MDA 121 Study Guide
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| 6 reasons that would deny or hold up ins. Carrier | Wrong date missing date, dx not supporting procedure, coding errors, patient ineligible, wrong carrier billed, coding or dates not compatible with documentation
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| What does choledocholithiasis mean | Stones in the bile duct
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| -rrhexis | Rupture
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| How long a ICD10 codes | 3-7
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| Upcoding | Increase a CPT code to receive higher reimbursements
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| How many levels are there in the E&M sections | 5
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| Where can I find and E&M code | The CPT code book
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| Healthcare professionals who may provide care sit on what's committee | Utilization Review committee. URC
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| When a person is referred to a specialist, what do you need to obtain first | Authorization
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| Does Medicare B cover preventative services? | Yes. Medically necessary ones too
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| Factory to use when determining the correct E&M codes | Place, type of service and patient status
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| What happens when a patient signs the assignment of benefits block on the insurance claim form | The payment goes to the provider
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| When looking for a ICD code, you find the. Sin term in the alphabetic index then what? | Cross reference code in tabular list.
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| According to what is medically necessary, what do you need to do in order to get services covered? | Diagnose and treat
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| Coding in the ICD book, what do you look up first? | The condition, then location
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| Why are E&M codes in the front | Most commonly used
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| How many excludes notes in ICD-10CM | 2
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| Which coding system uses a five letter alph-numeric format that begin with letters A-V and addresses services not covered in the CPT codes, such as pharmaceuticals, supplies and ambulance services? | HCPCS
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| Tell me about ICD-9 | Divided in 3 volumes, has fewer codes than 10, first digit can be alpha or numeric
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| X as a placeholder is for what? | Future expansion
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| Which reimbursement form can be mostly filled out using the EHR? | CMS 1500
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| What does a patient need to do before doctors office sends out claim form to the ins. Co.? | ROI. Because sometimes the offices needs to send out chart notes
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| Where is case management covered? | E&M section of the CPT code book
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| Perks of a PAR provider? | Direct reimbursement, free advertising, 800 numbers...
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| The words problem focused, expanded problem focused, detailed, and comprehensive talk about? | History and physical examination
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