How can we help?

You can also find more resources in our Help Center.

103 terms

NHA Billing & Coding Study Guide

Pages 1-8
STUDY
PLAY
Must be included when billing an insurance company:
DOS, POS, TOS, and dx or DX
DOS
Date of Service
POS
Place of service
TOS
type of service
DX or dx
diagnosis
HIPAA
under what rule mays use patients Protected Health Information (PHI) with out specific authorization for treatment, payment, and operation purposes (TPO).
T in TPO?
treatment
P in TPO?
Payment
O in TPO?
Operations
What does (T)reatment in TPO mean?
primarily for the purpose of discussion of the patients case with other providers
What does (P)ayment in TPO mean?
where providers submit claims on behalf of patients
What does (O)perations in TPO mean?
for purposes such as staff training and quality improvement
Employer Liability
physicians are legally responsible for their own conduct and any actions of their employees.
Employee Liability
"errors and omissions insurance" a protection against a loss of monies caused by failure through error or unintentional omission on the part of the individual or service submitting the insurance claim
Let the master answer
means an employee can be sued and brought to trial
Medical Record
: documentation on the patients social and medical history, family history, physical examination findings, progress notes, radiology and lab results, consultation reports and correspondence to patient
Reason 1 for Documentation of Pt Records
avoiding denied payments by insurance carriers investigating the medical necessity of services
Reason 2 for Documentation of Pt Records
enforcement of record keeping rules by insurance carriers requiring accurate documentation that supports procedure and diagnostic codes
Reason 2 for Documenting of Pt Records
Subpoena of medical records by state investigators of the court review
Reason 4 for Documenting of Pt Records
Defense of a professional liability claim
Indefinitely
a M.D. must keep living Pt records for
5 years
a MD must keep deceased Pt records for
pain
-algia
blood condition
-emia
inflammation
-itis
enlargement
-megaly
measure
-meter
tumor, mass
-oma
abnormal condition
-osis
disease condition
-pathy
bursting forth of bloos
-rrhagia
discharge or flow
-rrhea
hardening
-sclerosis
to view
-scopy
surgical puncture
-centesis
removal
-ectomy
record
-gram
process of recording
-graphy
seperation
-lysis
surgical fixation
-pexy
suture
-rrhaphy
visual examination
-scopyy
opening
-stomy
treatment
-therapy
incision
-tomy
without
an
before
ante
against
anit
slow
brady
painful
dys
inside, within
endo
upon, above
epi
out, out of
ex
half
hemi
below
hypo
between
inter
new
neo
scanty
oligo
all
pan
beside
para
through
per
many
poly
before, infront of
pre
false
pseudo
under
sub
above, beyond
supra
four
tetra
cartilage
arth
head
cephal
heart
cardi
gall bladder
cholecyst
cartlige
chondro
vagina
colp
skin
derm
intestine
enter
vulva
episi
stomach
gastro
tounge
gloss
liver
hepto
uterus
hyster
abdomen
lapar
milk
lact
stone
lith
breast
mast
muscle
myo
birth
nat
ovary
oophor
bone
oste
lung
pneum
nose
rhin
fallopian tubes
salping
mouth
stomat
anterior, ventral
front surface of the body
posterior, dorsal
back side of the body
superior
above another structure
inferior
below another structure
proximal
near the point of attachment to the trunk
distal
far from the point attachment to the trunk
medial
pertaning to the middle of the body
lateral
pertaining to the side
frontal, coronal
vertical plane diving the body by the front and the back
sagittal
vertical plane diving the body by the right to left sides
transverse
horizontal plane dividing the body into upper and lower portions