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Billing & Coding > CBCS Coding Exam > Flashcards

CBCS Coding Exam Flashcards

0
Q

A health record is derived from

A

1st medical treatment

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1
Q

What is health record?

A

Written information about patient collected from varies medical sorts

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2
Q

In the context do medical legal, what is the main record?

A

Unbiased opinion about patient conditions

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3
Q

How many health record should be kept on each patient

A

One

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4
Q

In a source oriented medical record the information about a patients care and illness is typically organized accounting to

A

Source & Chronological

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5
Q

What is flow sheet for?

A

The patient progress

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6
Q

Flow sheets are often used with what kind of health record

A

Source oriented

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7
Q

Progress notes are in what format

A

Flow sheets

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8
Q

Healthcare location and setting information is typically capture by

A

SYNOPSIS and preexisting pre established

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9
Q

What the most common form of database used in health care industry?

A

Rational Data base

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10
Q

What is a warehouse?

A

Central accessible location

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11
Q

What is the foundation do every health database system

A

TABLE

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12
Q

A master table has a list of variable that represent

A

The range of attributes

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13
Q

What refers to one or more data attributes that uniquely identify an entity?

A

Primary key - PK

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14
Q

In the US what often being considered for use as the choice patient identifier?

A

SS

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15
Q

The health care financing administration HCFA has produce a popular provider identifier known as

A

UPIN - Universal physician identifier pin

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16
Q

The health industry number HIN was issued by. The health industry business communications council HIBCC to serve as

A

Identifier for health facilities , retail, pharmacies, physical

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17
Q

The labeled identification code LIC is issued by HIBCC for identifying

A

Manufacturer or distributors

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18
Q

The universal product code (UPC) is maintain by the uniform code council for

A

Retail Product sold

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19
Q

The responsibility for the accuracy and completeness of a health record rests with

A

The attending doctor

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20
Q

What plays a strategic role I providing access to computerized health information

A

Clinical vocabularies

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21
Q

Standard vocabularies are a means a of

A

Encoding data for exchange

22
Q

The joint commission on the accreditation of Healthcare Organizations (JCAHO) sets stand for

A

Health care organizations

23
Q

The health Information and Management Systems Society (HIMSS) is a membership organization which focuses on advocating

A

Optimal use of healthcare information technology

24
Q

What is medicare

A

Federal health insurance program for the elderly

25
Q

Medicare has how many parts

A

4 parts - A&B - Hospital & Medical

C&D - Flexibility prescriptions

26
Q

What is Tricare

A

Military healthcare for families

27
Q

Primary care refers to

A

Principle point of consultation of patient

28
Q

Secondary care refers to

A

Specialize not first contact of patient

29
Q

Tertiary care refers to

A

Specialize with equipment in office for advance investrgation

30
Q

Quaternary care is an extension of

A

Tertiary care

31
Q

Define Electronic Health Record

A

Patient health record generated at an medical facility

32
Q

The ASTM standard ________ outlines practice for Content and Structure of the EHR

A

E1384

33
Q

__________ is a specific kind of digital medical record intended to be easily transported

A

Ambulatory

34
Q

Compare EMRs with EHRs

A

Computerize vs Shared Records with other medical & government clinic records

35
Q

What is Clinical data repository

A

Real time transactions

36
Q

What is HL7 for

A

Health related data exchange in (North America)

37
Q

What is the preeminent healthcare IT standards developing organization in Europe

A

CENTC 215

38
Q

HCPCS Codes are in fact based on what codes

A

CPT Codes

39
Q

HCPCS Level I codes are identical to what codes

A

CPT Codes

40
Q

HCPCS Level II codes are used mostly by

A

Medical supplier and equipment

41
Q

The In tern atonal Classification of Disease ICD is published by

A

WHO - World Health Organization

42
Q

The ICD CM (Clinical Modification) is developed by

A

national Center of Health Statices

43
Q

The ICD CM has the purpose of

A

Classifying mobility from patient records

44
Q

The ICD Provides a format for reporting cause

A

Of death on death certificate

45
Q

At the time a patient presents with an un diagnosed illness the ICD-9 code would be determined by

A

Signs & Systems

46
Q

Definitive ICD-9 codes should NOT be assigned and recorded in the medical record UNTIL AFTER

A

Diagnosis is determined

47
Q

The ICF (International Classification of Functioning Disability and Health) classification is in a position to complement

A

The ICD-10

48
Q

The language of the ICF is said to be made neutral as to etiology thus placing the emphasis

A

On function NOT Condition or Disease

49
Q

Systematized Nomenclature of Medicine (SNOMED) is developed by

A

SNOMED INTERNATIONAL PART OF American Pathologists College (CAP)

50
Q

SNOMED is created for the indexing of

A

For medical records in a comprehensive, multi-axial and control terminology

51
Q

SNOMED (systematized Nomenclature of Medicine) CT (Clinical Terms) aims at specifying

A

Core file structure of SNOMED CT (clinical terms)

52
Q

Prospective payment system (PPS) are indexed to

A

Motivate providers to deliver patient care more effectively & efficiently

Billing & Coding (1 decks)

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