Chapter 3 and 4 Flashcards
(16 cards)
The patient encounter begins with what step?
Scheduling an appointment.
Which of the following does not qualify a patient for coverage under Medicare?
A. End stage renal failure
B Age 65 and older C Under age 65 with disabilities
D Low-income individual
Low-income
What is a claim that is sent for reimbursement that contains all the required data elements to process the claim referred to as?
Clean claim
Listed below are examples of patient reminders for appointments. Which one is HIPAA compliant?
This is the obstetrical office calling to remind you of your appointment Tuesday, April 12 at 9 am for your annual exam.
B.This is Dr. Smith’s office calling to remind you of your appointment Tuesday, April 12 at 9 am for your annual exam.
C.This is to confirm your appointment for your first prenatal visit with Dr Jones. Please notify us if you are not able to keep this appointment.
D.This is the doctor’s office calling to remind you of your appointment Tuesday, April 12 at 9 am.
D
A child is brought into the doctor’s office by the mother to be seen. The mother (DOB 02/08/93) is the custodial parent and is remarried. She has an individual policy. The father (DOB 10/10/92) is covered by a policy from work. The stepfather is also covered at work. Whose insurance is primary?
The mother’s insurance is primary.
What is the abbreviation that indicates a provider has documented a specific diagnosis but there is not a code for that specificity?
NEC
If a patient has acute diastolic heart failure, what is the main term that is used in the ICD-10-CM Alphabetic Index?
Failure
Which sections of ICD-10-CM does a biller use to code for a physician’s office?
ICD-10-CM Alphabetic Index and Tabular List
In looking at the following listing in the ICD-10-CM Alphabetic Index, what coding is for curvature of the spine due to Charcot-Marie-Tooth disease?
Curvature
spine (acquired) (angular) (idiopathic) (incorrect) (postural) –see Dorsopathy, deforming
congenital Q67.5
due to or associated with
Charcot-Marie-Tooth disease (see also subcategory M49.8) G60.0
Two codes may be required; double check the Tabular List to be sure both codes are accurate and determine which to code first.
There is a see also note in parenthesis which means that there is anothe
In looking at the notes with this code, which statement is TRUE?
K67 Disorders of peritoneum in infectious diseases classified elsewhere
Code first underlying disease, such as:
congenital syphilis (A50.0)
helminthiasis (B65.0-B83.9)
Excludes1:peritonitis in chlamydia (A74.81)
peritonitis in diphtheria (A36.89)
peritonitis in gonococcal (A54.85)
peritonitis in syphilis (late) (A52.74)
peritonitis in tuberculosis (A18.31)
B.Code K67 may be coded with code A
Code K67 may be a first-listed code
C - K67 may never be coded with codes A74.81, A36.89, A54.85, A52.74 and A18.31
What is/are the correct codes for a patient with Type 1 diabetic neuropathy?
E10.40
How many chapters doe ICD-10-CM contain?
22
What general guideline is addressed in I.C.1.a.2.c?
Whether the patient is newly diagnosed.
What are the correct codes for benign hypertensive heart disease and stage 3a chronic kidney disease?
I13.10, N18.31
What is/are the correct codes(s) for a patient with acute on chronic maxillary sinusitis?
J01.00, J32.0
