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CBCS_Coding_6
| Term | Definition |
|---|---|
| Seven categories of ground service include all but.. | Advanced life support and level 3 |
| Modifier E3 means.. | Upper right eyelid |
| Health organizations monitor programs by auditing all but.. | Accounts receivable |
| Terminology codes for medical procedures and services | CPT |
| Category I CPT codes compromise with all sections but... | Admission |
| Coding for higher payment rates than the original code | Upcoding |
| ICD-9 code for poisoned by acetaminophen | 965.4 |
| ICD-9 code referring to therapeutic use of acetominophen | E935.4 |
| ICD is updated ... | every 10 years |
| Long term care facilities use what procedure codes | Not applicable |
| Code for patient giving birth to one alive infant | V27.0 |
| Modifier F5 means... | Right thumb |
| E Codes is .. | The first listed E-code should correspond to the cause of the most serious diagnosis |
| Likely to be an effective guideline for coding | Coding the sign or symptom rather than the diagnosis is acceptable when a related diagnosis has been established |
| Edit that pertains to HCPCS codes that doesn't go together... | Comprehensive/component edit |
| Coding system used to code diagnoses or disease... | ICD-9-CM |
| When an HMO hires there own physician and pays them a salary to provide medical services, what HMO model is implemented? | Staff |
| Staff Group | Consists of physicians who have formed an independent group and contract with an HMO to provide to its members. |
| IPA | Consists of several providers who agree to provide services to HMO members |
| Network | Two or more group practices and HMO contract to provide services. |
| Staff | HMO hires physicians and pays them a salary to provide medical services. |
| Issues that shouldn't be included in a coding compliance plan are... | U.S Healthcare Statistics, this is not something that is vital to a coding compliance plan. Besides the other three choices, the issues that might be included in a coding compliance plan include: Upcoding, unbundling, using complete documentation and ect |
| Issues that should be included in a coding compliance plan are.. | Physician query process, correct use of encoding software and complete process for using scrubber software. |
| Which membrane lines the abdominal cavity? | Peritoneum |
| Peritoneum | Membrane that lines the abdominal cavity. It covers most of the organs in the abdomen. |
| What would be defined as bad debts? | Uncollectible accounts allowance |
| Uncollectible Accounts Allowance | Bad Debts and unpaid fees |
| Charity Allowance | Discount given to indigent patients |
| Contractual Allowance | Discount given to third-party payer |
| Courtesy Allowance | Discounts given to employees, physicians and clergy |
| Ethics | "field of study that deals with moral principles, theories, and values; in healthcare, a formal decision-making process for dealing with the competing perspectives and obligations of the people who have an interest in a common problem" |
| Privacy | "the right of an individual to be let alone. It includes freedom from observation or intrusion into one's private affairs and the right to maintain control over certain personal and health information" |
| Confidentiality | "the responsibility for limiting disclosure of private matters. It includes the responsibility to use, disclose, or release such information only with the knowledge and consent of the individual" |
| Security | "physical and electronic protection of the integrity, availability, and confidentiality of computer based information and the resources used to enter, store, process, and communicate it; and the means to control access. |
| Skilled nursing facility (SNF)Care is covered by Medicare | when a patient requires skilled nursing or rehabilitation services reoccurring within 30 days of a 3-day long or longer acute hospitalization and is certified as medically necessary. |
| Medicare Summary notice (MSN) | Statement that is sent to a patient from Medicare that summarizes all services provided over a period of time with an explanation of benefits provided. It shows how much the provider billed, how much Medicare reimbursed the provider, patient pays provider |
| Medical term used to mean empty or remove or impurities | Purge |
| Permeable | Capable of being penetrated or allowing entrance |
| Pons | A portion of the brain stem connecting the medulla oblongata and cerebellum with upper portions of the brain |
| Prolapse | Dropping of an internal part of the body |
| Health information exchange (HIE) | The sharing of patient information between providers such as primary physicians, specialists, hospitals, and ambulatory care settings. HIE's benefit healthcare providers, patients, consumers, and payers. |