NAME

Question types


Start with


Question limit

of 59 available terms

Advertisement Upgrade to remove ads
Print test

5 Written questions

5 Matching questions

  1. Phantom Employees
  2. NOS - Not Otherwise Specified
  3. HCPCS Level II - National Codes
  4. History component levels
  5. HEAT
  1. a Expensing employees or hours worked that do not exist
  2. b Medicare/medicaid program that aims at catching fraud
  3. c Means Unspecified (don't know yet)
    Used when the coder does not have enough information to select a more definitive diagnosis (ie. Cultures are pending)
  4. d Problem Focused= HPI: Brief (1-3); ROS & PFSF N/A

    Expanded Problem Focused= HPI: Brief (1-3); ROS:Problem pert (1); PFSH: N/A

    Detailed= HPI: Extended (4-3 chronic); ROS Extended (2-9); PFSH: Pertinent (at least 1)

    Comprehensive= HPI: Extended (4 or 3 chronic); ROS: Complete (10+); PFSH: Complete (2 established) (3 new/consult)
  5. e Created by CMS
    Services and supplies not found in the CPT code set
    Ambulance services and durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)
    Alpha-numeric (one letter plus 4 numbers)

5 Multiple choice questions

  1. It's how we get paid.

    Optimal Reimbursement
    Avoid denials/delay in payment

    Avoid audit by coding properly
    Documentation must support code
    "If it isn't documented, you didn't do it"
  2. "DISTINCT PROCEDURE"
    Indicates that codes that usually are bundled together as a part of a global code are in this particular circumstance describing DISTINCT or SEPARATE precedures
  3. • A Medicare billing provision that enables services provided by NNPs (non-physician providers) in an office or clinic setting to be reimbursed at 100% of the physician fee schedule by billing using the physician's NPI (otherwise reimbursed 85%)
  4. Codes 99381-99397
    The "Comprehensive" nature of the Preventive Medicine Services reflects an age and gender appropriate history/exam.
    (anticipitory guidence, risk factor reduction, etc)
  5. A superbill is a form used by medical practitioners that can be quickly completed and submitted to an insurance company or employer for reimbursement.
    It generally has both CPT codes and ICD-9 codes that are frequently used in your practice in a check-box format.

5 True/False questions

  1. NEC - Not Elsewhere Classifiablecan be used in two instances:
    1) not enough info available to determine which specific diagnosis code should be used in situations where ICD-9 provides very specific diagnoses.
    2) The coder has specific information about the diagnosis that is not an option in the choice of ICD-9 codes

          

  2. Medical Necessityit is improper to bill medicare for services or treatment that is not medically necessary. To knowingly do so is a violation of the false claims act.

          

  3. CPT, Category IInflating the seriousness of the patient's condition or the level of E/M needed to help the patient to obtain a higher reimbursement the one is entitled

          

  4. ICD-9 CM codesVol 1= "Diseases- Tabular List"
    Vol 2= "Diseases- Alphabetical Index"
    Vol 3= Listing of procedure codes and an index to the procedures.

          

  5. Coding of underlying diseases*Code to the highest level of certainty at that visit.

    *Only code the reason for the encounter, and those conditions that affect the care delivered

    *Use the most specific code available (4th=complications of the disease; 5th=clarifies condition)

    *Do not use "rule out" or "suspected" diagnosis (codes as a pre-existing condition to insurance co)
    Instead use a code from the "symptoms, signs, and ill-defined conditions" chapter.

    *Make sure the ICD-9 code supports the CPT code.