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mod 150 theory 3

theory test

QuestionAnswer
A PERSON CAN LIVE WITHOUT A SPLEEN TRUE
THE MEDIASTINUM IS LOCATED BETWEEN THE LUNGS TRUE
THE STEM CELL HARVESTING IN 38205 IS THE COLLECTION OF STEM CELLS FROM THE BONE MARROW FALSE
THE UPPER JUGULAR GROUP OF LYMPH NODES ARE LOCATED IN THE GROIN FALSE
THE DIAPHRAGM IS A WALL OF MUSCLE THAT SEPARTES THE THORACIC AND ABDOMINAL CAVITIES TRUE
THERE IS MORE CHANCE FOR ADVANCEMENT WORKING IN A HOSPITAL FACILITY THAN IN A PRIVATE PHYSICIAN'S OFFICE TRUE
BECAUSE OF THE DIVERSITY IN REIMBURSEMENT METHODS IT IS VERY IMPORTANT THAT THE INSURANCE BILLING SPECIALIST HAVE BASIC KNOWLEDGE OF INSURANCE PROGRAMS TRUE
WHEN A MANAGED CARE PATIENT IS ADMITTED FOR A NONEMERGENCY TO A HOSPITAL WITHOUT A MANAGED CARE CONTRACT THE MANAGED CARE PROGRAM NEEDS TO BE NOTIFIED BY THE HOSPITAL WITHIN 48 HOURS FALSE
EMERGENCY DEPARTMENT CHARGES ARE BILLED ALONG WITH THE INPATIENT STAY ON THE CMS-1500 CLAIM FORM FALSE
WHEN ADMITTED AS A WORKERS COMP CASE THE PATIENT WILL NOT HAVE AN INSURANCE CARD TRUE
THE PHYSICIAN'S OFFICE USES ICD-9-CM VOL. 1,2,3 TO CODE DIAGNOSES AND PROCEDURES FALSE
SURGICAL PROCEDURES PERFORMED IN THE HOSPITAL OPERATING ROOM ARE BILLED BY THE HOSPITAL BILLING DEPARTMENT FALSE
ELECTIVE SURGERIES ARE DEFERRABLE TRUE
A PATIENT HAS A RIGHT TO REQUEST AN ITEMIZED BILL FROM A HOSPITAL STAY WITH NO COST TO THE PATIENT TRUE
ON THE UB-04 CLAIM FORM THE PATIENT'S DATE OF BIRTH SHOULD BE ENTERED USING 6 DIGITS IN BLOCK 14 FALSE
ON THE UB-04 CLAIM FORM IN FIELD 17 CODE 20 EXPIRED IS USED TO INDICATE THE PATIENT'S DISCHARGE STATUS TRUE
INFORMATION SUCH AS CONDITION IS EMPLOYMENT RELATED LISTED IN FIELDS 18 THROUGH 28 OF THE UB-04 CLAIM FORM IS CALLED A CONDITION CODE. TRUE
THE DRG IS ASSIGNED USING AN AUTOMATED SYSTEM CALLED THE DRG SELECTOR FALSE
THE PURPOSE OF THE DRG-BASED SYSTEM IS TO HOLD DOWN RISING HEALTH CARE COSTS TRUE
THE GROUPER DIFFERENTIATES BETWEEN CHRONIC AND ACUTE CONDITIONS FALSE
AMBULATORY PAYMENT CLASSIFICATIONS ARE BASED ON DIAGNOSES FALSE
THE__MANUFACTURES MOST BLOOD CELLS BONE MARROW
THE SPLEEN IS COMPOSED OF THIS MATERIAL THAT ALSO SURROUNDS VEINS AND ARTERIES LYMPH TISSUE
__IS A MALIGNANT DISEASE OF THE BONE MARROW IN WHICH EXCESSIVE WHITE BLOOD CELLS ARE PRODUCED LEUKEMIA
MEDIASTINUM CODES ARE IDENTIFIED BY WHICH FACTOR SURGICAL APPROACH
THIS TYPE OF LYMPHADENECTOMY IS THE REMOVAL OF THE LYMPH NODES GLANDS AND SURROUNDING TISSUES RADICAL
THE LYMPH NODE EXCISION CATEGORY CODES ARE BASED ON WHAT TWO THINGS METHOD AND LOCATION
HOW MANY CATEGORIES ARE LOCATED IN THE MEDIASTINUM SUBHEADING 4
A DIPHRAGMATIC HERNIA IS ALSO KNOWN AS A ESOPHAGEAL HIATAL HERNIA
THIS BONE MARROW IS TAKEN FROM A CLOSE RELATIVE SO THERE IS GENETIC SIMILARITY ALLOGENIC
THIS BONE MARROW IS COLLECTED FROM THE PATIENT AND LATER TRANSPLANTED OR REINFUSED BACK INTO THE PATIENT FROM WHOM IT CAME AUTOLOGENIC
WHAT WORD DESCRIBES A LYMPHADENECTOMY IN WHICH ONLY THE LYMPH NODES ARE REMOVED LIMITED
WHAT IS IT CALLED WHEN THE DIAPHGRAM IS OUT OF NORMAL POSITION AND HAD MOVED UP FARTHER INTO THE THORACIC CAVITY EVENTRATION
CONFIDENTIAL INFORMATION ABOUT PATIENT'S SHOULD NEVER BE DISCUSSED WITH CO-WORKERS, FAMILY, FRIENDS
WHEN CRITERIA ARE USED BY REVIEW AGENCY FOR ADMISSION SCREENING THIS IS REFERRED TO AS AEP'S
ONE CRITERION THAT NEEDS TO BE MET TO CERTIFY SEVERITY OF ILLNESS(SI) IN AN ADMISSION IS ACTIVE UNCONTROLLED BLEEDING
A PATIENT IS CONSIDERED AN INPATIENT TO THE HOSPITAL ON ADMISSION FOR AN OVERNIGHT STAY
WHEN A PATIENT WHO HAS A MANAGED CARE CONTRACT IS ADMITTEDTO A HOSPOTAL FOR AN EMERGENCY THE MANAGED CARE PROGRAM NEEDAS TO BE NOTIFIED WITHIN 48 HOURS
THE RULE STATING THAT WHEN A PATIENT RECIEVES OUTPATIENT SERVICES WITHIN 72 HOURS OF ADMISSION THEN ALL OUTPATIENT SERVICES ARE COMBINED WITH INPATIENT SERVICES AND BECOME PART OF THE DIAGNOSTIC RELATED GROUP RATE FOR ADMISSION IS CALLED THE 72 HOUR RULE
WHAT ORGANIZATION IS RESPONSIBLE FOR ADMISSION REVIEW READMISSION REVIEW PROCEDURE REVIEW DAY AND COST OUTLIER REVIEW DRG VALIDATION AND TRANSFER REVIEW QIO
READMISSION REVIEW OCCURS IF THE PATIENT IS READMITTED WITHIN 7 DAYS OF DISCHARGE
A REVIEW FOR ADDITIONAL MEDICARE REIMBURSEMENT IS CALLED DAY OUTLIER REVIEW
THE SIGNIFICANT REASON FOR WHICH A PATIENT IS ADMITTED TO THJE HOSPITAL IS CODED USING THE PRINCIPAL DIAGNOSIS
CLASSIFICATIONS OF SURGICAL AND NON SURGICAL PROCEDURES AND MISCELLANEOUS THERAPEUTIC AND DIAGNOSTIC PROCEDURES ARE FOUND IN ICD-9 VOLUME 3
ICD-9-CM PROCEDURE CODES CONTAIN AT LEAST TWO DIGITS, TWO TO FOUR DIGITS
THE CODEBOOK USED TO LIST PROCEDURES ON OUTPATIENT HOSPITAL CLAIMS IS CPT
THE PERSON WHO INTERVIEWS THE PATIENT AND OBTAINS PERSONAL AND INSURANCE INFORMATION AND THE ADMITTING DIAGNOSIS IS A /AN ADMITTING CLERK
DAILY PROGRESS NOTES ARE ENTERED ON THE PATIENTS MEDICAL RECORD BY AN NURSE
THE CLAIM FORM TRANSMITTED TO THE INSURANCE CARRIER FOR REIMBURSEMENT FOR INPATIENT HOSPITAL SERVICES IS CALLED A DETAIL STATEMENT
THE HOSPITAL INSURANCE CLAIM FORM MUST ALWAYS BE REVIEWED BY THE INSURANCE BILLING EDITOR
PROFESSIONAL SERVICES BILLED BY THE PHYSICIAN INCLUDE HOSPITAL CONSULTATIONS, HOSPITAL VISITS, EMERGENCY DEPARTMENT VISITS
IF A PATIENT IS BEING ADMITTED TO A HOSPITAL AND REFUSES ALL PREADMISSION TESTING BUT A BILL IS SENT TO THE INSURANCE CARRIER FOR THESE SERVICES ANYWAY THIS IS CALLED PHANTOM CHARGES
A TENTATIVE DRG IS BASED ON ADMISSION DIAGNOSIS SCHEDULED PROCEDURES AGE AND SECONDARY DIAGNOSIS
HOW MANY MAJOR DIAGNOSTIC CATEGORIES (MDC'S) ARE THERE IN THE DRG-BASED SYSTEM 25
ON THE UB-04 CLAIM FORM CODE 6 IN FIELD 15 IS USED TO INDICATE SOURCE OF ADMISSION
THE CLAIM FORM USED FOR THE OUTPATIENT HOSPITAL SERVICES IS THE UB-04 CLAIM FORM
LAPAROSCOPIC SPLENECTOMY 38120
BONE MARROW BIOPSY BY NEEDLE ASPIRATION 38221
BIOPSY OF A LYMPH NODE BY FINE NEEDLE ASPIRATION WITHOUT IMAGE GUIDANCE 10021
EXCISION OF A MEDIASTINAL TUMOR 39220
THE MEDIASTINUM CATEGORY CODE RANGE IS 39000-39499
SUPRAHYOID LYMPHADENECTOMY 38700
THE PHYSICIAN PERFORMS A COMPLETE AXILLARY LYMPHADENECTOMY 38745
IMBRICATION OF DIAPHGRAM FOR EVENTRATION TRANSABDOMINAL NONPARALYTIC 39545
THE PHYSICIAN REPAIRS A LARGE LACERATION OF THE DIAPHGRAM THAT OCCURED DURING A CARE ACCIEDENT FROM THE SEAT BELT THE PATIENT WAS WEARING THROUGH TRANSABDOMINAL APPROACH 39501
THE PHYSICIAN PERFORMS AN EXTENSIVE DRAINAGE OF A LYMPH NODE ABSCESS 38305
PAT IS AN ABBR. PREADMISSION TESTING
THE HOSPITAL DEPARTMENT CONDUCTS AN ADMISSION AND CONCURRENT REVIEW ON ALL CASES AND PREPARES A DISCHARGE PLAN TO DETERMINE WHETHER ADMISSION ARE JUSTIFIED IS CALLED THE__DEPARTMENT UTILIZATION REVIEW
THE ___CODING SYSTEM IS USED TO LIST PROCEDURAL CODES FOR MEDICARE PATIENTS ON THE HOSPITAL INSURACE CLAIMS THAT ARE NOT IN THE CPT BOOK HCPCS
THE __IS THE CLINICAL RESUME FOR FINAL PROGRESS NOTE DISCHARGE SUMMARY
THE UNIFORM BILL CLAIM FORM IS CONSIDERED A __STATEMENT SUMMARY
MEDICARE PROVIDES STOPP LOSS CALLED ___IN IT REGULATIONS OUTLIERS
THE ABBR OF THE PHRASE THAT INDICATES WHEN CLAIMS ARE SUBMITTED ELECTRONICALLY IS EDI
ON THE UB-04 CLAIM FORM THE SECOND DIGIT OF THE FOUR DIGIT BILL CODE IN FIELD 4 INDICATES THE TYPE OF FACILITY
ON THE UB-04 CLAIM FORM 1553 LISTED AS THE HOUR OF ADMISSION INDICATES THAT THE PATIENT WAS ADMITTIED AT 3:53 PM
A FOUR DIGIT CODE CORRESPONDING TO EACH NARRATIVE DESCRIPTION OR STANDARD ABBREVIATION THAT IDENTIFIES A SPECIFIC ACCOMMODATION ANCILLARY SERVICE OR BILLING CALCULATION RELATED TO SERVICES BILLED IS CALLED A __ CODE REVENUE
THE DRG BASED SYSTEM CHANGED HOSPITAL REIMBURSEMENT FROM A FEE FOR SERVICE SYSTEM TO A LUMP SUM FIXED FEE PAYMENT BASED ON THE __ RATHER THAN ON TIME SERVICES RENDERED DIAGNOSIS
CASES THAT CANNOT BE ASSIGNED AN APPROPRIATE DRG BECAUSE OF ATYPICAL SITUATIONS ARE CALLED COST OUTLIERS
AN UNETHICAL PRACTICE OF UPCODING A PATIENTS DRG CATEGORY FOR A MORE SEVERE DIAGNOSIS TO INCREASE REIMBURSEMENT IS CALLED DRG CREEP
__IS A PREEXISTING CONDITION THAT WILL BECAUSE OF ITS EFFECT ON THE SPECIFIC PRINCIAPL DIAGNOSIS REQWUIRE MORE INTENSIVE THERAPY OR CAUSE AN INCREASE IN LENGTH OF STAY BY AT LEAST 1 DAY IN APPROX 75 % OF CASES COMORBIDITY
WHAT IS QIO AN ABBR FOR QUALITY IMPROVEMENT ORGANIZATION
WHAT IS THE DOCUMENT THAT NEEDS TO BE COMPLETED AND SIGNED BY THE PHYSICIAN AFTER A PATIENT LEAVES THE HOSPITAL BEFORE THE HOSPITAL CAN RECIEVE REIMBURSEMENT DISCHARGE SUMMARY
WHAT ARE THE SEVEN VARIABLES THAT ARE RESPONSIBLE FOR DRG CLASSIFICATIONS PRINCIPAL DIAGNOSIS, SECONDARY DIAGNOSIS, SURGICAL PROCEDURES, COMORBIDITY AND COMPLICATIONS , AGE AND SEX, DISCHARGE STATUS, TRIM POINTS
WHAT DOES THE ABBR. CC INDICATE WHEN USED WITH DRG'S COMORBIDITY AND COMPLICATIONS
Created by: moviegrl on 2011-06-03



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