Medical Billing and Coding pt 2 Flashcards
What code would you use for DME’s (durable medical equipment)
HCPCS
List some common billing errors that can be made
upcoding unbundling assumption coding
How much would a patient owe for a noncovered service costing $900 if their insurance policy has a coinsurance rate of 80-20, and they have already met their deductible?
$900 because of non-coverage services
Managed care organizations and indemnity plans typically offer what kind of plans?
Lower premiums and lower deductibles
Define coinsurance
percentages of each claim that the insured pays
What is considered “out-of-network” for insurance.
Not under contract
What are the three key components of E/M coding?
History, exam and medical decision making
- How should you code if a diagnosis is not established?
Describe symptoms and signs
Where do medical insurance companies summarize the payments they may make for medically necessary medical services?
Schedule and benefits
