Save
Busy. Please wait.
Log in with Clever
or

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever
or

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
focusNode
Didn't know it?
click below
 
Knew it?
click below
Don't know
Remaining cards (0)
Know
0:00
share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Insur. bill. & Code

Chapter 6

QuestionAnswer
Who developed HCPCS codes? CMS(centers for medicare services)
How often are CPT codes revised? annually(October)
What does CPT stand for? Current Procedural Terminology
How many levels of HCPC's are there? 3
How many digits are there in the CPT code? 5
What is inpatient status? FORMALLY admitted to Hospital or Healthcare facility for over night stay.
What is outpatient status? services received in an office, clinic,urgent care center,ER,or surgery center.
What is observation status? NOT FORMALLY admitted,on hold while a decision is made to discharge the patient based on conditions observed.
What is preventative medicine? services provided to prevent occurrence of illness, injury and disease.
How is preventative medicine categorized? by the patients AGE.
What are bundled services? services grouped together that are related to a procedure.
What criteria need to be met in order to bill 99211? Face to Face,Physician must be in office,separate service must be provided,proper documentation
What is a referral? transfer of total or specific care of patient from one physician to another. NOT A CONSULT.
What ways are referral's used/AKA? Can also be an authorization for a patient to receive services, typically with HMO members.
What is an Initial new patient consult? first visit by consulting doctor.
What is a Follow-up in patient consult? when doctor is asked to follow-up after patient is admitted but DOES NOT assume management of patient's condition.
What is a Confirmatory consult? Consulting Doctor offers an opinion about the treatment plan after a diagnosis ha been made.
What is an office/outpatient consult? When the patient is seen in the office by a specialist.
What is E/M(Evaluation&management)? services that the physician provides to evaluate patients that were previously referred to as office,hospital,or home visits.
What is a consult? when an opinion or advice is requested by another physician in the evaluation or treatment of a patient's illness.
What is a Follow-up? when a patient comes back for a return visit after the initial visit.
How is a consult Vs. a Follow-up coded? Code Initial 1st, Code Established second.DO NOT USE FOLLOW UP CONSULT CODES,b/c patient is established. After the consultation is complete & the physician assumes management of the patient's condition.
What is a New Patient? has not been seen by group or provider within the past 3 years.
What is an Established patient? Has been seen by group or provider with the past 3 years
What is an Inpatient? someone who has been FORMALLY admitted to the hospital.
What are the contributory factors to level of service? Counseling;Coordination of Care;Time;Nature of presenting problem.
What are the key components used to ID the correct level of Service? History;Exam;Medical decision making.
How many key components need to be present to assign a code? New patient- 3of3 Established/Subsequent patient- 2of3
Created by: First Institute
Popular Insurance sets

 

 



Voices

Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!
"Know" box contains:
Time elapsed:
Retries:
restart all cards