HCR 220 UOP Tutorials,HCR 220 UOP Assignments,HCR 220 UOP Entire class Flashcards
HCR 220 Week 9 Final Project How HIPAA Violations Affect The Medical Billing Process
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Part One:
Resources: Appendix A, Appendix C, and Table 8.3 on pp. 258–259 of Medical Insurance
Refer to Table 8.3 on pp. 258–259 of your text to complete the CMS-1500 form, located in Appendix C, according to the following case study:
A 67-year-old Medicare patient presents to the office, exhibiting symptoms of HIV infection. After detailed examination, symptoms are determined to be advanced AIDS with manifestation of Kaposi’s sarcoma and other opportunistic infections.
Name: James Brown
Account Number: 080811
Insurer: Medicare
Policy Number: 1098765
ID number: 12345678910
DOB: 02/01/1940
Gender: Male
Insured: James Brown
Address: 1600 Pennsylvania Ave.
Wash. D.C. 60000
Marital Status: Widowed
Patient’s Employer: Retired
Nature of Condition: HIV, AIDS, Kaposi’s sarcoma
Date of Illness: 06/01/2007
Referring Physician: Thomas Glassman, M.D.
Physician ID: 1080808080
Federal Tax ID: 5551116679
Dates of Service: 06/01/2007, 06/15/2007, 07/07/2007, 08/01/2007
Procedure: Detailed examination, screening blood panel, pathology services
Patient Signature
Include ICD (categories only), CPT, HCPCS, and insurance information.
If you believe there is insufficient information provided to fill a required field with data, indicate this by typing N/A.
Post the completed CMS-1500 form as an attachment.
Final Project: How HIPAA Violations Affect the Medical Billing Process
Part Two:
Write a 1,500 to 1,750 word essay in which you discuss implications of both forms of the patient’s diseases, HIV and AIDS, from the perspective of HIPAA confidentiality. Include the following in your essay:
Discuss why HIV and AIDS information is more sensitive than other types of health conditions.
Examine the social, legal, and ethical ramifications of improper information disclosure.
Provide a minimum of three references from the University Library or the Internet.
Your paper must be formatted according to APA standards to be graded.
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HCR 220 Week 9 Capstone CheckPoint
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Post a 250 to 300 word response in which you explain, in your own words, how HIPAA, ICD, CPT, and HCPCS influence each of the ten steps of the medical billing process.
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HCR 220 Week 8 DQ 2
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Why is it important to prepare a clean claim? What suggestions might you make to ensure that submission of a clean claim takes place? Provide examples.
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HCR 220 Week 8 DQ 1
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How are the data elements contained in the HIPAA 837 claim form similar to the CMS-1500, and how does each form relate to the claims process? In your opinion, do the similarities between HIPAA 837 and CMS-1500 complicate or simplify the claims process? Explain your answers.
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HCR 220 Week 7 Individual Assignment Evaluating Compliance Strategies
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Write a 750 to 1,050 word essay evaluating billing and coding compliance strategies. In your essay, provide an overview of the compliance process, and offer your judgment either supporting or criticizing a particular method. Make suggestions for improvement at the end of your evaluation.
Address the following questions in your essay:
What is the importance of correctly linking procedures and diagnoses?
What are the implications of incorrect medical coding?
How are medical coding, physician, and payer fees related to the compliance process?
Provide a minimum of one reliable reference from the University Library or the Internet.
Your paper must be formattedaccording to APA standards to be graded.
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HCR 220 Week 7 CheckPoint Errors And Compliance In Coding
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Resource: pp. 207 & 211 of Medical Insurance, and Medical News Today Web site athttp://www.medicalnewstoday.com/
Review the NPR Web site athttp://www.npr.org/templates/story/story.php?storyId=5348863
Write a 250 to 300 word response to the following:
Briefly explain causes and solutions for three of the most common billing and coding errors. What effect does the Medicare National Correct Coding Initiative have on the billing and coding process? Explain your answers.
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HCR 220 Week 6 DQ 2
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Briefly explain the steps used to assign HCPCS codes for billing purposes. Do you believe it is more or less efficient to use different billing procedures for Medicare, Medicaid, or private payers? Why or why not? What are advantages and disadvantages of having unique coding systems for each type of insurance?
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HCR 220 Week 6 DQ 1
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How are permanent codes different from temporary codes? What could be the result of a system without permanent codes? Provide examples in your answer.
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HCR 220 Week 6 CheckPoint Applying Level II HCPCS Modifiers
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Resource: Table 5.2 on p. 154 of Medical Insurance
Complete the exercise by identifying the correct CPT modifier to its corresponding procedure for the following: Bilateral procedures Multiple procedures Prolonged evaluation and management Unusual anesthesia Mandated services
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HCR 220 Week 5 Individual Assignment Assigning Evaluation And Management Codes
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Assignment: Assigning Evaluation and Management (E/M) Codes
Resources: Figure 5.3 on p. 161, and Table 5.4 on p. 165 of Medical Insurance
Assign appropriate E/M codes for the following five cases:
Initial consultation performed for a 43-year-old woman with unexplained weight loss, abdominal pain, and rectal bleeding. A comprehensive history and examination is performed.
A 32-year-old patient presents complaining of flu-like symptoms characterized by unremitting cough, sinus pain, and thick nasal discharge. An examination reveals bronchitis and sinus infection. The patient is prescribed a 7-day course of Zithromax.
Established patient on Lithium presents for routine blood work to monitor therapeutic levels and kidney function. A nurse reviews the results and advises the patient that tests are normal, and no change in dosage is indicated.
A 78-year-old diabetic female presents for check-up and dressing change of wound on left foot. An examination reveals the wound is healing. The nurse applied new dressing and patient will return for a check-up in one week.
A mother brings in her 4 ½ month-old baby for a routine wellness check. An examination reveals the child to be in good health and making adequate progress.
Provide the rationale you used to assign a particular E/M code in 2 to 3 complete sentences for each of the case studies.
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HCR 220 Week 5 Exercise Working With CPT Modifiers
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Resource: Table 5.2 on p. 154 of Medical Insurance
Complete the exercise by identifying the correct CPT modifier to its corresponding procedure for the following: Bilateral procedures Multiple procedures Prolonged evaluation and management Unusual anesthesia Mandated services
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HCR 220 Week 5 CheckPoint Describing CPT Coding Categories
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Resource: p. 145 of Medical Insurance
Write a 250 to 300 word response in which you assume you are a medical office manager who wants to make the coding process easier for employees to understand.
To facilitate better understanding of this process, respond to the following:
Come up with buzzwords or slogans that would best describe the three CPT code categories.
What types of procedures or services are included in each of the three CPT code categories?
Provide one example for each category in your description.
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HCR 220 Week 4 DQ 2
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What is the main distinction between V and E codes? How are they similar or different? What are your suggestions to streamline the V and E coding process? Explain your answers.
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HCR 220 Week 4 DQ 1
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Suppose you were helping a new office file clerk who was curious about the coding process. How would you explain appropriate use and purposes of the Alphabetic Index and Tabular List to the file clerk? What problems might occur if proper coding procedures are not used? Provide examples of problems and propose solutions.
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HCR 220 Week 4 CheckPoint Determining Diagnosis Code Categories
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Resource: pp. 130-135 of Medical Insurance
Post a response to the following: Determine a diagnosis code category for the following case studies and explain the rationale for your selections:
A 56-year-old woman presents to the office complaining of pronounced weakness on the right side of her body and slurred speech for the past 18 hours. Based on the examination, the physician orders an MRI to investigate a possible transient ischemic attack (TIA). A 42-year-old man comes to the office complaining of intermittent chest pain. The physician orders an EKG to rule out a possible cardiac event. A 23-year-old diabetic female exhibits a non-healing wound on her left foot.
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