Insurance claims management Flashcards
ICD classification of drugs is located?
Appendix C.
A health care entitlement program for the indigent that is funded by both state and federal revenues but is administered by the state is
medicaid
Care that is financed according to a fixed, prepaid payment for each enrolled patient during a fixed period, usually annually is called
capitation
The ICD Classification of Industrial Accidents According to Agency is
Appendix D
Existing CPT codes are represented by HCPCS
Level 1
The CPT symbol located on the left side of a code number indicating a new procedure is
bullet (•)
The ICD List of Three-Digit Categories is
Appendix E
The CPT symbol located after a code number indicating variable preoperative and postoperative services is
asterisk (*)
Title 18 of the Social Security Act best describes
Medicare
A fixed, prepaid fee per person enrolled in a managed care program is a(n)
capitation
Determining medical necessity before a hospital admission is approved is called
preadmission certification
COBRA requires that government claim forms and attachments be maintained for at least
5 years
Anesthesiology is a section in which coding system?
CPT
Title 19 of the Social Security Act best describes
medicaid
Which of the following acronyms refers to procedural coding?
CPT- current procedural terminology
Which of the following codes best characterizes a HCPCS Level II code?
V4995
Medicare Part B covers
outpatient care
The method of controlling health care delivery by reviewing the appropriateness and necessity of care before (prospectively) and after (retrospectively) the care is provided is called
utilization review
A term after the brace ( } ) indicates
a required modifier of the statement before the brace
The CPT symbol indicating a code description has been revised is
triangle (▲)
Which of the following acronyms refers to diagnosis coding?
ICD-International Classification of Diseases
The ICD Glossary of Mental Disorders is
Appendix B
EPSDT stands for
Early and Periodic Screening, Diagnosis, and Treatment
A group of procedures associated with a diagnosis is called
DRG-Diagnosis related group
