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COMP 3
EXAM
| Question | Answer |
|---|---|
| According to the OSHA computer workstations checklist, when working at a computer, wrists and hands should be | straight |
| How long before the office opens should the person opening the office arrive? | 30 minutes |
| The most appropriate way for a highly contagious patient to be seen in a medical office is to | bring the highly contagious patient directly into the examination room to wait |
| What is the first priority in opening the office and beginning the day. after you have unlocked the door and turned off the security system? | retrieve voicemail or answering service messages |
| Which of the following is not a symptom of carpal tunnel syndrome? | pale, cool fingertips |
| Which of the following is not an activity involved with closing the office at the end of the day? | Check the fax machine. |
| Which of the following is typically not included in a new patient registration packet? | living will/durable power of attorney form |
| Which of the following patients is at greatest risk if another patient who is highly contagious comes into the office? | immunocompromised patient |
| The first impression a patient gets of a medical office is of the | reception area |
| * A teletype (TTY) device, also known as a(n)_____ device for the deaf (TDD). is a specially designed telephone that helps hearing-impaired patients communicate with a medical office through a relay service. | Telecommunications |
| * Children with ____ diseases should wait in an area away from well children to prevent transmission of illnesses | Contagious |
| * In addition to body fluids and human tissue,____ waste includes any potentially hazardous waste generated in the treatment of patients, such as needles. | Infectious |
| * Long-term use of computers, tablets, and cell phones can cause a disorder known as ___ ___ ___. | Computer vision syndrome |
| * Mr. Philips, a new patient, arrives for his appointment and has his service dog with him. Because he needs your assistance in completing the required forms due to visual impairment, he is said to have a ____. | Disability |
| * Patients in a medical practice are usually a diverse group of people. To make patients feel comfortable, the reception area should reflect aspects of their ___ backgrounds whenever possible. | Cultural |
| * Some of the responsibilities of a medical ___ include greeting people, registering them, giving them directions, and answering the phone. | Receptionist |
| * To prevent ___ against people with physical or mental handicaps, the Americans with Disabilities Act was enacted in 1990. | Discrimination |
| * ___ is the federal agency that has developed guidelines for workplace safety in healthcare practices. | OSHA |
| A disadvantage of extremely bright light is that it ___. | creates a glare |
| The single most important factor that affects a patient's perception of a physician's office is ___. | cleanliness |
| * A(n) ___ healthcare claim is one that is error-free and is accepted for processing by the payer. | Clean |
| * Because Medicare pays 80% of approved charges and the patient is responsible for the remaining 20%, individuals enrolled in the Original Medicare Part B plan often buy additional insurance called a(n) ___ plan. | Medigap |
| * Billing the patient for the difference between a higher usual fee and a lower allowed charge is called ___ billing. | Balance |
| * CHIP allows states to provide health coverage to uninsured ___ in families that do not qualify for Medicaid but cannot afford private health insurance. | Children |
| * Federal law requires employers to purchase and maintain a certain minimum amount of workers' ___ insurance for their employees. | Compensation |
| * If your office submits paper claims, you should create and maintain a claims ___ to track the progress of submitted claims. | registration |
| * The electronic claim transaction preferred by Medicare is the X12 837 Health Care Claim, commonly referred to as the ___ claim." | HIPAA |
| * The health plan that pays for medical services is known as ___ ___ a payer. | Third party |
| * The list of drugs approved by an insurance company is called an) ___. | Formulary |
| * Under a Medicare managed care plan, the primary care physician (PCP) provides treatment and manages the patient's medical care through ___ and authorization to specialists when additional care is required. | Referrals |
| A husband and wife are both employed and have work-sponsored insurance plans that cover each other and their three children. Which insurance plan is the primary payer? | the insurance plan of the person whose birthday comes first in the calendar year |
| An appropriate approach to maintaining patient confidentiality on the computer is to ____ | change your password every 90 days |
| An organization that provides pain relief to terminally ill patients and supports these patients and their families is a ____. | hospice |
| Greg Owen is in the office today for treatment, he has employer-provided insurance and also is listed as a dependent on his wife's insurance. His DOB is 7/19/1973 and his wife's DOB is 5/23/1978. Who is the primary payer in this case? | Greg's wife's insurance, because her birthday occurs earlier in the calendar year |
| Of the federal programs providing healthcare, the largest is ___ which provides health insurance for citizens aged 65 and older. | Medicare |
| Patients under the age of 65 who are blind or widowed or who have serious long-term disabilities, such as ___ may be entitled to Medicare. | kidney failure |
| Patients who belong to a managed care health plan, such as an HMO, are responsible for a small per-visit fee collected either prior to seeing the practitioner or at the time the patient is leaving the office. This fee is commonly called an) ____. | copayment |
| The fixed dollar amount a subscriber must pay or "meet each year before the insurer begins to cover expenses is the | deductible |
| The most likely outcome of an insurance claim submitted with a diagnosis code of a sore throat and a treatment code indicating a cast for a broken leg would be | denied because the treatment was not medically necessary based on the diagnosis |
| The person whose name the insurance is carried under is called the | subscriber |
| When a provider agrees to accept assignment for a Medicare patient, this means the provider | will accept the amount of money Medicare pays as payment in full |
| When the insured person pays an annual cost for healthcare insurance, it is called a | premium |
| Which Medicare plan covers prescription medications? | Part D |
| Which of the following guidelines is applicable when filing a Medicaid claim and interacting with Medicaid patients? | Treat the patient as if he or she has private insurance. |
| Which of the following types of insurance covers injuries that are caused by the insured or that occurred on the insured's property? | liability |
| In the problem-oriented medical record (POMR), which of the following includes a record of the patient's history, information from the initial interview, and any tests? | database |
| In which section of the CHEDDAR format of documentation can the diagnosis be found? | Assessment |
| Objective or external factors that can be seen or felt by the practitioner or measured by an instrument are called | signs |
| Recording information in the medical record is called | documentation |
| Subjective or internal conditions felt by the patient are | symptoms |
| The O section of SOAP documentation is | data that comes from examination results and from the provider |
| The P section of SOAP documentation is | the plan of action |
| The appropriate way to delete information on a medical record is to | draw a line through the original information so it is still legible |
| The best place to interview a patient is | in a private room |
| The purpose of having a patient sign an informed consent form is to ensure that the | patient understands the treatment offered and the possible outcomes |
| What does the A in SOAP documentation stand for? | Assessment |
| When do most states consider children to be adults with the right to privacy? | age 18 |
| When you document problems, be careful to distinguish between signs and symptoms. An example of a sign is | a rash |
| What color ink is used by some facilities to ensure handwritten records are the original versus a copy? | blue |
| * A physical examination form that is used during an "oral examination" to identify any signs or symptoms the patient may be experiencing or reveal information about an illness or condition is called a review of ____ of ROS. | Systems |
| * Everything that is entered into the patient's health record by the medical assistant must be dated and ____. | initialed |
| * Medical records must be written neatly and legibly, contain up-to-date information, and present a(n) ___ professional record of a patient's case. | Accurate |
| * Part of creating timely and accurate records is maintaining a(n) ___ tone in your writing. | Professional |
| * The ____ summary form generally includes a summary of the reason the patient entered the hospital; tests, procedures, or operations performed in the hospital; medications administered in the hospital; and the disposition or outcome of the case. | Discharge |
| * The informed ____ form verifies that a patient understands the treatment offered and the possible outcomes or side effects of treatment. | Consent |
| * The primary problem for which a patient comes to see the healthcare provider is known as the ___ complaint. | Chief |
| * The specific information required of a population that must be obtained when a new patient makes an appointment with the office is _____. | Demographics |
| * To reduce confusion in medical records, ____ are being used less often, except for those that are very clear in meaning | Abbreviations |
| * When you release medical information, always send _____ unless the record will be used in a court case, in which case you should send the original records. | Copies |
| Internal audits are done | by medical staff on random records. |
| * Aln) ___ diagnosis is used in addition to the primary diagnosis to describe another condition that also is affecting the patient at the time of the visit. | Secondary |
| * ICD stands for "International ____ of Diseases." | Classification |
| * In ICD-10, three-digit categories known as ___ are used for diseases, injuries, and symptoms | Rubrics |
| * One of the original reasons for the ICD coding system was to classify patient morbidity (sickness) and ___ (death) statistics. | Mortality |
| * Payment for inpatient claims are based on a system known as ___. | DRGs |
| * The ICD coding system was originally created for the classification of patient ___ (sickness) and mortality statistics and to provide access for medical research, education, and administration. | Morbidity |
| * The____ Index is organized by the condition, not by the body part in which it occurs. | Alphabetic |
| * The primary condition for which a patient is receiving care is communicated to the third-party payer through a(n) ___ code on the healthcare claim. | Diagnosis |
| * To assign a proper code for a neoplasm in ICD-10, the documentation must state whether it is benign, ____ in situ, or of uncertain behavior. | Malignant |
| * Unlike outpatient coding, which uses the patient's primary diagnosis, hospital coding uses the ____ diagnosis, which is the condition that was chiefly responsible for the patient's admission to the hospital. | Principal |
| * When "see" appears after a main term, you must look up the term that follows the word "see" in the index. This is an example of a ____. | Cross reference |
| * When a practitioner does not document an exact diagnosis, outpatient coding rules require that unclear diagnosis be coded using the ____ that that led the patient to seek care, until an absolute diagnosis is made. | Symptoms |
| A code in which two diagnoses are included in one code is known as a(n) | combination code |
| A condition that is long-standing is considered a(n) | chronic condition |
| A condition that is of sudden onset or that suddenly becomes much worse is considered a(n) | acute condition |
| About how many codes does the ICD-10-CM contain? | 70,000 |
| Barry is a healthy 32-year-old established patient who has come in for his annual physical exam. When asked if he has any current problems or complaints. he says no. The ICD-10 code for his visit will be found in which of the following code ranges? | Z00-Z99 |
| Eight-year-old Geri climbed the oak tree in her back yard to rescue her cat, who had climbed the tree but could not get back down. The physician diagnoses an open fracture and orders X-rays of the lower arm. Where will you locate the ICD-10 code for this? | S00-T88 |
| How often are the ICD codes updated? | yearly |
| Mrs. Evans has brought her child in for surgery to correct a cleft palate. Which code range in ICD-10 applies to this procedure? | Q00-Q99 |
| The Alphabetic Index is organized by | diseases, conditions. and related terms |
| The use of ICD codes is mandated by | HIPAA |
| What does the ICD convention NEC indicate? | not elsewhere classified |
| Which of these is used only in the hospital inpatient setting? | ICD-10-PCS |
| * Patients' description of their medical problem is called their ____ complaint and is documented at each visit. | Chief |
| patient comes to office for annual physical, at the end of the examination the patient complains of low back pain that has been bothering few weeks. Which modifier should be used with the E/M code to explain the need for two E/M codes at the same visit? | 25 |
| A plus sign (+) is used to indicate | add-on codes |
| An act of deception used to take advantage of another person or entity is called | fraud |
| Dr. Breckell is scheduled to perform a cyst removal on Haley's right hand. Complete cyst removal takes 30 minutes longer than expected. Which modifier would you use to describe this special circumstance? | 22: Increased Procedural Services |
| Having a medical practice compliance plan in place | shows a "good-faith" effort to be compliant with coding regulations |
| In order to find information regarding prefixes and suffixes used in the PT coding manual, you would look in the | Introduction to the manual |
| The CPT is updated and new codes are provided for use beginning | annually on January 1 |
| The Healthcare Common Procedure Coding System (HCPCS) was originally developed for use in coding services, such as durable medical equipment. for | Medicare patients |
| The most frequently used CPT codes are the | evaluation and management codes |
| There is a question concerning a claim for a procedure submitted last year. Where will you look to double-check the codes in question? | last year's PT |
| To ensure reimbursement at the highest allowed level, CPT codes must | include codes and modifers that reflect the services performed |
| When a patient has no symptoms of a disease and the provider performs the tests for that disease at the patient's request, the provider has committed which of these fraudulent coding and billing practices? | Performing procedures not related to the patient's condition. |
| When coding a surgical code, where should you look to be sure you find the correct code? | Use the alphabetic listing of procedures at the back of the CPT manual. |
| Where in the CPT manual can you find a complete listing of all add-on codes? | Appendix D |
| Where in the CPT manual will information about the proper use of modifers be found? | Appendix A |
| Which of the following best describes the CPT code format? | 5-digit numeric codes |
| Which of the following is not one of the six main sections in the CPT manual? | Physical Therapy |
| * Care provided to unstable, critically ill patients that require constant bedside attention is known as _____ care. | Critical |
| * Each procedure or service performed on or for a patient during a patient encounter is reported on healthcare claims using a(n) ____ code. | CPT or procedure |
| * The CPT considers a patient ____ if that person has not received professional services from the practitioner within the last three years | New |
| * The extent of the patient ___ taken is a key factor in determining the level of E/M codes selected. | History |
| * The use of a(n) ___ with a CPT code shows that some special circumstance applies to the service or procedure the practitioner performed. | Modifier |
| * When coding E/M from the CPT manual, you must first know whether the patient is new or ___ and where the services took place. | Established |
| * You will locate procedure codes in the ___ manual | CPT |
| * A(n) ___ account is an account with only one charge, usually for a small amount. | Single entry |
| * A(n) _______ gives a person the legal right to handle financial matters for another person who is unable to do so. | Power of attorney |
| * A(n) ______ is a kind of certificate of guaranteed payment that can be purchased from banks and post offices and from some convenience stores. | Money order |
| * A(n) ____ or encounter form, includes the charges for each service rendered on that day, a request for payment or insurance copayment, and all the information for submitting an insurance claim. | Superbill |
| * After receiving a check, immediately _____ it to prevent the check from being cashed if it is lost or stolen. | Endorse |
| * Bills sent to patients that contain an itemized accounting of services performed, an indication of payments received from the patient or the patient's insurance, and an amount due to the practice are called ____ . | Statements |
| * In order to be considered negotiable, a check must be signed by the ____. | Payer |
| * Most medical offices collect ____ from patients who belong to managed care organizations at the time of the office visit. | Copayments |
| * Most medical offices have a(n) ____ with the office name on it for patients who pay by check to ensure that the name of the practice is spelled correctly on the check. | Stamp |
| * Most practices may use checks from a standard checkbook or ____ checks, which often come in a three-ring binder and provide a stub for recordkeeping. | Voucher |
| * The money the medical practice must pay out to run the practice is called accounts ____. | Payable |
| * The part of the accounting process known as ___ is the systematic recording of business transactions. | Bookkeeping |
| * The person who has financial responsibility for a patient is known as the | Guarantor |
| * The process of communicating the income and expenses of a business and its financial health is known as ____. | Accounting |
| * The process of keeping a daily log of the patient charges and payments received from patients each day is called ____. | Journalizing |
| * When a patient pays using a(n) _____ card, the money is immediately moved from the patient's bank account to the medical practice account. | Debit |
| A collection letter containing stronger wording that asks the patient to specify when the amount will be paid and to contact the office to make payment arrangements may be sent when an account is ___ days past due . | 90 |
| A letter that has a friendly, "we want to help tone and gives the patient options but makes it clear that the patient must take some sort of action, is most appropriately sent when the account is _____ days past due | 60 |
| A superbill | includes the charges and procedure codes for each service rendered on that day |
| Elena is a pregnant 16-year-old patient whose parents are divorced. She has legally left her mothers' home and set up housekeeping with her boyfriend, Alan. Elena shows proof that she is "emancipated. Who is responsible for payment for Elena's treatment? | Elena |
| If an account is ____ days past due, send a letter explaining that unless you hear from the patient by a specific date, the account will be given to a specific collection agency for collection. | 120 |
| On average how much will a medical practice generally receive if the provider charges $100 for services and the patient pays with a credit card? | $95 - $99 |
| The process of classifying and reviewing past-due accounts from the first date of billing is a(n) ___. | age analysis |
| When a patient has a credit balance, _____ | the practice owes the patient money |
| When you ask Mrs. Redding how she would like to pay the $48 she owes for today's services, she hands you a credit card. When you look at the card, you realize that the card expired two months ago. Which is your best response to Mrs. Redding? | "I'm sorry. Mrs. Redding. but this card has expired. Do you have another card we might use?" |
Created by:
evelynlarios1
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