CODING

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Terms in this set (74)
True
ICD-10-CM is an update and major revision to the ICD-9-CM.
False
Both ICD-9-CM and ICD-10-CM use over 70,000 codes.
False
Abuse is knowingly billing for services that were never provided or billing for a service that has a higher reimbursement than the service actually provided.
True
The purpose of the Office of the Inspector General (OIG) is to fight waste, fraud, and abuse in Medicare, Medicaid, and more than 300 other HHS programs.
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Conventions are specialized rules, abbreviations, formatting, and symbols that alert users to important information.
False
A multiple code identifies the condition and various manifestations or two conditions that commonly occur together.
False
For outpatient coding, always use uncertain diagnoses.
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The first step in using the ICD-10-CM coding manual is to identify the diagnosis in the Index.
True
In diagnostic coding, Main Terms usually do not include anatomic sites.
False
Symptoms are captured with a statement in the patient's own words of the reason for the visit.
FalseSubterms are words indented five spaces under the boldfaced Main Term that further describe variations of the condition.TrueNever use the Index to make the final code selection.TrueThe Tabular List contains 21 chapters based on etiology or the body system.FalseICD-10-CM codes may be between 6 and 15 characters in length.TrueThe medical assistant may need to help patients with understanding their diagnoses.FalseWhen the Main Term or subterm is too long to fit on one line, the line is truncated.TrueEtiology is another word for cause.FalseThe introductory material at the beginning of the ICD-10-CM includes an alphabetical list of diseases and injuries.TrueThe Patient Protection and Affordable Care Act (PPACA) mandates compliance programs for providers who contract with Medicare and Medicaid.FalseICD-10-CM provides a list of all the most common patient diagnoses.FalseMedical assistants will be called upon to perform medical coding as a regular part of their jobs.alphanumericMedical coding is the process of assigning ________ characters that represent patient diagnoses and services.70,000The ICD-10-CM coding manual contains ________ codes.complianceCompanies and organizations establish ________ programs to actively keep informed about regulations, educate employees, and make sure that everyone in the company is cooperating.Health Insurance Portability and Accountability Act (HIPAA)The ________ mandates the approved code sets for all covered entities, such as a medical office, that handle claims related to health care services.Parentheses________ indicate nonessential modifiers that describe the default variations of a term.NECThe convention ________ signifies that the medical record contains additional details about the condition, but there is no more specific code available for use.Subterms________ are words indented two spaces under the boldfaced Main Term that further describe variations of the condition.Perform an Internet search on the Main Term.Which of the following is NOT a step in using the ICD-10-CM to identify a diagnosis? a. Locate the Main Term. b. Perform an Internet search on the Main Term. c. Read the subterms and modifiers. d. Identify the preliminary code(s).Advanced calculusWhich of the following is NOT a type of knowledge required to perform medical coding? a. Anatomy and physiology b. Clinical procedures c. Local, state, and federal regulations d. Advanced calculusdeathHistorically, diagnosis coding was used to track the causes of disease and _______.ICD-10In 1994, the World Health Organization (WHO) published the ________ for worldwide reporting of morbidity and mortality data.Tabular ListDiagnosis codes are located in the ________, listed alphanumerically and divided into 21 chapters based on cause and body system.supervisorAny time a medical assistant is uncertain about how to select a code, he or she should reach out to a certified coder or to a ________.state-specific conventions.Introductory material in the ICD-10-CM manual contains all of the following information EXCEPT a. instructions on how to use the ICD-10-CM. b. Official Guidelines for Coding and Reporting (OGCR). c. universal conventions. d. state-specific conventions.Tabular ListCodes found in the Index must be verified in the ________ to confirm the code description and assign additional characters specifying details of the condition.referencesAlthough most information is located in the Index of Diseases and Injuries, the ICD-10-CM manual also uses additional ________ for specialized purposes.XWhen codes that are four or five characters long require a seventh character for special purposes, the placeholder ________ is used to fill in any empty positions.codesThe medical assistant must understand the ________ to inform confused patients of their meanings.International Classification of Diseases (ICD)The first coding manual, published in 1901, was called the ________.16,000The ICD-9-CM had _________ codes.fraudA physician who knowingly bills for services that were never actually provided is committing an act of ________.abuseSomeone billing for a non-covered service commits an act of ________.Plural codeWhich of the following is NOT a valid code type? a. Combination code b. Multiple code c. Single code d. Plural codediagnosisThe ________ code reflects detailed information about the illness or injury converted to alphanumeric form.An anatomic siteWhich of the following is NOT usually seen as a Main Term? a. A condition b. A disease c. An anatomic site d. An adjectivepatient self-diagnoses.27. When coding for office-based or other outpatient services, medical assistants may refer to any of the following EXCEPT a. patient self-diagnoses. b. lab and radiology reports. c. encounter forms. d. operative reports for outpatient procedures.sectionsThe 21 chapters in the Tabular List are divided into ________ with boldfaced or highlighted headings.alphabeticallyThe Index to Diseases and Injuries is organized ________ by Main Term and subterms.Table of Mental IllnessesIn the Index to Diseases and Injuries, which of the following is NOT one of the references used for specialized purposes? a. Table of Neoplasms b. Table of Drugs and Chemicals c. Table of Mental Illnesses d. Index to External CausesinjuriesThe seventh character of an ICD-10-CM code is reserved for special use, most commonly the episode of care for ________.impressionWhich of the following words would NOT be used to indicate a qualified diagnosis? a. possible b. probable c. suspected d. impressionUncertain Diagnosis33. Which of the following should NOT be used by a medical assistant for outpatient coding? a. Patient's signs b. Uncertain diagnosis c. Patient's symptoms d. Chief complaintBoldfaced numberingWhich of the following is NOT a Tabular List convention? a. Punctuation b. Instructional notes c. Symbols d. Boldfaced numbering7ICD-10-CM codes should be between 3 and ________ characters in length.errors in the ICD-10-CM.Reporting incorrect diagnosis codes can result in all of the following EXCEPT a. improper reimbursement. b. inaccurate patient medical history. c. fraud. d. errors in the ICD-10-CM.documentationCoding of procedures and diagnoses must be supported by the ________ in the patient record.Procedure________ codes describe services performed for patients.sevenCodes in the ICD-10-CM can be up to ________ characters in length.all of the aboveWhich of the following should a medical assistant NOT code? a. Uncertain diagnosis b. Probable diagnosis c. Rule out diagnosis d. All of the aboveExcludes2________ means that the condition excluded from the diagnosis is not part of the condition represented by the code, but the patient may have both conditions at the same time.Index to Diseases and InjuriesWhich ICD-10-CM volume is an alphabetic index?Tabular ListWhich ICD-10-CM volume is an alphanumeric list?chaptersThe Tabular List contains 21 ________.causeEtiology is another word for ________.Multiple coding________ refers to reporting several codes to fully describe a condition.first-listedThe main reason for the services provided is known as the ________ diagnosis.ICD-10-CMIn 1999, the United States began using the ________ for coding and classification of mortality data.fiveThe overall process to plan for, implement, and monitor the ICD-10-CM transition requires approximately ________ years.XICD-10-CM codes using six or seven characters may use a(n) ________ as a placeholder.annuallyICD-10-CM codes are updated ________.identify the first-listed diagnosis.The first step in assigning an ICD-9-CM code is tocertain infectious and parasitic diseasesChapter 1 of the ICD-10-CM tabular list covers ________.the medical record contains additional details about the condition, but there is no more specific code available for use.According to ICD-10-CM conventions, NEC means ________.