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5 Written questions

5 Matching questions

  1. National Codes
  2. ICD-9 characteristics
  3. Unbounding
  4. Services not Rendered
  5. Colon :
  1. a The simplest scheme of HC fraud is the billing for services that were never rendered to patients
  2. b are placed after an incomplete term which requires one or more of the modifying terms that follow it in order to make the code assignable to a given category.
  3. c Example:
    Q0113 Pinworm examinations (kit given= supply billed)
    A0100 Non-emergency transportation; taxi
    D0270 Bitewing-single film
    H0030 Behavioral health hotline service
    J0120 Injection, tetracycline, up to 250 mg
    P9019 Platelets, each unit
    K0005 Ultralightweight wheelchair
  4. d Codes are a series of 3-5 numbers, the last two numbers separated by a decimal (111.11)
    3 digits before decimal = general category
    2 digits post decimal = specific description
    (4th Digit = Subcategory)
    (5th Digit = Subclassification)
    Codes are divided into 17 primary chapters
    Separated out by body systems etc.
  5. e using tow codes when a combined code exists

5 Multiple choice questions

  1. Medicare/medicaid program that aims at catching fraud
  2. "A consultation is a type of service provided by a physician whose opinion or advice regarding evaluation and/or management of a specific problem is requested by another physician or other appropriate source."
    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
  4. International Classification Of Disease, 9th Revision, Clinical Modifications

    Initially developed by the World Health Organization as a way to report morbidity and mortality statistics worldwide
    Not initially meant to be used for billing purposes

    Maintained and updated yearly by the National Center for Health Statistics
  5. Billing for tests not performed

5 True/False questions

  1. bundlingusing tow codes when a combined code exists


  2. Phantom EmployeesExpensing employees or hours worked that do not exist


  3. Coding of underlying diseasesboth the manifestation of the condition and its underlying cause need to be listed. ITALICIZED codes are never to be reported w/o an additional code and they are never to be reported as the patients primary diagnosis.


  4. Brackets [ ]Used to enclose a series of terms, each of which is modified by the statement appearing to the right of the brace.


  5. Physical Exam LevelsProblem focused= 1-5 elements

    Expanded problem focused= >6

    Detailed= >12

    Comprehensive= 18+ or 2 bullets in 9 systems