Coding Test Flashcards
30 Question Test on Day 8 10-26-2016
What mandates the approved CPT code sets for all covered entities, such as medical office, that handle claims related to health care services?
HIPAA (The Health Insurance Portability and Accountability Act)
Definition for Matching:
mistakenly accepting payment for items that should not be paid as a result of improper coding and billing practices
abuse
Definition for Matching:
following the rules established by government agencies
compliance
Definition for Matching:
knowingly billing for a service that were never given or billing for a service that has a higher reimbursement than the service actually provided
fraud
Written:
Briefly describe a reason as to why the medical assistant should be knowledgable about coding.
To assist in communication between coders and physicians when a question arises.
To provide appropriate diagnosis codes when an insurance preauthorization is required for a procedure, or when a patient is referred to another provider for a procedure or consultation.
To facilitate communication with attorneys who may need information about medical codes related to injured patients they represent.
To answer patient questions about the meaning of codes on their insurance claims or other paperwork.
To review or facilitate medical documentation to help ensure it provides adequate specificity for coding.
What is the maximum length of an ICD-10 code?
7 characters
True or False:
Recording incorrect diagnosis codes can be considered fraud.
True
True or False:
If the physician gives you a diagnosis verbally and it is not charted, you can code and bill for it.
False
How many characters are in a category code?
3 characters
Definition of an ICD-10-CM Convention:
When more than one code may be required to fully describe the condition
Code Also
Definition of an ICD-10-CM Convention:
When coder may refer to an alternative or additional main term if the desired entry is not found under the original main term
See Also
Written:
Name and briefly describe the use of one of the three additional references in the ICD manual.
Table of Neoplasms - used for cysts or lesions
Table of Drugs and Chemicals - used for poisoning, reactions to medication, or accidental overdose
Index to External Causes - used for outside conditions and injuries for example debree in the eye
True or False:
Coding is to be performed to the highest level of certainty.
True
Definition for Matching:
reexamination for accuracy
audit
Definition for Matching:
in procedure coding the number of days surrounding a surgical procedure during which all services relating to that procedure were performed
global period
Definition for Matching:
billing for a service at a higher level than was actually provided
upcoding
