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"hold harmless clause" - * found in some non-Medicare health plan contracts * prohibits billing to patient for anything beyond deductibles and co-pays. A compliance plan may offer several benefits, including: - * more accurate payment of claims * fewer billing mistakes * improved documentatio...

Many coding professionals go on to find work as: - Consultant A medical record contains information on all but what areas? - Financial records Technicians who specialize in coding are called: - Coding specialists EHR stands for: - Electronic health record What type of provider goes through appro...

Local Coverage Determinations are administered by whom? a. State Law b. NCDs c. Each regional MAC d. LMRPs - c. Each regional MAC ABN stands for _____. a. Advanced Benefits Notification b. Advisory Beneficial Notice c. Admitting Beneficiary Notice d. Advance Beneficiary Notice - d. Advance ...

A 46-year-old female had a previous biopsy that indicated positive malignant margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent ...

Which statement is TRUE for reporting external cause codes of morbidity (V00-Y99)? A. All external cause codes do not require a seventh character. B. Only report one external cause code to fully explain each cause. C. Report code Y92.9 if the place of occurrence is not stated. D. External cause ...

When coding in operative report what action would NOT be recommended? - Coding from the header with out reading the body of the report If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient who determines coverage? - Medicare administrative contractor (MAC) M...

What document is referenced to when looking for potentialproblem areas identified by the government indicatingscrutiny of the services within the coming year?: A) OIG Compliance Plan Guidance B) OIG Security Summary C) OIG Work Plan D) OIG Investigation Plan - C (Rationale: Twice a year, the OI...

What is the patient's right when it involves making changes in the personal medical record? A. Patient must work through an attorney to revise any portion of the personal medical information. B. They should be able to obtain copies of the medical record and request corrections of errors and mis...

What is the meaning of provider in the ICD-10-CM guidelines? - The physican The terms malignant, benign, in situ, and uncertain behavior are all terms used when coding what? - Neoplasms What is an example of an eponym? - Paget's disease Who are the parties responsible for providing the ICD-10-C...

What type of health insurance provides coverage for low-income families? - Medicaid Rationale: Medicaid is a health insurance assistance program for some low-income people (especially children and pregnant women) sponsored by federal and state governments. The minimum necessary rule applies to - ...

The provider documents CKD stage 5 and ESRD. What ICD-10-CM code(s) is/are reported? - N18.6 What does the abbreviation CKD stand for? - Chronic Kidney Disease What would be considered an adverse effect? - Rash developing when taking penicillin. What does the 7th character A indicate in Chapter ...

In ICD-10-CM what condition is reported as the default code when the provider documents urosepsis? - The provider must be queried before an ICD-10-CM code can be applied. According to the ICD-10-CM guidelines, how is bilateral glaucoma of the same type and stage reported? - A bilateral code can b...

CASE 1 CRNA performed anesthesia (Use Modifier QX to indicate CRNA services with medical direction by a physician.) Anesthesiologist medically directing two cases (Use modifier QK to indicate medical direction of two cases.) Anesthesia Time: 9:30 to 10:06 Physical Status 3 (Physical status 3 -...

CASE 1 10-Year-old established patient (The patient is established.) presents today for well child check (Patient presents for a preventive exam.) with mother with complaints of frequent urination during the day. The patient has two sisters and sees dad sporadically. Lives in a smoke free enviro...