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Week 1

The Business of Medicine

QuestionAnswer
Many coding professionals go on to find work as: Consultants
Which type of information is NOT maintained in a medical record? Financial records
**Professionals who specialize in coding are called: Coding specialists
**EHR stands for: Electronic health record
**What type of provider goes through approximately 26 ½ months of education, after completion of a bachelor's degree, 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 covers provider fees without the use of a private insurer? Part B
***The Medicare program is made up of several parts. Which part is affected by the Centers for Medicare & Medicaid Services - Hierarchical Condition Categories (CMS-HCC)? Part C
What does CMS-HCC stand for? Centers for Medicare & 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.
Which coding manuals do outpatient coders focus on learning? CPT®, HCPCS Level II and ICD-10-CM
If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage? Medicare Administrative Contractor (MAC)
**Which CMS product describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare? National Coverage Determinations Manual
What is the purpose of National Coverage Determinations? To explain CMS policies on when Medicare will pay for items or services.
**What does the abbreviation MAC stand for? Medicare Administrative Contractor
** Local Coverage Determinations are administered by whom? a Each regional MAC
LCDs only have jurisdiction in their ____. Region
Created by: Breeannaj33
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