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week 3 Health Ins

Health Insurance week 3

QuestionAnswer
The first several pages of the ICD-9 manual consititute? An introduction
An alphabetic listing of diagnoses is contained in Volume 2
which volume comes first volume 2
Italics are used in volumes 1 and 2 to? Identify new codes and identify rubrics that should not be listed as primary codes
The largest section in volume 2 the Index to Diseases is organized? Alphabetically by main terms
Diseases, procedures, or syndromes named for individuals who discovered or first used them are called? Eponyms
Essential modifiers describe Various anatomic sites, the cause or origin of a disease or condition, and clinical types
Terms in parentheses following main terms are called? Nonessential Modifiers
The codes used to classify environmental events, circumstances, and other conditions that are the cause of injury and other adverse effects are referred to as? E codes
Codes in the Tabular List (Volume 1) are arranged? Numerically
Codes on health insurance forms must conform to the standards that are published in/on the federal register
If a patient's condition has not been specifically diagnosed, the health insurance professional most code the? Signs or symptoms
When a single code is used to describe conditions that frequently occur together a ______ code is used? Combination
Under HIPAA, any set of codes used for encoding data elements, such as tables of terms, medical concepts, medical diagnosis codes, or medical procedure codes, is called a? Code set
The main term for acute depressive reaction is? Reaction
The following instruction "330 cerebral degenerations usually manifest in chaildood: use additional code to identify associated mental retardation" indicates to the health insurance professional? A fourth and fifth digit must be assigned to the code and an additional code should be used for better clarification
V codes show problems or situations that influence a patient's health status but are not a current illness or injury such as? Family history of cancer, routine physical examination and colonoscopy screening
E codes provide a slassification of external causes, such as? How an accident occurred and whether a drug overdose was accidental or purposeful
ICD-9-CM stands for International classification of diseases 9th revision clinical modification
The primary diagnosis is used by? Physician
The principal diagnosis is used by Hospital
Name the three volumes of ICD-9-CM? Tabular list, Alphabetic list, and Used for hospital inpatient procedure coding
What is contained in Volume 2 of the ICD-9-CM? Index to Diseases
What is contained in Volume 1 of the ICD-9-CM? Tabular list
What is contained in the Appendix A of the ICD-9-CM? Morphology of Neoplams
What is contained in the Appendix B of the ICD-9-CM? Glossary of Mental Disorders
What is contained in the Appendix C of the ICD-9-CM? Classification of druge by american hopital formalary service
What is contained in the Appendix D of the ICD-9-CM? Industrial Accidents according to agency
What is contained in the Appendix E of the ICD-9-CM? Three digit catagories
The first step in diagnostic coding is to identify the? Main Term
List the four ways main terms appear in the Index to Diseases? Diseases, Conditions, Nouns, and Adjectives
Name the tables that appear in the Alphabetic Index to Diseases? Hypertension and Neoplasm
List the seven essential steps to diagnostic coding? Locate the diagnosis, Determain the main term, find main term in volume 2, read and apply any notes, cross reference the codes, read and be guided by the conventions and symbols and code it at highest level
List steps for selecting the correct E code? Locate the drug in index, verify code, and do not use an E code as the first diagnosis
The manual containing codes used in reporting medical services and procedures performed and supplies used by healthcare providers in the care and treatment of patients is the? CPT-4
CPT codes were developed by? The AMA
The CPT manual is published by? The AMA
A new CPT manual is published how many times? once a year
The main body of the CPT manual is organized in? 6 sections
The 5-digit CPT codes may be defined further by 2 additional digits to help explain an unusual circumstance associated with a service or procedure, which are called? Modifiers
As with the ICD-9-CM the CPT index is organized by? Main terms
A main term can stand alone, or it can be followed by up to _______ modifying terms 3
To help determine the appropriateness and medical necessity of a service or procedure, a ________ should accompany the claim? Special report
The narrative describing a procedure/service that contains the full description of the procedure without additional explanation is referred to as a? Stand-alone-code
Procedures that do not contain the entire written description and refer back to the common portion of the procedure listed in the preceding entry are coded with a? Indented code
CPT uses _________ to separate main and subordinate clauses in the code descriptions? A semicolon
The rason the patient is seeing the physician-usually stated in the patient's own words-is referred to as the? Chief Complaint-CC
The series of questions the provider asks the patient to identify what body parts or body systems are involved is referred to as the? Review of Systems-ROS
What does CC stand for Chief Complaint
What does HPI stand for? History of present illness
What does ROS stand for? Review of Systems
What does PFSH stand for? Past, family, and social history
The amount of time the physician spends on bedside care of the hospitalized patient and reviewing the health record and writing orders is called? Unit/Foor time
The classification for a patient who is not sick enough to qualify for acute inpatient status, but requires hospitalization for a brief time, is referred to as? Observation status
A procedure by which codes used for data in one database are translated into the codes fo another database, allowing information to be shared among databases, is called? A crosswalk
HCPCS level II codes are organized into _____ sections? 17
The health record must contain adequate documentation to support the use of? modifiers
Each main section of the CPT is preceded by _______ specific to that section? Guidelines
What is the purpose of Category III codes? A set of temporary codes for emerging technologies, services, and procedures
Name each of the four primary classes of main term entries? Procedure or service, Organ or other anatoanic sites, Condition, and synonyms, eponyms, and abbreviations.
What are the three ways a CPT code can be displayed? A single code, Multiple codes, and a range of codes
If a special report accompanies a claim to explain unusual circumstances, list what should be included in this document? A defination or description of the service or procedure, the time, effect, and equipment needed, symptoms and findings and size, diagnostic and the raputic services, concurrent problems, follow-up care
Explain the use and importance of a ; in assigning a CPT code? it is used to separate main and subordinate clauses in the code descriptions.
Codes in the tabular section of CPT are formatted using four classifications? Section, subsection, subheading, and category
how long does a patient have to be away before they are considered a new patient? 3 years
List the three factors that direct the health insurance professional to the proper category in the E & M coding section of CPT? place of service, type of service, and patient status.
Created by: Seanmorrone
 

 



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