Thriteenth Test Flashcards

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1
Q

Hospital insurance began in

A

1929

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2
Q

Medicare and Medicaid were enacted in

A

1965

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3
Q

In 2010 the health insurance exchange debated as a part of the Patient

A

Protect and affordable care act

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4
Q

The person who owns an insurance policy is called the

A

Member, subscriber insured or policy holder

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5
Q

Those covered by government insurance programs aer known

A

as beneficiary

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6
Q

Dependents are Family members also covered on

A

commercial insurance plans.

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7
Q

List three common types of out-of-pocket expenses.

A

Deductible
Copay
Coin insurance

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8
Q

List the groups of people eligible for government health insurance.

A

Older adults
Disabled
Military personnel
retired

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9
Q

Medicare part B covers what

A

phusician care, therapy, and
testing, and members must pay
-based premiums because Part b is a voluntary program.

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10
Q

Medicare Part C is known as the _medicate choice
and si often sold by

A

private insurance companies offering all parts of Medicare

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11
Q

Medciare Part D covers _

A

prescription drugs through private companies contracted with Medicare

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12
Q

Medicaid covers

A

low income patients

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13
Q

TRICARE provides health insurance benefits to family’s of

A

current and retired military personnel

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14
Q

workers compensation insurance covers workers who have been

A

injured in the work place or as a result of a work related illness

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15
Q

Disability income insurance is either

A

Short term or long term

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16
Q

The Family medical leave Act allows employees to take

A

unpaid leave for specified family and medical reasons, while protecting their jobs

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17
Q

The national prouder Identifer is a

A

unique, 10 digit number assigned to health care providers by CMS.

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18
Q

The CMS-1500 form is printed in a specific color of _

A

Red ink so that it is recognizable by OCR scanners.

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19
Q

Insurance companies may accept claims for as long as up to

A

one year from the date of service or for as little as _90 days

20
Q

Diagnosis

A

codes identify the reasons that health care services were provided.

21
Q

Procedure

A

codes describe services performed for patient

22
Q

Physicians

A

are responsible for coding and billing for all the services the personally provide 4 The Medical Assistant’

23
Q

The MAs’ role regarding coding involves the following.

A

assisting communication between physicians and coders when a question arises

24
Q

The Bertilon Classification of Causes of Death was adopted in

A

1098 by the American Public Health Association (APHA).

25
Q

The patient protection and Affordable care act mandates

A

compliance programs for providers who contract
with Medicare and Medicaid.

26
Q

Thsi is an alphabetically sequenced list of diagnostic codes divided into

A

21 chapters based on the cause of the cause or etiology and body system

27
Q

Verify the code(s) in the

A

Tabular List

28
Q

List the three tabulated levels within the sections.

A

Category three character entries
Subcategory Four- and five-character entries)
the most specific entry that requires no additional characters)

29
Q

ICD-10-CM codes can be between

A

Three and seven characters in length.

30
Q

CPT stands for

A

Current procedural Terminology.

31
Q

The first edition of the CPT was published ni

A

1966 in the American Medical Association, and codes were four numbers long.

32
Q

The second edition of the CPT published in

A

1970 expanded Surgical procedures.

33
Q

The fourth edition, which si used today, was published in

A

1977

34
Q

Only one code is

A

correct in any given situation.

35
Q

upcoding Is billing

A

for a higher level of service than was actually provided in order ot gain higher reimbursement.

36
Q

downcoding is coding for

A

a lower level of service than was actually provided.

37
Q

Examples of abuse

A

Charging excesively high fees for Services or SUPPlies

38
Q

The C M S website offers information to consumers and patients

A

to encourage them to identify and _report fraud

39
Q

The tabular list si a(

A

Numerical listing of al CPT codes, divided into threw categories

40
Q

Appendix A

A

Modifiers

41
Q

Apendxi B:

A

Summary of Additions

42
Q

Appendix C:

A

Clinical examples

43
Q

The surgical section is the

A

largest section in the CPT manual.

44
Q

Immunizations require 2 codes

A

one of that _administering of the immunization and one for the particular. Vaccine or toxin

45
Q

E&M codes begin with the numbers

A

99

46
Q

List five services billed in addition to the E&M code.

A

Venipuncture
Immunization
ECGS EKG
ab test performed in office.
X-rays