Lesson 2 Terminology

Question 1

•What is the most common claim form used to request payment for services rendered by the healthcare provider?

Answer 1

• CMS-1500 form

Question 2

• who uses the CMS-1500 claim form ?

Answer 2

• Physicians offices and government programs use this form

Question 3

• what is the design and maintenance of form CMS-1500 ?

Answer 3

• the design and maintenance is the National Uniform Claim Committee or the ( NUCC)

Question 4

• Before the CMS-1500 form was standard what form was used ?

Answer 4

• 1st Providers used the HCFA-1500

Question 5

• What other way can the CMS-1500 form be referenced?

Answer 5

• in 2014 version 08/05 was updated to 02/12 an referenced as CMS-1500(02/12)

Question 6

• The UB-04 form is also known as as what?

Answer 6

• also known as CMS-1450

Question 7

• Where is the UB-04 uniform claim form used ?

Answer 7

• Used in hospitals and other impatient settings

Question 8

• what committee is responsible for the design and printing of the UB-04 claim form ?

Answer 8

• The National Uniform Billing Committee or the ( NUBC)

Question 9

•what did the NUBC do in 1982 that was so significant?

Answer 9

• the NUBC accepted the UB-82 as a National Uniform bill for hospitals

Question 10

What is a CMS-1500 claim form

Answer 10

• Is the document that is completed and submitted to an insurance carrier to request reimbursement, services rendered

Question 11

• After 8 years what did the NUBC DO?

Answer 11

• the NUBC improved on the claim form resulting in the UB-92

Question 12

• in 2007 the UB-04 was updated again and turned into what?

Answer 12

• in 2007 it was turned into The Mandated Claim for inpatient Services

Question 13

• After a patients office visit, tests and other procedures are done what is then done

Answer 13

• A claim form is then completed

Question 14

• claim forms require special close to identify the diagnosis and procedure
~True or false?

Answer 14

• True

Question 15

• what is medical coding?

Answer 15

• Is the translation of medical record documentation of illnesses diseases and injuries treatments and procedures

Question 16

• medical coding is anything the physician does to determine the diagnosis and treatment and procedures into numeric and alphanumeric characters .
~true or false?

Answer 16

• True

Question 17

•In medical billing Numeric and alphanumeric characters are done what with ?

Answer 17

• these characters are then submitted for reimbursement purposes and statistical analysis

Question 18

• what are the tools medical coding specialist you utilize to transfer documentation?

Answer 18

• ICD-9-CM volumes 1,2,and,3 ; CPT, HCPCS, ICD-10-CM and ICD-10-PCS manuals

Question 19

• what does accurate and complete coding in ensures ?

Answer 19

• it ensures maximum reimbursement and provides meaningful statistics Assist the nation with healthcare Nene

Question 20

• what is ICD –9- CM Stand for ?

Answer 20

• International classification of Diseases 9th Revision Clinical Modification

Question 21

What is ICD-9-CM used for ?

Answer 21

• to determine diagnostic codes for both inpatient and outpatient services and inpatient procedures