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Chapter 1

Many coding professionals go on to find work as Consultants
A medical record contains information on all but what areas Financial records
Technicians who specialize in coding are called medical coders or coding specialist
EHR stands for electronic health records
What type of provider goes through approximately 26 1/2 months of education and is licensed to practice medicine with the oversight of a physician physician assistant (PA)
The Medicare program is made up of several parts. Which part is most significant to coders working in physician offices and covers physician fees without the use of a private insurer Part B
What does CMS-HCC stand for Centers for Medicare and Medicaid Services - Hierarchal Condition Category
When coding an operative report, what action would NOT be recommended Coding from the header without reading the body of the report
Outpatient coders focus on learning which coding manuals CPT, HCPCS Level II, and ICD-10-CM
If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient, who determines coverage Medicare Administrative Contractor (MAC)
The describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare national coverage determinations manual
National Coverage Determinations serve what purpsoe to spell out CMS policies on when Medicare will pay for items or services
MAC stands for what Medicare administrative Contractor
Local coverage determinations are administered by each regional MAC
LCD's only have jurisdiction in their area regional
ABN stands for advance beneficiary notice
When are providers responsible for obtaining an ABN for a service not considered medically necessary prior to providing a service or item to a beneficiary
HIPAA stands for health insurance portability and accountability act
HIPAA was made into law in what year 1996
A covered entity does NOT include patient
What is the definition of coding translating documentation into numerical /alphanumerical codes used to obtain reimbursement
Who is responsible for enforcing the HIPAA security rule OCR
Healthcare providers are responsible for developing and policies and procedure regarding privacy in their practices notices of privacy practices
A covered entity may obtain consent of the individual to use or disclose protected health information to carry out all but what of the following for public use
The minimum necessary rule is based on sound current practice that protected health information should not be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. What does this mean providers should develop safeguards to prevent unauthorized access
The minimum necessary rule applies to covered entities taking reasonable steps
Created by: reggie0603