MAAS 211 review 2.0

All filling equipment must be _ to protect the confidentiality of medical records?

Secured

A numeric filing system should be used when_ of patient information is an issue?

Confidentiality

Files that feature pullout drawers that contain a metal bar equipped to handle letter size or legal size documents are called_?

Vertical

What constitutes an active file, as opposed to an inactive file?

The criteria are established by each individual practice.

A variation of shelf filing kept on rolling shelves that slide along permanent tracks in the floor is called ?

Compatible files

When a patient's records are kept electronically, it is important to files to prevent loss of information if the computer's hard drive crashes?

Backup

Some medical offices keep older patients records and insurance records in ____ files?

Supplemental

Which type of filing system allows several people to retrieve and return records at one time?

Filing shelves

A tapered rectangular or round extension at the top of a file folder is the____?

Tabs

Security drills____?

Keeps staffs aware of security risks

Which of the following is a filing system that is used by only one person at a time?

Filing Cabinets.

The final step in the filing process is_?

Storing

Patients who belong to a managed care health plan such as HMO, are responsible for a small pre-visit fee collected either prior to seeing the practitioner or at the time the patient is leaving the office. This fee is commonly called?

Co-payment

In a typical medical practice, insurance claims are filed____?

A few business day after the service

An insurance claim department compares the fee the doctor charges with the benefits provided by the patient's health plan. This is called the payment of benefits?

Review for Allowable Benefits

Which of the following is the patient owed after the insurance company has paid?

Patient Liability

What percent of the allowable fee does medicare pay the healthcare provider after the annual deductible is met?

80%

In which program can enrolls who are aged 65 and older continue to obtain medical services at military hospitals and clinics as they did before they turned 65?

Tricare for life

One advantage in submitting claims electronically is ?

Cost Efficient

Using a clement house to transmit electronic medical claims?

Include data elements that are transmitter on a computer file

How should data in medical billing programs be entered?

All Caps

Which of the following is NOT part of the process for verifying workers compensation coverage?

Getting the name and policy number of the patient's health insurance policy.

The ABN, or Advance Beneficiary Notice of Non coverage must be verbally reviewed with the beneficiary or his or her representative and any questions raised during that review must be answered before it is signed.

Underpayments

can occur when healthcare providers submit claims for a simple procedure but the medical record reveals that a more complicated procedure was actually performed

How often are ICD codes updated?

Every year in October 1

1. Brackets are used around synonyms, alternative wordings, or explanations in ICD-10-CM. They may assist you in choosing the correct code by providing specific terms that may be found in the medical record.

A colon is used in the Tabular list after an incomplete term that needs one of the terms that follows the colon to make it assignable to a given category.

"Excludes"

indicates that an entry is not classified as part of the preceding code and also may give the correct location of the excluded condition to help you find the correct code.

OB will look in ch 15(000-09A) of the ICD-10 book for pregnancy, childbirth, and the puerperium coding.

The ICD-10 code for a traumatic injury due to an external factor such as this will be found in ch 1, "injury, poisoning, and certain other consequences of external cause" whiccontain the code rangers S00-T88.

How many codes does the ICD-10CM contain?

70,000 codes

All ICD codes beginning with what character?

They begin with the alphabetic character.

Ulike the numeric ICD-9 codes

ICD-10 codes are alphanumeric, and all codes begin with an alphabetic character.

To assign a proper code

you must know whether the neoplasm is benign, malignant, in situ, or of uncertain behavior.

The appropriate use of modifiers with CPT codes

can greatly enhance your reimbursement and can cut down on claim inquiries from the insurance carrier.

The evaluation and management (E/M) codes

are used so frequently that they are placed in the front of the CPT manual for easy reference.

HCPCS was originally developed

by the Centers for MEdicare and MEdicaid Services (CMS) for use in coding services for medicare patients such as durable medical equipment (DME)

To avoid the risk of fraud

medical offices have a compliance plan to uncover compliance problems and correct them.

Billing separately for items that are bundled in a single procedure code is referred to as

Unbundling.

HCPCS Level ll codes are issued

by CMS and cover many supplies such as sterile trays, drugs, injections, and durable medical equipment.

A blue triangle next to a code

indicates that the code description has changed since the previous edition of the CPT manual.

A red dot appears next to codes that are new since the previous edition of the CPT.

A pound (#)

sign appears next to a code that appears out of numerical sequence.

Category ll codes are optional, supplemental tracking codes used to track healthcare performance measures, such as programs and counseling to avoid tobacco use or reduce weight.

Naiten

(The common cold is a self limiting condition that will run its covers; afterward the patient will recover without medical intervention.)

HCPCS Level ll codes have 5 characters

either numbers, letters, or a combination of both.