Coding

Question 1

Which of the following manuals is used for diagnostic coding?

Answer 1

ICD-10-CM

Question 2

Which of the following represents the reason for a patient visit?

Answer 2

A code that represents the reason for a pt. visit.

Question 3

Which of the following best describes a procedural code?

Answer 3

A code that represents the service performed by the physician.

Question 4

Which of the following organizations publishes the CPT manual?

Answer 4

The American Medical Association (AMA)

Question 5

1830

Answer 5

International List of Causes of Death reported data on causes of death and documented diseases classified by anatomical location around the world

Question 6

1893

Answer 6

Bertillon Classification of Causes of Death later became known as International Classification of Causes of Death used as the standard in North merica until the mid-twentieth century.

Question 7

1948

Answer 7

World Health Organization (WHO) published reports on disease and causes of death in the International Classification of Disease. This document was used to index hospital records, categorizing them for medical research.

Question 8

1977

Answer 8

The US began using the International Classification of Disease to code medical records acording to diagnoses. This allowed diseases to be classified and studied.

Question 9

1979

Answer 9

Classification was modified for medical billing and insurance claims, and is used in the medical office today. The International Classification of Disease, 10th Edition, Clinical Modification, or ICD-10-CM

Question 10

2015

Answer 10

ICD code set is updated periodically to reflect changes in medicine and clinical practice. On October 1, 2015, the code was updated to the ICD-10 code set.

Question 11

In what year did CPT codes become a part of the HCPCS coding system?

Answer 11

1983

Question 12

ICD

Answer 12

International Classification of Diseases are published by the United States Department of Health and Human Services, and is supervised on an international level by the United Nations World Health Organization
A12.3456

Question 13

ICD code set

Answer 13

• used in the medical office to provide diagnostic codes
• The ICD-10-CM code set is 3-7 charcters long and each code starts with a letter, and then a three character code before a decimal point
• represented by the first three characters

Question 14

CPT Codes

Answer 14

Current Procedural Terminology, provides diagnostic, therapeutic, and surgical codes for all services that medical staff may perform. The CPT codes were added as a part of HCPCS code set, and sometimes referred to as a Level 1 HCPCS code.
-used to report procedure performed and used for reimbursement
-five numbers long and doctors can add a modifier
12345-12

Question 15

HCPCS

Answer 15

maintaned by the Centers for Medicare and Medicaid Services (CMS). Requires use of HCPCS codes and its claims, and only accepts CPT codes when there is no HCPCS code that is available. HCPCS codes known as Level II odes represent a variety of medical services, supplies, drugs, and durable medical equipment not found in CPT codes.
-Required for reporting of all Medicare Part B claims

Question 16

In which coding system would a MA find codes for durable medical equipment?

Answer 16

HCPCS

Question 17

Which set of codes was adopted as a part of the HCPCS coding system?

Answer 17

CPT

Question 18

What two reasons do medical offices use ICD, CPT, and HCPCS for coding?

Answer 18

• to keep statistical data within an office

- to communicate with insurance carriers

Question 19

Why is coding used in the medical office?

Answer 19

• to keep statistical data

- to communicate with insurance carriers

Question 20

What is the purpose of modifiers?

Answer 20

To further specify the codes

Question 21

Diagnostic codes

Answer 21

codes that refer to the physician’s diagnosis, the codes are used to record and track statistical healthcare data. Diagnostic code aid in the insurance claim process, the actual amount of payment recieved from the insurance company is based on the procedure.

Question 22

Accurate diagnostic coding is important to both financial and legal status of the medical practice because improper coding can….

Answer 22

• result in a reduced reimbursement from insurance carriers

- If improper codes are in result fraud or abuse, civil or criminal penalties can be assigned.

Question 23

Which of these best defines a primary diagnosis?

Answer 23

The most significant condition for which service was provided.

Question 24

In what order should secondary diagnoses be documented?

Answer 24

According to the coding guidelines

Question 25

Which typer of ICD-CM-10 is not generally used for coding in the medical office?

Answer 25

ICD-10-PCS

Question 26

What are the four sections of the ICD?

Answer 26

• The Index to Diseases
• Neoplasm Table
• Table of Drugs and Chemicals
• Index to the External Cause of Injury and Poisoning

Question 27

If a patient is diagnosed with a fractured ankle, which of the following terms should be used as a main term?

Answer 27

Fracture

Question 28

What kind of central modifiers in diagnostic coding be used for?

Answer 28

Specify the location of an injury, specify the type of illness, specify the cause of an illness or injury, all of the above.

Question 29

When coding a diagnosis, in which volume of the ICD-10-CM should the assistant look to first?

Answer 29

Volume 2

Question 30

An essential modifier, if available, must be included into the code.

Answer 30

True

Question 31

A manifestation should be documented as a primary diagnosis.

Answer 31

False

Question 32

From which volume of the ICD-10-Cm should the final code for the insurance claim come?

Answer 32

Volume 1

Question 33

Codes selected should be the LEAST specific available, because this gives more chances for reimbursement.

Answer 33

False

Question 34

What does it mean when a code in Volume 1 of the ICD-10-CM is highlighted in yellow?

Answer 34

Unspecified

Question 35

Procedure for Performing Diagnostic Coding

Answer 35

1. Prepare for Procedure
2. Determine the Diagnosis
3. Use the ICD-10-CM
4. Assign the Code

Question 36

After detemining the appropriate cide, in which the following places should you document the code?

Answer 36

• On the patient’s medical record
• On the superbill
• On the claim form

Question 37

In which volume would you locate the main term?

Answer 37

Volume 2

Question 38

The main term will be an automatic site.

Answer 38

False

Question 39

After you locate the main term in Volume 2, where do you cross-reference the code?

Answer 39

On Volume 1

Question 40

Which of the following best describes a procedure?

Answer 40

The action a physician takes in response to a diagnosis.

Question 41

Which level of HCPCS is actually the American Medical Association’s CPT-4

Answer 41

Level 1

Question 42

How many digits does a procedural code have?

Answer 42

Five, with two-digit, optional modifiers

Question 43

HCPCS Level III codes are no longer used for Medicare reporting

Answer 43

True

Question 44

Main terms in procedural coding systems, such as the CPT-4, can be anatomical sites.

Answer 44

True

Question 45

What should the assistant read before performing procedural coding?

Answer 45

The CPT-4 manual guidelines

Question 46

In the CPT-4 Index, what will you find indented underneat main terms?

Answer 46

Subterms

Question 47

What should the assistant do when a code range is given in the CPT-4 Index?

Answer 47

Read through the entire code range

Question 48

If procedure is performed by more than one physician a modifier should be used.

Answer 48

True

Question 49

If assistant cannot find an appropriate procedural code in the CPT-4, where should the assistant look next?

Answer 49

HCPCS Level II

Question 50

In the CPT-4, after you locate the code for the main term in the alphabetic index, where should you reference it?

Answer 50

In the main section of the manual

Question 51

What documents would you use to determine the procedure?

Answer 51

The physicians clinical notes and the superbill