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38 terms

Mod 112-3

Is it the coder's responsibility to ensure that the data is accurate as possible not only for classification and study purposes, but also to obtain appropriate reimbursement?
In the M/care guidelines it allows kickbacks from patients under certain circumstances.
Information given in the notes preceding a subsection is also contained in the section Guidelines
Parenthetical phrases that sometimes follow a code or code group provide further info about codes tat may be applicable
Unlisted codes are assigned to identify procedues for which there is not more specific code.
Third party payers determine the contents of a surgical package.
Part B services are billed using
ICD-9-CM, CPT, HCPCS codes
Know the physician payment reform
Limits providers liability
If a QIO provider renders a covered service that costs $100 and bills M/care for the service and M/care allowed $58.00 the provider would bill this amt to the patient
What plan is M/care prescription drug fall under
Plan D
What M/care Plan had M/care advantage
Plan C
? are activities involving the transfer of hlth care info and ? means the movement of electronic data between two entities and the technology that supports the transfer
What needs to accompany the claim when an unlisted code is used?
A special report
What does the surgical package include?
Tempical follow-up care
What is the usual global surgery period for a major procedure
90 days
What does the usual global surgery period include?
All routine, pre-op, post-op care
What type of anesthesia is used for a simple closure of benign lesion of the skin?
The divisions of the surgery section are based on?
Body system
What does a triangle before a code mean?
Revised code
Match the M/care parts w/ the coverage:
Hospice Care
Plan A
Match the M/care parts w/ the coverage:

Prescription Drug
Plan D
Match the M/care parts w/ the coverage:

Physician visits
Plan B
Match the M/care parts w/ the coverage:
Automatic coverage when age 65
Plan A
Match the following, common procedures and suffixes with the correct definition.

To remedy, replace, heal
Match the following, common procedures and suffixes with the correct definition.

Suffix for molding or surgically forming
Free flow or withdrawal of fluids from a wound or cavity
Cutting or taking away
To unite parts by stitching them together.
inspection of body organs or cavities by the use of a lighted scope that may be placed through an existing opening or through a small incision
Scraping of a cavity using a spoon-shaped instrument.
Forcing a fluid into a vessel or cavity
Sufix for suturing
Suffix for puncture of a cavity
Suffix for removal of part or all of an organ of the body
Removal of a small piece of living tissue for diagnostic examination
Surgically cutting into
Binding or tieing off, as in constricting blood flow of a vessel or binding fallopian tubes for sterilization
Suffix for incision into