT uses a basic__-digit system for coding services rendered by physicians, plus__-digit ass-on modifiers

three

the E/M code 99203 is considered a level__code

done/performed

insurance companies go by the rule: "if it is not documented, then it was not___"

dislocation

displacement of a bone from a joint is called

closed reduction

pulling the broken ends of a bone into alignment by manipulation without surgery is called

extension

the movement that brings the leg into a straight position is

arthroscopy

visualization of the interior of a joint is called

orthopedist

the name for a physician who specializes in disorders of the skeletal and muscular systems is..

shoulder blade

the scapula is..

compound fracture

the term for a broken bone that is visible through an opening in the skin

spondylitis

inflammation of the vertebrae

coccyx

the tail bone is called the...

herniated disk

rupture of an intervertebral disk is also called

metatarsals

bones that are located between the toes and the bones of the ankle are...

osteochondritis

inflammation of the bone and cartilage

cerebrospinal

pertaining to the brain and spine

pertaining to the lower back

lumbar

cervical

pertaining to the neck

myleosuppression

suppression of the bone marrow

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