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Review
Chapter 1
| Question | Answer |
|---|---|
| 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 |
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reggie0603
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