ICD 10 Drills/Quiz Wk 1

TRUE about managed care plans? (Which of the following is )
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Terms in this set (148)
TRUE about managed care plans? (Which of the following is )
Managed care plans seek to achieve better outcomes while controlling the cost of healthcare.
What portion of health benefit plans are funded by federal and state programs?
47%
How many months is it recommended that coders receive ICD-10 training prior to ICD-10 implementation?
3-6 months
Surgical encounters that do not require an overnight inpatient stay in the hospital are known as
ambulatory surgery.
NOT true about Medicare Part B? (Which of the following is )
It covers inpatient stays at a skilled nursing facility.
When a healthcare provider is overpaid by Medicare, what should they do?
Both statements are true: Return the overpayment and Report the overpayment to Medicare.
Payers are allowed to do which of the following in order to process a claim for payment?
Request additional information to verify whether or not the service is covered.
Which of the following things should a coder do when coding an encounter?
Assign codes based on the documentation in the chart.
Workers' compensation programs are
not subject to HIPAA regulations
Which of the following type of healthcare employees might NOT use codes as part of their jobs?
HR generalists
FCA was passed during the Civil War for what reason?It was intended to combat widespread fraud when contractors sold the government faulty rifles, ammunition, rotten food, and sick horses.ICD-10-PCS stands forInternational Classification of Diseases, 10th Revision, Procedure Classification SystemUnited States has been using ICD-10-CM since January 1, 1999 tocode and classify mortality data.medical recordAll of these.How will patients be affected by the change from ICD-9-CM to ICD-10-CM PCS?Any change will most likely be negligible. The code set used for assigning codes is generally unseen by patients.mid-level job allows coders toAll of theseAdvanced level coding positions typically require a minimum of how many years of proven coding experience?5Official coding guidelines require proper sequencing of diagnosis and procedure codes. The sequencing depends onthe codes assigned and the circumstances of the encounter.What does GEMs stand for?General equivalence mappingscoding certifications is NOT offered by either AAPC or AHIMA? (Which of the following)CBCSWhich of the following is TRUE?ICD-10-CM PCS provides more detailed and higher quality data for tracking safety and quality.There is a change in the definition of acute MI from ICD-9-CM to ICD-10-CM. What is the change?In ICD-9-CM, and acute MI is defined as one occurring within the last eight weeks. In ICD-10-CM, the timeframe is within the last four weeks.Documentation of current and past medications, along with any medication allergies, is important to the patient's care. What should coders do with this information?Code the long-term use of specific medications.When a payment for service is denied by the insurance company, an accounts receivable specialistneeds to investigate the situation.When processing claims, excellent documentation in a patient's paper or electronic health record can do all of the following EXCEPTinsure the patient will not file a medical malpractice suit.lifecycle of an insurance claim beginswhen the patient contacts the physician to make an appointment.Which organization developed National Drug Codes?Department of Health and Human ServicesOnce Medicare publishes a final ruletheir stance is that providers should know about it and follow it.It is important that coders do which of the following in order to transition to ICD-10-CM PCS?All of these.Companies and organizations develop compliance programs for which of the following reasons?All of thesedistinguishes the difference in coding immunizations in ICD-9-CM and ICD-10-CM? (Which of the following)All of theseDr. Lorenzo asks his patient, Bella, questions about the pain she is currently experience in relation to the severity level, what makes it worse or better, and if she's experienced this pain before. This is an example ofperforming a medical history.Typically, which of the following is NOT a reason claims for payment may be suspended?When the claims manager has a hunch, something is inaccurateTRUE about ICD-10-CM? (Which of the following is )It replaces ICD-9-CM Volume 1 and II.chief complaint is defined asthe reason problem for which the patient sought treatment.G9784 is an example of the code format for which HIPAA-mandated code set?HCPCSNOT true in relation to the terminology differences between ICD-9-CM and ICD-10-CM PCS? (Which of the following is )Bleeding in ICD-9-CM refers only to ulcers.ICD-10-PCS contains a number of new procedural terms. What impact does this have on physicians?There will be no real impact because they are not expected to document using these terms.NOT true about using GEMs to assign codes for patient encounters? (Which of the following is )Forward mapping is taking ICD-10-CM codes and mapping them to the corresponding ICD-9-CM codesNOT true about the surgical history (Which of the following is )It is unimportant to the patient's current condition in most instances.Third-party payers are entities other than the physician or patient who pay for healthcare services. What percentage of healthcare services in the United States is paid by third-party payers?86%three major sources of private health insurance aregroup health plans, self-insured plans, individual plans.Case production standards are based on all of the following EXCEPTwhich encoder is being utilized.All modifications made by the United States when creating ICD-10-CM had toconform to WHO conventions for ICD-10ICD-10-PCS was initially published in1998How many alphanumeric characters does each ICD-10-PCS code have?7TRUE about Medicare Part D? (Which of the following is )It is also known as "prescription drug coverage."International Classification of Diseases, 10th revisionis a worldwide reporting system for classifying diseases.NOT a key rule for abstracting outpatient diagnoses? (Which of the following is )Do code conditions that are resolvedSelect the correct code for each of the diagnosesD18.02Read the following diagnosis statement and then identify which is the primary site and which is the secondary site Breast cancer with mets to colon.Breast primary, colon secondarycategory for congenital-iodine deficiency syndrome has an instructional note that statesuse additional code (F70 to F79) to identify associated mental retardation.four cooperating parties are part of the federal interdepartmental committee known as theCoordination and Maintenance Committee.Cancer cells that have metastasizedretain the characteristics of the organ in which they originated.This type of neoplasm does NOT have the ability to invade surrounding tissue isbenign neoplasm.Blank is the condition resulting from the spread of diseased cells.MetastasisCoders should NOT apply rules about coding manifestations if ICD-10-CM does NOT list instructional notes or other conventions indicating this relationship.TrueWhen looking up the Main Term sarcomatosis, what is the FIRST subterm found in the IndexMeningealSubterms in the Table of Neoplasms describe specific locations within a large anatomic site.TrueWhat range of codes is included in the chapter for Endocrine, Nutritional, and Metabolic Diseases?E00 to E89Neoplasms are classified by which of the following?All of theseVerifying a code in the Tabular List is essential for all the following reasons EXCEPTthere is no need to verify codes in the Tabular List.NOT true about ICD-10-CM conventions? (Which of the following is )They appear only in the ICD-10-CM Draft Conventions.D05.91 is an example of acode.Physicians who specialize in a particular body system may also treat patients with tumors cancers affecting that body systemTrueApproximately what percent of ICD-10-CM codes include a designation for laterality?28FIRST step in assigning ICD-10-CM diagnosis codes is to search the Tabular List by the condition.FalseICD-10-CM, Chapter 2 Neoplasms, contains codes that begin with the letter C and the letter D. Which of the following is NOT true?Codes beginning with D classify metastatic neoplasms.Leiomyosarcomas originate insmooth muscle tissueTable of Neoplasms has ________ columns for each anatomic site.sixEntries that require a seventh character extension are referred to as subcategories because it cannot be called a code until the extension is added.Falsephysician who specializes in diagnosing and treating cancer is known as a anoncologist.When the provider documents that a patient has both an acute and chronic form of the same condition, the sequencing is determined byhow the Index presents the acute and chronic conditions.Blank uses radioactive pellets with a body cavity to target a malignancy.Internal radiotherapyWhich section of the OGCR reflects any new and updated conventions?Section I. A.TRUE about benign neoplasms? (Which of the following is )They do not metastasize.NOT a key rule for abstracting inpatient diagnoses? (Which of the following is )Uncertain diagnoses should never be coded.FIRST subterm a coder encounters when looking up the Main Term "genu"? (what is the)CongenitalNOT an example of a screening exam for neoplasms? (Which of the following is )CXRSection IV of the OGCR containsAll of these.OGCR for ICD-10-CM provide specific directions for sequencing codes for which of the following?All of theseCan the two following codes be used together M42.00 and M40.04?NoRead the following diagnosis statement and then identify which is the primary site and which is the secondary site Metastatic lung cancer.Lung primary, unknown secondary siteWhat should the coder do when there are diagnoses that relate to an earlier episode but have no bearing on the current (inpatient) hospital stay?Do not code the diagnosesWithin in the ICD-10-CM chapters, a contiguous range of codes within a chapter is known as ablock or subchapterCoders must take care when assigning codes and sequencing the codes for malignant neoplasms of the liver becauseboth of these answers are correct.final step in diagnosis coding when there is more than one diagnosis? (what is the)Arrange or sequence the codes in the correct order.Codes in square brackets [ ] should always be sequenced firstFalsecombining form sarc\o meansconnective tissue.CA in situ is defined ascells that have started to change but still remain in the epithelial layerMultiple myeloma in remissionC90.01Which is TRUE about ICD-10-CM codes?The first character is always alphabetic; the second character is always numeric.Prior to assigning a default code, the coder should do which of the following?Review all subterms and locate a more specific code if available.Overlapping lesions arecontiguous sites where the tumor continues from one site to an adjacent one without interruptioncode listed next to the Main Term in the ICD-10-CM Index is referred to as adefault codeMain Term is the name of the condition or reason for the visit, usually presented as a noun in the ICD-10-CM Index to Diseases and Injuries.TrueWhen a coder encounters a "Use additional code" note, the coder should NOT assign a code from the list unless it is documented in the record.TrueBased on the instructional information found under subcategory F98.2, other feeding disorders of infancy and childhood, which of the following codes CANNOT be used with the subcategory?R63.3NOT an expected benefit from using ICD-10-CM PCS? (Which of the following is )It will help to reduce the cost of providing healthcare in the United States.Radiology case production standards can range from 100 to 200 records per hour. The reason this number is higher than those for other types of records is becausethe radiology records are far less complicated than other records.Which organization developed CPT?AMAQui Tam provision of the False Claims Actincludes financial rewards to whistleblowers that turn in violators.HCPCS stands forHealthcare Common Procedure Coding System.ICD-10-CM requires coders to determine the weeks of gestation for pregnant women. Which of the following is TRUE in regards to the impact this might have on diagnosis abstracting?Both statements are true: Coders will need to search the documentation further for the weeks of gestation and Coders will have to develop a new methodology.In 2009, CMS issued a final rule thatupdated the HIPAA transaction standards.social history is an integral part of a patient's health record and can provide information that could potentially be coded. Which of the following information should be coded?Lifestyle habitsexample of a "least restrictive setting" in regards to medical necessity criteria? (Which of the following is an)Both statements are true: Outpatient colonoscopy and Inpatient colonoscopy with a valid medical reasonGEMs can be found as public domain electronic files on theCMS websiteE16.8 is an example of the code format for which HIPAA-mandated code set?ICD-10-CMNOT a new coding concept in ICD-10-CM? (Which of the following is )There are more combination codes in ICD-10-CMICD-9-CM was developed by which organization?NCHSEven though physicians will continue to use CPT to report procedures performed in their offices, they will still be affected by ICD-10-PCS documentation requirements. Why is this?Because hospitals will be using PCS codes to report inpatient procedures these same physicians perform.When coding anemia in cancer, which of the following is NOT true?ICD-10-CM guidelines direct coders to sequence always the anemia first.What year was ICD-9-CM first implemented?1979term granular meansdetailedFor complicated problems that may take a while to diagnose, physicians may ________ to provide relief until the underlying cause is determined.treat symptomsPatient Protection and Affordable Care Act was passed in 2010. The PPACA placed a greater burden on smaller healthcare providers for which of the following reasons?Though they were previously not required to establish a voluntary compliance program, they are now required to do so if they want to continue serving Medicare beneficiariesOffice of the Inspector General (OIG) is a division of theDepartment of Health and Human Services.It is important for coders to be proficient in what type of keyboarding?Alphanumeric keyboardingNot counting modifiers, how many numbers does a CPT code have?5Patients who have injuries or health problems that cannot be delaying without harming the patient are usually treated atthe emergency department.conventions NOS and NEC are used interchangeably.falseWhat is the final step in diagnosis coding when there is more than one diagnosis?Arrange or sequence the codes in the correct order.Intracranial nevusD18.02CA in situ does NOT occur inThese are correct: bone, muscle and connective tissue.eponym isnamed after a personSebaceous cyst of the eyelids has a code that represents "bilateral eyelids."falseICD-10-CM has how many additional indexes for specialized codes?3When more than one type of therapy is used to treat a neoplasm, the additional treatments are known asadjuvant therapyOGCR Section I.C. contains which of the following?Chapter-Specific Coding Guidelines-guidelines for specific diagnoses or conditions divided by IC-10-CM chapterWhen there is a "Code first" note and an underlying condition is present, the _____.underlying condition should be sequenced first.F95 Tic disorder is an example of acategoryBlank _______is the process of determining how far a cancer has spread.stagingWhen the first listed diagnosis is unclear, what should the coder do when sequencing additional diagnoses?List the additional diagnoses in order of importance to the encounter.Which of the following is TRUE when coding a personal or family history of a malignant neoplasm?all of theseWhich of the following is NOT true about the OGCR?they are always published on October 1st of each year, just like the updated coding manual.Which is TRUE about ICD-10-CM codes?The first character is always alphabetic; the second character is always numeric.neoplasm's primary site isthe anatomic site where a neoplasm begins.Inflammatory diseases of the central nervous system (G00 to G09) is an example of ablock.Payers are allowed to do which of the following in order to process a claim for payment?Request additional information to verify whether or not the service is covered.physician usually treats a patient throughout the patient's stay at an inpatient facility is known as theattending physician.It is estimated that the overall process to plan, implement, and monitor the transition to ICD-10-CM PCS will takeapproximately five yearsHemangiopericytoma, left eyelidD48.1Entries that require a seventh character extension are referred to as subcategories because it cannot be called a code until the extension is added.falseWhich of the following coding certifications is NOT offered by either AAPC or AHIMA?CBCSAccording to Chapter 1, Your Career and Coding, which of the following is NOT one of an "ace" coder's skills?appraisingCoding burns using ICD-10-CM will be different from coding burns using ICD-9-CM. Why?ICD-10-CM makes a distinction between burns and corrosions. Burns are classified by heat source, electricity, and radiation. Corrosions are burns due to chemicals.Which of the following distinguishes the difference in coding immunizations in ICD-9-CM and ICD-10-CM?all of these