MAAS 211 Medical Records and Coding Review

Security drills

will keep staff secure of security risks.

Commercial record center

When choosing storage facility for files, consider a(n).

Records management system

What is the way patient records are created, filed, and maintained is called a(n).

File guides

heavy cardboard plastic inserts to separate the contents of the file.

Supplemental types of files

Some medical offices keep older patient records and some insurance records on.

Sorting

the process of arranging records in the sequence in which they are to be filed or stored.

Office tickler file

How often should the office tickler file be checked? daily.

Housing files in boxes

What is the disadvantage of housing files in boxes? they dont remain in one location and easily misplaced.

Retention schedule

What does a retention schedule detail? how long different records should be kept.

Filing process

What is the first step in the filing process? inspecting.

File sorters

organizers.

Medicaid coverage

What happens when a patient has Medicaid, and Medicaid does not cover the services provided? the patient may be responsible for out of pocket costs.

Standardized sheet protector

If a document is smaller than the standard size, what should be done prior to filing? store it in a standardized sheet protector.

Data entry in medical billing programs

How should data be entered in medical billing programs? enter information using capital letters.

Medicare benefits for respite care

What could be included in Medicare benefits for respite care? short term relief for caregivers.

Medicare payment percentage

What percent of allowable fee does Medicare pay the healthcare provider after the annual deductible is met? 80 percent.

Medicaid patient visit

What should happen with every visit of a patient who is covered by Medicaid? providers should verify for eligibility, document services provided.

Cost-efficient claims submission

Which type of claims submission is more cost-efficient? electronic.

Insurance claim outcome

What will most likely be the outcome of an insurance claim submitted with the diagnosis code not aligned with the procedure code?

Preauthorization

What is it when the request for approval for payment from a third-party prior to a procedure is the.

Medicare entitlement

Patients under 65 who are blind or widowed or who have serious long-term disabilities, such as kidney failure may be entitled to Medicare.

Birthday rules for dependents

Explain birthday rules for dependents. the parent whose birthday comes first in the calendar year has the primary coverage for the child.

Fee schedules

Explain fee schedules that have usual fees that are listed on the medical office's fee schedule are fees charged to most of their patients most of the time under typical conditions.

Medicare's resource-based relative value scale

What is not a part of Medicare's resource-based relative value scale? Medigap, to reduce the gap in coverage.

TRICARE or CHAMPVA coverage

What group of employees is not covered by TRICARE or CHAMPVA?

Braces

Define braces.

Circulatory/Cardiovascular System Codes

Chapter 9 with codes ranging from 100 to 199

Tabular List Organization

Mainly organized by the body system involved

Pre-employment Physical and Drug Test Code

ICD-10 code is Z02.1. Range is Z00-Z99

Number of ICD-10-CM Codes

About how many ICD-10-CM codes are there?

First Step in Neoplasm Coding

Table of neoplasm

ICD-10 Entry Indicator

NEC and Excludes2

ICD-10 Code Updates Frequency

Twice a year

Diagnosis-related Groups (DRGs) Exclusion

Based on all the following except length of hospital stay

Chapter for Accident or Injury Codes

Ch 20

Chapter for Congenital Malformations Codes

Ch 17

Code Linkage Definition

An analysis of the connection between the diagnostic and procedural information on a claim

Visit Reason Documentation

The reason for the visit is listed first on a bill and the condition that resulted from a diagnosis would follow the primary diagnosis.

Plus Sign (+) Usage

Indicates an add on code

3 Rs of Consultation

Request, render, and report

Modifier #22 Definition

Increased procedural services, it is used to identify a service that requires significantly greater effort

Symbol for Code Description Change

A solid triangle

CPT Manual Prefixes and Suffixes Information

Introduction to the CPT manual

Maximum Modifiers per Procedure Code

Maximum of three

Modifier Purpose

To provide additional information about a procedure or service without changing the core definition of the CPT codes

Unbundling Fraud Definition

Unbundling done intentionally to receive more payment than is allowed

CPT Manual Add-on Codes Listing

Appendix D

Medical Practice Compliance Plan Purpose

Shows a good faith effort to be compliant with coding regulations

Main Sections in the CPT Manual

1. Evaluation and management 2. Anesthesia 3. Surgery 4. Radiology 5. Pathology and laboratory 6. Medicine except anesthesiology