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Terms in this set (28)
Name 2 common documentation errors that could cause a denial in payment:
Red Flag words: words that do not reflect progress; words that do not reflect potential for gains
The largest payer of health care services in the United States is
Which is the largest payer of health care in the United States?
The ICD-10-CM codes are
What three components of health care reform are said to be in an interdependent "iron triangle"?
Cost, access, and quality
What does the acronym SNF stand for?
Skilled Nursing Facility
If a client is seen for 20 minutes of PNF which CPT code should be billed?
Under the ACA, the OTA has the potential to:
See an increased client base
The following statement does not accurately describe occupational therapy documentation:
It requires a physician's signature
T/F: Reimbursement is controlled by corporate and regulatory factors.
What does the acronym IDEA stand for?
Individuals with Disabilities Education Act
Which act currently provides funds to support access of students with disabilities to education that is equal to that of their peers?
Explain the difference between habilitation and rehabilitation services.
Habilitation services: Health care services that help a person keep, learn, or improve skills and functioning for daily living.
Rehabilitation services: Health care services that help a person keep, regain, or improve skills and functioning for daily living that have been lost or impaired because a person was sick, hurt, or disabled.
What is a modifier 59 used for?
To indicate that a procedure or service was distinct or independent from other services performed on the same day.
T/F: The rules and regulations for reimbursement are always subject to change.
What does the acronym CMS stand for?
Center for Medicare and Medicaid Services
Which program provides financial support to states to provide health insurance to individuals who qualify based on their income?
If it takes a client 24 minutes to complete lower body dressing, you would charge [x] CPT code and [y] units?
What does the acronym ICD stand for?
International Classification of Diseases
What does the acronym HCPCS stand for?
Healthcare Common Procedure Coding System
In what year was Medicare passed?
Which statement best describes private health insurance?
It can be provided through an employer
What does the acronym ACA stand for?
Affordable Care Act
What does the acronym CPT stand for?
Current Procedural Terminology
What does the acronym IEP stand for?
Individualized Education Program
Documentation should include all of the following EXCEPT
Always demonstrate therapeutic intervention
Demonstrate need for skilled services
X Must always be on a federally mandated form
Demonstrate medical and functional progress
Which program provides health insurance to individuals over the age of 65, individuals with disabilities, individuals with ALS, and individuals in need of dialysis or kidney transplant?
Identify the primary practice setting where most OTAs work
Skilled nursing facilities
THIS SET IS OFTEN IN FOLDERS WITH...
Standards of Practice
Code of Ethics
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