MOD F - Final Exam

Medical coding is the?

the process of assigning alphanumeric characteristics that represent the diagnosis patients have and the services they receive

ICD

International classification of diseases

CPT

Current Procedural Terminology

What are ICD-10 codes used for?

Prior authorizations & referrals

ICD-10 codes are ____ & takes effect OCT one every year

Updated annually

Only ___, ___ & ____ are coded as ICD-10 codes

Conditions, diseases & symptoms

Reporting incorrect DX codes on an insurance claim can create problems such as?

• Improper reimbursement

• Inaccurate pt medical hx

• Fraud

Procedure Coding is the?

act of assigning alphanumeric characteristics to the procedures & services that physicians & healthcare facilities provide to pts

_____ is the active intentionally billing for services that were never given or billing for a service

that has a higher reimbursement than the service actually provided

Fraud

Abuse is ______ & billing practices that result in improper financial gain

improper behavior

all of the processes involved in using food for growth, repair & maintenance of the body

Nutrition

the process of the body undergoes when it converts food into chemicals substance that can be absorbed

Digestion

Fats are also known as ___?

Lipids

Saturated fat is?

Bad fat

2 Unsaturated fats:

• Polyunsaturated (bad)

• Monounsaturated (good)

a measurement of a unit that provides energy for the body

Calorie

contain no solid food or milk products, used for pre-op lab test and gastric illnesses

Clear Liquid Diet

prescribed for patients who have GI problems & food allergies

Bland Diet

___ prescribed for patients with GI upsets such as Dirarrhea

Brat Diet

• B-banana

• R-rice

• A-applesacue

• T- toast

used for patients recovering from bone injury

High protein diet

used for patients who have hypertension or kidney disease

Low sodium Diet

The ______ is a muscular tube consisting of the organs of the digestive system, this tube

begins at the mouth and ends at the anus

digestive system

The esophagus measuring __inches is responsible for transporting food from the pharynx to

the stomach

10 inches

The pharynx is a common passageway not only for food but also for ___ & ___

water & air

The rhythmic contractions that the esophagus make to work the food down to the stomach is

known as ___?

peristalsis

Almost % of of the absorption of usable nutrients take place in the __

80% & small intestine

_____ results when the fluid contents from the small intestine are rushed through the large

intestine before water can be adequately reabsorbed creating watery feces

Diarrhea

____ is when the feces travel so slowly through the colon that too much water is reabsorbed and

the stool becomes hard and dry

Constipation

________ is a branch of medicine that entails the medical care that pertains to the health

of the digestive system or gastrointestinal tract

Gastroenterology

___ is a type of bacteria that could cause ulcers in the stomach

H.Pylori

________ is a non surgical procedure that is used to view a person's digestive tract with a

scope that includes a light and a camera attached

Endoscopy

Procedures done through ____ are cholecystectomy, appendectomy, tubal ligation & biopsies

laparoscopy

_____ are needed after a perforated diverticulitis, colorectal blockage or cancer

Colostomy

SOAP charting

• Subjective

• Objective

• Assessment

• Plan

Subjective

information gather from the patient, the things that the patient believes he is seeing a physician for, their chief complaint, signs and symptoms the patient has experienced

Objective

information is composed of the data gathered during the visit such as vital signs, weight change, blood work results, radiology reports

Assessment

is the physicians preliminary diagnosis, discusses strategy for care of the patient

Plan

a proposed treatment, follow up care, and any additional instructions for the patient

Health insurance was originally designed to help those with _____?

catastrophic medical expenses that occurred as a result of an unexpected illness or injury

___ is designed for those 65 older and those severely disabled

Medicare

Medicare part A-D & what do they cover?

• Medicare part A: covers hospital expenses

• Medicare Part B: covers office visits, outpatient hospital and DME expenses

• Medicare part C: more comprehensive care but limited in providers

• Medicare part D: prescription drug coverage

_____ designed for low income patients

Medicaid

_____ is insurance designed for those persons who became injured while on the

job or who are suffering from a workplace related illness

Workers compensation

_____ is insurance reimburses the patient for lost wages because they became ill

or injured and cannot work

Disability insurance

______ is entitles eligible employees of covered employers to take unpaid

leave for specific family and medical reasons

Family Medical Leave Act

EHR is a ____?

(Electronic health Records) is a computerized version of a patient’s medical history

PHR is health information that?

(Personal Health Record) the patient stored electronically on a computer or on a secured internet site

_____ a predetermined list of medications that every insurance company has that they will pay for

Formulary