One way to review this data is to collect information from the.
Goal 3: Cost per pound of sausage should not exceed 8. Which part of the ICD-9 code makes it most specific? A patient who has not been admitted to a health care facility. What are the three factors documented in patient's medical record? The coding steps for HCPCS are almost identical to those for CPT codes. If a physician documents in the patient's record the level of Medical Decision Making (MDM) as straightforward, low, moderate, or high complexity, that is sufficient to warrant the appropriate level of decision making. Reporting services at a higher level than was carried out. Which of the following will MOST likely delay the timely coding of an inpatient account? The CPT is updated and new codes are provided for use beginning ____. Use the alphabetic listing of procedures at the back of the CPT manual. Used primarily for cancer registries and terminal illness. The CPT considers a patient ________ if that person has not received professional services from the physician within the last three years. Which of the following is not a potential reason for downcoding? A design feature of an object that limits the possible uses of a device making it more difficult to perform incorrect actions is known as. When wounds of more than one classification are repaired, list the less complicated repair as the primary procedure and the more complicated repair as the secondary procedure. In which chapter of the ICD-10 manual would you expect to find the diagnosis code for an adolescent who comes to the office for a physical examination before enrolling in a school sports program? The first three characters of an ICD-10-CM code are composed as Who is the official channel for the DOD for engaging the news media? Which of the following is a method of closed treatment of fractures? - HIPAA requires specific code sets to be adopted for use by clearinghouses, health plans, and providers (covered entities). In an anesthesiologist's practice, which type of modifiers indicate the patient's condition at the time of the administration of the anesthesia? The state of the patient as either new or established is called the patient __________. when you submit a claim for immunization separately for services that are bundled in a single procedure code. refer to the description for the previous CPT code to complete the description. You have consulted the index in the CPT and discovered that a dressing for a burn is found in procedure codes 16010-16030. When a patient has no symptoms of a disease and the provider performs the tests for that disease at the patient's request, the provider has committed which of these fraudulent coding and billing practices? To simplify the preimplementation process, only key decision makers and a staff representative should be involved. The modifiers are delineated in the front of each section of the CPT to alert the coder to modifiers available for that section. Which organization compiled the first disease classification system in the United States? 112.1 State the purpose of Naval Intelligence. An example of a Category II code is a code used for ____. Current Procedural Terminology system was developed by the AMA (American Medical Association) to convert commonly accepted descriptions of medical procedures into five-digit numeric codes. For coding purposes, which of the following is not a level of patient history? - define the term social networking and describe the use of social networking websites as a means of communication. The Medicare outpatient prospective payment system (OPPS) reimbursement is based on. The period of time that is covered for follow-up care after surgery is called the ________ period. A healthcare provider who practices under false qualifications or credentials is guilty of ____.
A patient who has been seen by one of the physicians in the practice in the same specialty within the past 3 years. Inaccuracy in linking diagnostic codes and procedural codes will result in all of the following except ____. to make coding processes more efficient, medical offices often list frequently used procedures and their applicable CPT codes. HCPCS was developed by the CMS, which stands for. straight forward, low complexity, moderate complexity, and high complexity. 112.1 State the purpose of Naval Intelligence. An inpatient encounter in the chargemaster has a revenue code (or UB-04 code) of 360. $$, Show that $2^{n}$ divides an integer $N$ if and only if $2^{n}$ divides the number made up of the last $n$ digits of $N .$ Each machine has a fixed setup cost, variable production costs per-unit-processed, and a production capacity given in Table 15. Used for patient visit reason that is not related to sickness or injury. Where in the CPT manual can you find a complete listing of all add-on codes? In which category does Nathan's chief complaint fall? An act of deception used to take advantage of another person or entity is called ____.
The MS-DRG is classified according to the principal diagnosis. \begin{matrix} \text{Machine} & \text{Fixed Cost (\$)} & \text{Variable Cost per Unit (\$)} & \text{Capacity}\\ \text{1} & \text{1,000} & \text{20} & \text{900}\\ \text{2} & \text{920} & \text{24} & \text{1,000}\\ \text{3} & \text{800} & \text{16} & \text{1,200}\\ \text{4} & \text{700} & \text{28} & \text{1,600}\\ \end{matrix} Has 6 sections. significant procedure subject to multiple-procedure discounting. If a laboratory bills for a general health panel but fails to perform one of the tests, it is guilty of which of these fraudulent coding and billing practices? What are the four questions of cultural evolution. Simple lacerations can be found under this tab. section takes every possible combination of visits into consideration of visits into consideration and assigns each its own number. Imprecise Coding can affect how quickly the provider is reimbursed and also the amount of the reimbursement. Using a code to obtain a higher level of reimbursement than is justified by medical procedures performed as documented in the medical record. - Reporting codes for signs and symptoms associated in addition to an established diagnosis code. When coding a surgical code, where should you look to be sure you find the correct code? The Healthcare Common Procedure Coding System (HCPCS) was developed for use in coding services for ____. If the painting shop were completely devoted to painting Type I trucks, then 800 per day could be painted; if the painting shop were completely devoted to painting Type 2 trucks, then 700 per day could be painted. "If it wasn't documented, it wasn't done". For coding purposes, which of the following is not a complexity level for medical decision making? Reimbursement rates in the Medicare prospective payment system for skilled nursing facilities are based on. Which department would be responsible for charges including a urine culture? Occasionally, a service or procedure needs to be modified. $$ A number that quantifies the amount of physician labor, resources, and expertise necessary to provide the service represented by a CPT code. What is the correct code assignment for the emergency department admission?
Qualitative and quantitative codes for drug testing are found in which of the following CPT sections? The OPPS payment status indicator "C" means. special circumstances apply to the procedure. A diagnosis code that is not elsewhere classified. - Patient record serves as medicolegal document and facility's business record. $$. If L hours of labor and K units of capital are available, then L2/3K1/3 machines can be produced. All of the following are found in the hospital's chargemaster EXCEPT, The OPPS payment status indicator "T" means. To find information regarding prefixes and suffixes used in the CPT manual, you would look in the ____. The first statement is false; the second is true.-. HCPCS codes have 5 numeric characters, each character is a number. A claim is rejected because it contains codes for both an open cholecystectomy and a laparoscopic cholecystectomy within a single operative episode. This is an example of, Fundamentals of Complex Analysis with Applications to Engineering and Science, A product can be produced on four different machines.
Which method of calculating errors from an inpatient record review recognizes the coder's ability to identify all codes that require reporting. Which of the following elements are included when coding using the problem-focused level of service regarding the patient's history? - International Classification of disease, 9th revision, and Clinical Modification, (ICD-9-CM). About biorhythms, measuring time in quarter days (so that the units will be integers). shows a "good-faith" effort to be compliant with coding regulations. (a) Find the values of a, b, c, and d. To correctly code the dressing for the burn, you should ____. insurance fraud includes practices such as billing when a service such as a consult is required by the insurance carrier or a governmental or regulatory agency, the CPT modifier used is called. For billing purposes, a patient who has not received services during the previous 3 years from a physician in a medical practice. Which of the following codes is ONLY assigned to the health record of a newborn? $$ A conjecture of Lagrange $(1775)$ asserts that every odd integer greater greater than 5 can be written as a sum $p_{1}+2 p_{2},$ where $p_{1}, p_{2}$ are both primes. It is acceptable to code from the Alphabetic Index. In the ICD-10, which term indicates that a condition is not coded here, and the patient cannot have this condition in addition to the condition listed above it? Formulate a preemptive goal programming model for Deancorp. How many quarts of formula has he taken in a four-day period? The place of service never changes for physician billing. 1 Contributions to relief organizations are often wasted. How are most diseases or conditions arranged in the tabular section of the ICD-10 manual? check each code in the range to choose the correct code. The purpose of ______________ in the ICD-10 are to gather statistics about causes and severity of injury. Each can be interpreted as expressing one or more arguments. to decrease the risk of fraud charges, medical offices should have a red dot next to a CPT in the manual denotes that this code is, it is used to consolidate more than one coded procedure. $$ Healthcare Common Procedure Coding System was developed by Medicare as a supplement to the CPT system for procedures not defined with sufficient specificity. A physician bills separately for a comprehensive metabolic panel and a quantitative glucose test, which is normally included in the metabolic panel. Truckco manufactures two types of trucks: 1 and 2. Physical status modifier P4 is assigned to which of the following? A group of diagnostic tests done in one machine at the same time.
-99 -22). What will happen to the claim when it is sent to billing? An infant receives 4 oz. Find services on superbill, check to see which services were documented, look up in CPT manual, determine appropriate modifiers, match procedure w/corresponding diagnosis. A diagnosis code that is not elsewhere classified. For reporting purposes, CPT considers a patient "new" if the patient has not received professional services within the past ____ year(s). Formulate an IP whose solution will tell us how to minimize total costs. Which of the following is not a subcategory title used as a type of E/M code? which of the following statements does not describe the function or result of unbundling? Ture or False: The following is an example of upcoding, "A physician sends a patient to an outside laboratory and the laboratory bills the insurance company"? The coding system used on the claim forms does not match the coding system used by the insurance carrier. Where in the CPT manual should you look to find information about the proper use of modifiers? Care provided to unstable, critically ill patients that require constant bedside attention is known as ________ care. Insurance company representatives analyze the connection between the diagnostic and procedural information, called code ________, to evaluate the medical necessity of the reported charges. True or False? Some images used in this set are licensed under the Creative Commons through Flickr.com.Click to see the original works with their full license.
Is reason for the visit or the cause of the injury. Having a medical practice compliance plan in place ____. It is used when a more specific code for the condition is not available. Complete cyst removal takes 30 minutes longer than expected. The fraudulent practice of coding a procedure or service at a higher level than that provided to receive a higher level of reimbursement is known as code creep, overcoding, overbilling, or ________. Use the two examples in the text as models. It is used to classify inpatient procedures performed. How do insurance companies use ________________ to decide whether the care given corresponds to the patient's disease. A plus sign (+) is used to indicate ____. Important! What is the meaning of the "10" in the abbreviation ICD-10-CM? Which of the following will MOST likely result in incorrect total charges on an inpatient claim? - Routinely assigning an unspecified ICD-9-CM or ICD-10-CM disease code instead of reviewing the coding manual to select the appropriate code number. After ruling out strep throat, the physician diagnoses a common cold and tells Nathan to take over-the-counter medications for symptom relief. What symbol appears next to a code that appears out of numerical sequence? After he begins the procedure, he notices that the cyst is much larger than anticipated and is involved with nerves and ligaments in the right thumb. Auxiliary medical treatment, including vaccines, medical transport, drugs, durable medical equipment-. of formula q.4h. To complete the description for a CPT code that has an indented description, you should ____. Some may turn out to be good ones. TABLE 15: - Reporting multiple codes to increase reimbursement when a single combination code should be reported. A patient who has not been admitted to a health care facility. Which of the following forms is a notice of payments and adjustments of processed claims sent to the provider? Medical records used for procedural coding can include which of the following? True or False, Metal crutches are more likely to require a HCPCS Level II code? is an alphabetic listing of all known diagnosis (index to Disease). Billing for a moderate level evaluation and management service when only a simple BP check and injection were carried out is an example of ____. - Coders are responsible for reviewing patient records to select appropriate diagnosis and procedure or service. Level II National Modifiers are located in the introduction section of the HCPCS and also in the Appendix A of the CPT. What is included in the code for a surgery? After you decide on the appropriate CPT code(s) for a procedure, you should ____. How many characters are contained in category codes (ICD-10 codes)?
Who publishes the CPT manual for procedure codes?
