WEEK FOURTEEN

Question 1

International Classification of Diseases (ICD-10CM)

Answer 1

maintained by World Health Organization (WHO)

established to track morbidity(disease) and mortality(death) rates

Question 2

how characters for diagnosis code

Answer 2

three to seven characters

Question 3

first diagnose code

Answer 3

alphabetical

Question 4

second and third diagnose code

Answer 4

numeric

Question 5

fourth to seventh diagnose code

Answer 5

either alphabetical numeric

Question 6

what is needed before writing codes

Answer 6

• chief complaint
• review of systems
• patient exam
• proper documentation by both physician and medical assistant

Question 7

starting point for coding

Answer 7

alphabetic index
(no final code from this section)

Question 8

the tabular list

Answer 8

21 chapter of disease descriptions/codes based on body system or condition
(choose final code)

Question 9

ICD10- Z Codes is for..

Answer 9

when a person who may or may not be sick encounter heath service for some specific purpose.

when some circumstance or problem is present which influences the person’s health status but is not in itself a current injury or illness

Question 10

current procedural terminology (CPT)

Answer 10

document procedures and services in outpatient setting

usually 5 digit numerical

explains what services were provided

CODE MUST LINK WITH DIAGNOSIS

Question 11

Modifiers

Answer 11

help further describe a procedure code without changing its definition

Question 12

E & M codes

Answer 12

Evaluation and Management codes

use CPT code from the range 99202 to 99499

represent services provided by a physician or other qualified healthcare professional

Question 13

HCPCS

Answer 13

Healthcare Common Procedure Coding

Question 14

Level II HCPCS codes

Answer 14

designed to represent non-physician services

(ambulance rides, wheelchairs, walkers, other durable medical equipment, and other medical services)

Question 15

reasons for diagnostic codes

Answer 15

• facilitation of payment
• evaluation of care patterns
• study healthcare costs
• research
• prediction of trends
• planning for future

Question 16

Superbill

Answer 16

ICD-10 codes assigned by provider and used to justify CPT codes

Question 17

Downcoding

Answer 17

-reimbursement on a lower code level than submitted
- lack of documentation most common cause

Question 18

Upcoding

Answer 18

• reimbursement on a higher code level than submitted for a higher fee
• fradulent

Question 19

NPI

Answer 19

National Provider Identifier
- unique ID number for covered health care providers
- must be used when using clearinghouses

Question 20

problem-focused examination

Answer 20

a limited examination of the affected body or organ system

Question 21

expanded problem focused examination

Answer 21

a limited examination of the affected body area or organ system, and any other symptomatic or related body area or organ system

Question 22

detailed examination

Answer 22

an extended examination of the affected body area or organ system and any other symptomatic or related to it

Question 23

comprehensive examination

Answer 23

a general multi system examination or complete examination of a single organ system and other symptomatic or related body area(s) or organ system(s)