Lesson 2 Terminology Flashcards
(21 cards)
•What is the most common claim form used to request payment for services rendered by the healthcare provider?
• CMS-1500 form
• who uses the CMS-1500 claim form ?
• Physicians offices and government programs use this form
• what is the design and maintenance of form CMS-1500 ?
• the design and maintenance is the National Uniform Claim Committee or the ( NUCC)
• Before the CMS-1500 form was standard what form was used ?
• 1st Providers used the HCFA-1500
• What other way can the CMS-1500 form be referenced?
• in 2014 version 08/05 was updated to 02/12 an referenced as CMS-1500(02/12)
• The UB-04 form is also known as as what?
• also known as CMS-1450
• Where is the UB-04 uniform claim form used ?
• Used in hospitals and other impatient settings
• what committee is responsible for the design and printing of the UB-04 claim form ?
• The National Uniform Billing Committee or the ( NUBC)
•what did the NUBC do in 1982 that was so significant?
• the NUBC accepted the UB-82 as a National Uniform bill for hospitals
What is a CMS-1500 claim form
• Is the document that is completed and submitted to an insurance carrier to request reimbursement, services rendered
• After 8 years what did the NUBC DO?
• the NUBC improved on the claim form resulting in the UB-92
• in 2007 the UB-04 was updated again and turned into what?
• in 2007 it was turned into The Mandated Claim for inpatient Services
• After a patients office visit, tests and other procedures are done what is then done
• A claim form is then completed
• claim forms require special close to identify the diagnosis and procedure
~True or false?
• True
• what is medical coding?
• Is the translation of medical record documentation of illnesses diseases and injuries treatments and procedures
• medical coding is anything the physician does to determine the diagnosis and treatment and procedures into numeric and alphanumeric characters .
~true or false?
• True
•In medical billing Numeric and alphanumeric characters are done what with ?
• these characters are then submitted for reimbursement purposes and statistical analysis
• what are the tools medical coding specialist you utilize to transfer documentation?
• ICD-9-CM volumes 1,2,and,3 ; CPT, HCPCS, ICD-10-CM and ICD-10-PCS manuals
• what does accurate and complete coding in ensures ?
• it ensures maximum reimbursement and provides meaningful statistics Assist the nation with healthcare Nene
• what is ICD –9- CM Stand for ?
• International classification of Diseases 9th Revision Clinical Modification
What is ICD-9-CM used for ?
• to determine diagnostic codes for both inpatient and outpatient services and inpatient procedures
