Medical Insurance Management- CH 15

Which character is used to indicate the stage of care, such as in a fracture?

7th

How often are diagnostic and procedural codebooks updated?

Every year

If a diagnostic code consists of 7 characters with the 5th character a placeholder, which form is correct when writing the code?

T36.0X1A

A patient has diagnosis of secondary hypertension related to chronic kidney disease. Which type of diagnosis code will the medical assistant use?

Combination code

What is the term for a disease process or condition that develops more slowly than an acute process but more rapidly than a chronic condition?

Subacute

What is the main term in the diagnostic statement, “umbilical hernia in a 3 year old child”?

Hernia

Nonadherence to the Official Guidelines for Coding and Reporting is a violation of which federal act?

HIPAA

What code does the medical assistant apply to a risk factor to indicate that a patient has a personal or family of a disease that affects their current condition?

Z code

What is the terms for an area of new and abnormal tissue growth?

Neoplasm

Which code classification does the 7th character represent?

Type of encounter

What is the term for a tumor or tissue that has been found to be cancerous and/or threatening to life and health?

Malignant

ICD-10-CM includes how many more codes than ICD-9-CM to cover more diseases and conditions and allow for greater specificity in coding?

More than 55,000 additional codes

Per CMS, which term refers to healthcare services or supplies need to diagnose or treat an illness or injury, condition, or its symptoms and meets accepted standards of care?

Medical necessity

Per CMS, which term refers to healthcare services or supplies needed to diagnose or treat an illness or injury, condition, or its symptoms and meets accepted standards of care?

Medical necessity

A patient is seen in the office for a urinary tract infection. During the visit, the provider notices a rash on the patient’s arm. The patient has a history of hypertension and COPD. Which diagnoses is the primary diagnosis?

Urinary tract infection

If the provider has written “rule out Lyme disease,” which action will the medical assistant perform when coding?

Not code for Lyme disease

What is the meaning of a diagnostic code that has “NEC” by it?

The description necessary to code the diagnosis in a more specific category is not listed

How many digits do all codes have in ICD-10-CM?

3 to 7

A patient is diagnosed with an open fracture of the right tibia and ulna related to falling while hiking. Which term is the main term?

Fracture

What is the term for a tumor or tissue that has been found to be noncancerous?

Benign

What does a dash after a code in the Alphabetic index indicate?

Additional character(s) are required

A patient is admitted to the hospital after having a seizure. While working to determine the cause of their seizure, the physicians discover that the patient is also suffering from hypertension. What is the term for the presence of two simultaneous conditions?

Comorbidity

In a narrative statement, what does the term “and” represent?

And/or

How does the medical assistant code conditions that have an underlying cause along with a disease that occurs due to the underlying condition?

Etiology first and the manifestation second

Where can one find the ICD-10-CM codes used for diagnoses in an outpatient setting?

Volumes 1 and 2