Study sets matching "chapter 5 medical coding"
Study sets
Classes
Users
physician's fee profile
primary diagnosis
secondary diagnosis
etiology
Each physician's charges and the payments made to him or her o…
The first listed condition (chief complaint) of a claim for a…
Listed after the primary diagnosis, may contribute to the cond…
The underlying cause of a disease.
physician's fee profile
Each physician's charges and the payments made to him or her o…
primary diagnosis
The first listed condition (chief complaint) of a claim for a…
Current Procedural Terminology (CPT)
Category I codes
Category II codes
Category III codes
Contains the standardized classification system for reporting…
Procedure codes found in the main body of CPT
Optional CPT codes that track performance measures
Temporary codes for emerging technology, services, and procedu…
Current Procedural Terminology (CPT)
Contains the standardized classification system for reporting…
Category I codes
Procedure codes found in the main body of CPT
Current Procedural Terminology
Category 1 Codes
Category 2 Codes
Category 3 Codes
Contains the standardized classification system for reporting…
Procedure codes found in the main body of CPT
Optional CPT codes that track performance measures
Temporary codes for emerging technology, services, and procedu…
Current Procedural Terminology
Contains the standardized classification system for reporting…
Category 1 Codes
Procedure codes found in the main body of CPT
abrasion
acute renal failure
adverse effect
aftercare
an area on the skin or some other surface of the body that has…
a rapid loss of kidney function
a harmful, unintended reaction to a drug administered at the c…
continued care of the patient following the acute phase of tre…
abrasion
an area on the skin or some other surface of the body that has…
acute renal failure
a rapid loss of kidney function
current procedural terminology
category 1 codes
category 2 codes
category 3 codes
procedure codes for physicians' and other health care provider…
five-digit procedure odes found in the main body of CPT
optional CPT codes that track performance measures
temporary codes for emerging technology, services, and procedu…
current procedural terminology
procedure codes for physicians' and other health care provider…
category 1 codes
five-digit procedure odes found in the main body of CPT
Why must diagnostic coding be accurate?
What is the Primary Diagnosis?
What is the Secondary Diagnosis?
What is the Principal Diagnosis?
1. Payment for inpatient services rendered to a patient may be…
1. Related to the chief complaint... 2. Main reason for the encou…
1. May contribute to the primary diagnosis... 2. Not the underlyi…
1. Only applicable to inpatient cases/claims... 2. Similar to pri…
Why must diagnostic coding be accurate?
1. Payment for inpatient services rendered to a patient may be…
What is the Primary Diagnosis?
1. Related to the chief complaint... 2. Main reason for the encou…
Why must diagnostic coding be accurate?
What is the Primary Diagnosis?
What is the Secondary Diagnosis?
What is the Principal Diagnosis?
1. Payment for inpatient services rendered to a patient may be…
1. Related to the chief complaint... 2. Main reason for the encou…
1. May contribute to the primary diagnosis... 2. Not the underlyi…
1. Only applicable to inpatient cases/claims... 2. Similar to pri…
Why must diagnostic coding be accurate?
1. Payment for inpatient services rendered to a patient may be…
What is the Primary Diagnosis?
1. Related to the chief complaint... 2. Main reason for the encou…
Current Procedural Terminology (CPT)
Category I codes
Category II codes
Category III codes
contains the standardized classification system for reporting…
procedure codes found in the main body of CPT
optional CPT codes that track performance measures
temporary codes for emerging technology, services, and procedu…
Current Procedural Terminology (CPT)
contains the standardized classification system for reporting…
Category I codes
procedure codes found in the main body of CPT
Why must diagnostic coding be accurate?
What is the Primary Diagnosis?
What is the Secondary Diagnosis?
What is the Principal Diagnosis?
1. Payment for inpatient services rendered to a patient may be…
1. Related to the chief complaint... 2. Main reason for the encou…
1. May contribute to the primary diagnosis... 2. Not the underlyi…
1. Only applicable to inpatient cases/claims... 2. Similar to pri…
Why must diagnostic coding be accurate?
1. Payment for inpatient services rendered to a patient may be…
What is the Primary Diagnosis?
1. Related to the chief complaint... 2. Main reason for the encou…
Diagnosis Coding for Outpatient Profess…
What must a coder know?
Why should diagnostic coding be accurat…
Should you code conditions that relate…
* Guidelines for diagnostic coding must be followed when assig…
the current diagnostic coding guidelines, medical terminology,…
because payment for inpatient services rendered to a patient m…
No
Diagnosis Coding for Outpatient Profess…
* Guidelines for diagnostic coding must be followed when assig…
What must a coder know?
the current diagnostic coding guidelines, medical terminology,…
acute renal failure and acute respirato…
a patient with early onset Alzheimer's…
patient with known Hepatitis B seen in…
an obstetric patient in her third trime…
A41.9 (sepsis general), R65.20 (sepsis severe), N17.9 (failure…
G30.0, F02.81
E86.0 (dehy), B19.10 (hep)
B59, B20, O36.73
acute renal failure and acute respirato…
A41.9 (sepsis general), R65.20 (sepsis severe), N17.9 (failure…
a patient with early onset Alzheimer's…
G30.0, F02.81
Diagnosis Coding for Outpatient Profess…
What must a coder know?
Why should diagnostic coding be accurat…
Should you code conditions that relate…
* Guidelines for diagnostic coding must be followed when assig…
the current diagnostic coding guidelines, medical terminology,…
because payment for inpatient services rendered to a patient m…
No
Diagnosis Coding for Outpatient Profess…
* Guidelines for diagnostic coding must be followed when assig…
What must a coder know?
the current diagnostic coding guidelines, medical terminology,…
Add on code
Bundling
Category I Codes
Category II Codes
Procedure performed and reported in addition to a primary proc…
Using a single payment for two or more related procedure codes
Procedure codes found in the main body of CPT
Optional CPT codes that track performance measures
Add on code
Procedure performed and reported in addition to a primary proc…
Bundling
Using a single payment for two or more related procedure codes
acute renal failure and acute respirato…
a patient with early onset Alzheimer's…
patient with known Hepatitis B seen in…
an obstetric patient in her third trime…
A41.9 (sepsis general), R65.20 (sepsis severe), N17.9 (failure…
G30.0, F02.81
E86.0 (dehy), B19.10 (hep)
B59, B20, O36.73
acute renal failure and acute respirato…
A41.9 (sepsis general), R65.20 (sepsis severe), N17.9 (failure…
a patient with early onset Alzheimer's…
G30.0, F02.81
add-on code
bundling
Category I codes
Category II codes
Procedure that is performed and reported only in addition to a…
Using a single procedure code that covers a group of related p…
Procedure codes found in the main body of CPT (Evaluation and…
Optional CPT codes that track performance measures for a medic…
add-on code
Procedure that is performed and reported only in addition to a…
bundling
Using a single procedure code that covers a group of related p…
Code identifying medical treatment or d…
Connection between a service and a pati…
Contains the standardized classificatio…
Procedure codes found in the main body…
procedure code
code linkage
Current Procedural Terminology (CPT)
Category 1 Code
Code identifying medical treatment or d…
procedure code
Connection between a service and a pati…
code linkage
a delay in payment of a claim, denial o…
Specificity
The condition of provider evaluated and…
local coverage determination (LCD'S) an…
The consequences of inacurate assigment of diagnostic codes in…
Diagnosis codes should be reported to the highest level of
When a provider makes a hospital visit, the encounter should b…
To determine the diagnosis codes that would support medical ne…
a delay in payment of a claim, denial o…
The consequences of inacurate assigment of diagnostic codes in…
Specificity
Diagnosis codes should be reported to the highest level of
Add on code
Bundling
Category I Codes
Category II Codes
-Procedure performed and reported in addition to a primary pro…
-Using a single payment for two or more related procedure code…
-Procedure codes found in the main body of CPT... -Ex: The basics
-Optional CPT codes that track performance measures... -Ex: Apart…
Add on code
-Procedure performed and reported in addition to a primary pro…
Bundling
-Using a single payment for two or more related procedure code…
Orthotics
Prosthetics
HCPCS Level II Temporary Codes
Ambulatory Surgical Center (ASC)
is a branch of medicine that deals with the design and fitting…
is a branch of medicine that deals with the design, production…
are maintained by the CMS and other members of the HCPCS Natio…
is a state-licensed, Medicare-certified supplier (not provider…
Orthotics
is a branch of medicine that deals with the design and fitting…
Prosthetics
is a branch of medicine that deals with the design, production…
neoplasm
behavior, anatomical site, morphology t…
malignant
primary
New or abnormal growth
Neoplasms are classified according to what three criteria?
Neoplasm that can invade and destroy adjacent structures and s…
Type of neoplasm that is contained at the site where it origin…
neoplasm
New or abnormal growth
behavior, anatomical site, morphology t…
Neoplasms are classified according to what three criteria?
floor division
modulus operator
boolean expression
relational operator
An operator, denoted //, that divides two numbers and rounds d…
An operator, denoted with a percent sign (%), that works on in…
An expression whose value is either True or False
One of the operators that compares its operands: ==, !=, >, <,…
floor division
An operator, denoted //, that divides two numbers and rounds d…
modulus operator
An operator, denoted with a percent sign (%), that works on in…
American Health Information Management…
American Hospital Association (AHA)
Carryover line
Category
One of the Cooperating Parties that provides training and cert…
One of the Cooperating Parties that maintaINS THE Central Offi…
Format used when a complete entry does not fit on one line
A three-digit code that represents a single disease or a group…
American Health Information Management…
One of the Cooperating Parties that provides training and cert…
American Hospital Association (AHA)
One of the Cooperating Parties that maintaINS THE Central Offi…