Week 2 - Ch. 4 & 5

Question 1

value of estimates in patient treatment

Answer 1

helps the patient plan; helps the practice by collecting those fees as soon as possible; helps with confusion and expense with collections

Question 2

professional fees

Answer 2

amount the provider charges

Question 3

HIPAA mandated diagnosis code set

Answer 3

ICD-10-CM

Question 4

3-7 character alphanumeric representation of a disease or condition

Answer 4

code

Question 5

part of ICD-10-CM listing diseases and injuries alphabetically with corresponding diagnosis codes

Answer 5

alphabetic index

Question 6

part of ICD-10-CM listing diagnosis codes in chapters alphanumerically

Answer 6

tabular list

Question 7

summary table of code numbers for neoplasms by anatomical site and divided by the description of the neoplasm

Answer 7

neoplasm table

Question 8

index in table format of drugs and chemicals that are listed in the tabular list

Answer 8

table of drugs and chemicals

Question 9

index of all external causes of diseases and injuries classified in the tabular list

Answer 9

index to external causes

Question 10

physician’s description of the main reason for a patient’s encounger

Answer 10

diagnostic statement

Question 11

typographic technique that provides visual guidance for understanding information

Answer 11

convention

Question 12

word that identifies a disease or condition in the alphabetic index

Answer 12

main term

Question 13

ICD-10-CM code listed next to the main term in the alphabetic index that is most often associated with a particular disease or condition

Answer 13

default code

Question 14

word or phrase that describes a main term in the alphabetic index

Answer 14

subterm

Question 15

cause or origin of a disease or condition

Answer 15

etiology

Question 16

supplementary word or phrase that helps define a code in ICD-10-CM

Answer 16

nonessential modifier

Question 17

name or phrase formed from or based on a person’s name

Answer 17

eponym

Question 18

abbreviation indicating the code to use when a disease or condition cannot be placed in any other category

Answer 18

NEC (not elsewhere classifiable)

Question 19

term that indicated the code to use when no information is available for assigning the disesase or condition a more specific code

Answer 19

NOS (not otherwise specified)

Question 20

characteristic sign or symptom of a disease

Answer 20

manifestation

Question 21

code for diagnosis that is the patient’s main condition; in cases involving an underlying condition and a manifestatoin; the underlying condition is the

Answer 21

first listed code

Question 22

single code describing both the etiology and the manifestation(s) ofa a particular condition

Answer 22

combination code

Question 23

character “x” inserted in a code to fill a blank space

Answer 23

placeholder character (X)

Question 24

necessary assignment of a seventh character to a code; often for the sequence of an encounter

Answer 24

seventh character extension

Question 25

three character code for classifying a disease or condition

Answer 25

category

Question 26

four or five character code number

Answer 26

subcategory

Question 27

tabular list entries addressing the applicability of certain codes to specified conditions

Answer 27

inclusion notes

Question 28

tabular list entries limiting applicability of particular codes to specified conditions

Answer 28

exclusion notes

Question 29

exclusion note used when two conditions could not exist together; such as an acquired and a congenital condition; means “not coded here”

Answer 29

excludes 1

Question 30

exclusion note meaning that a particular condition is not included here; but a patient cound have both conditions at the same time

Answer 30

excludes 2

Question 31

use of ICD-10-CM classification system to capture the side of the body that is documented; the fourth; fifth; or sixth characters of a code specify the affected side

Answer 31

laterality

Question 32

general rules; inpatient (hospital) coding guidelines; and outpatient (physician/office/clinic) coding guidance from the four cooperating parties (CMS advisers and participants from the AHA; AHIMA; and NCHS)

Answer 32

ICD-10-CM Official Guidelines for Coding and Reporting

Question 33

first listed diagnosis

Answer 33

primary diagnosis

Question 34

additional illness that either has an effect on the patient’s primary illness or is also treated during the encounter

Answer 34

coexisting condition

Question 35

illness or condition with severe symptoms and a short duration

Answer 35

acute

Question 36

illness or condition with a long duration

Answer 36

chronic

Question 37

condition that remain after an acute illness or injury has been treated and resolved

Answer 37

sequelae

Question 38

in inpatient coding; the condition established after study to be chiefly responsible for the admission of the patient

Answer 38

principal diagnosis

Question 39

ICD-10-CM code for an external cause of a disesase or injury

Answer 39

external cause code

Question 40

abbreviation for codes from 21st chapter of the ICD-10-CM that indentify factors that infuence health status and encoutners that are not due to illness or injury

Answer 40

Z code

Question 41

patient’s description of the symptoms or other reasons for seeking medical care

Answer 41

chief complaint (CC)

Question 42

previous HIPAA mandated diagnosis code set

Answer 42

ICD-9-CM

Question 43

acronym for general equivalence mappings; reference tables of related ICD-10-CM and ICD-9-CM codes

Answer 43

GEMs

Question 44

contains the standardized classification system for reporting medical procedures and services

Answer 44

Current Procedural Terminology (CPT)

Question 45

procedure codes found in the main body of CPT

Answer 45

Category I Codes

Question 46

optional CPT codes that track performance measures

Answer 46

Category II Codes

Question 47

temporary codes for emerging technology; services; and procedures

Answer 47

Category III Codes

Question 48

usages notes at the beginning of CPT sections

Answer 48

section guidelines

Question 49

service not listed in CPT

Answer 49

unlisted procedure

Question 50

note explaining the reasons for a new; variable; or unlisted procedure or service

Answer 50

special report

Question 51

procedure performed and reported in addition to the primary procedure

Answer 51

add-on code

Question 52

most resource intensive CPT procedure during an encounter

Answer 52

primary procedure

Question 53

CPT procedure codes that have been reassigned to another sequence

Answer 53

resequenced

Question 54

number appended to a code to report particular facts

Answer 54

modifier

Question 55

reflects the technician’s work and the equipment and supplies used in performing it

Answer 55

technical component (TC)

Question 56

represents a physician’s skill; time; and expertise used in performing it

Answer 56

professional component (PC)

Question 57

codes that cover physicians’ services performed to determine the optimum course for patient care

Answer 57

E/M Codes (Evaluation and mangement codes)

Question 58

service in which a physician advises a requesting physician about a patient’s condition and care

Answer 58

consultation

Question 59

factor documented for various levels of evaluation and management services

Answer 59

key component

Question 60

patient who receives healthcare in a hospital setting without admission

Answer 60

outpatient

Question 61

code used with anesthesia codes to indicated a patient’s health status

Answer 61

physical status modifier

Question 62

combination of services included in a single procedure code

Answer 62

surgical package

Question 63

combination of services included in a single procedure code

Answer 63

global surgery rule

Question 64

days surrounding a surgical procedure when all services relating to the procedure are considered part of the surgical package

Answer 64

global period

Question 65

descriptor used for a procedure that is usually part of a surgical package by may also be performed separately

Answer 65

separate procedure

Question 66

using a single payment for two or more related procedure codes

Answer 66

bundling

Question 67

incorrect billing practice of breaking a panel or package of services/procedures into component parts

Answer 67

unbundling

Question 68

incorrect billing practice in which procedures are unbundled and separatedly reported

Answer 68

fragmented billing

Question 69

single code grouping laboratory tests frequently done together

Answer 69

panel

Question 70

procedure codes from Medicare claims

Answer 70

Healthcare Common procedure coding system (HCPCS)

Question 71

HCPCS national codes

Answer 71

Level II

Question 72

reusable physical supplies ordered by the provider for home use

Answer 72

Durable medical equipment (DME)

Question 73

situation in which a policy never pays a provider

Answer 73

never event