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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


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