HCM 425 QUIZ 2 QUESTIONS AND
ANSWERS
When coders have questions about documented diagnoses or procedures/services,
they should use a __________ process to contact the responsible physician to request
clarification about documentation and the code(s) to be assigned. - Answer-physician
query
ICD-10-PCS is an entirely new procedure classification system that was developed by
CMS for use in __________ settings only, replacing Volume 3 of ICD-9-CM. - Answer-
inpatient hospital
ICD-10-PCS uses a __________ seven-character alphanumeric code structure (e.g.,
047K04Z) that provides a unique code for all substantially different procedures, and it
allows new procedures to be easily incorporated as new codes. - Answer-multiaxial
Private companies publish __________, which automate the coding process so that
computerized or web-based software is used instead of coding manuals. - Answer-
encoders
The ICD-10-CM/PCS Coordination and Maintenance Committee is responsible for
overseeing all changes and modifications to ICD-10-CM and ICD-10-PCS codes,
including the creation and update of general equivalency mappings. ICD-10-CM codes
are reported for __________, while ICD-10-PCS codes are reported for __________. -
Answer-diagnoses, procedures
Matching ICD-10-CM diagnosis codes to CPT and HCPCS level II procedure and
service codes on a claim submitted for a patient encounter ensures that services and
procedures are reasonable and necessary for the diagnosis or treatment of an illness or
injury. This concept is called __________. - Answer-medical necessity
According to Medicare, if it is possible that scheduled tests, services, or procedures
may be found medically unnecessary, the patient must sign an advance beneficiary
notice, which __________. - Answer-acknowledges the patient's responsibility for
payment if Medicare denies the claim
Which is the face-to-face contact between a patient and a health care provider who
assesses and treats the patient's condition? - Answer-encounter
ANSWERS
When coders have questions about documented diagnoses or procedures/services,
they should use a __________ process to contact the responsible physician to request
clarification about documentation and the code(s) to be assigned. - Answer-physician
query
ICD-10-PCS is an entirely new procedure classification system that was developed by
CMS for use in __________ settings only, replacing Volume 3 of ICD-9-CM. - Answer-
inpatient hospital
ICD-10-PCS uses a __________ seven-character alphanumeric code structure (e.g.,
047K04Z) that provides a unique code for all substantially different procedures, and it
allows new procedures to be easily incorporated as new codes. - Answer-multiaxial
Private companies publish __________, which automate the coding process so that
computerized or web-based software is used instead of coding manuals. - Answer-
encoders
The ICD-10-CM/PCS Coordination and Maintenance Committee is responsible for
overseeing all changes and modifications to ICD-10-CM and ICD-10-PCS codes,
including the creation and update of general equivalency mappings. ICD-10-CM codes
are reported for __________, while ICD-10-PCS codes are reported for __________. -
Answer-diagnoses, procedures
Matching ICD-10-CM diagnosis codes to CPT and HCPCS level II procedure and
service codes on a claim submitted for a patient encounter ensures that services and
procedures are reasonable and necessary for the diagnosis or treatment of an illness or
injury. This concept is called __________. - Answer-medical necessity
According to Medicare, if it is possible that scheduled tests, services, or procedures
may be found medically unnecessary, the patient must sign an advance beneficiary
notice, which __________. - Answer-acknowledges the patient's responsibility for
payment if Medicare denies the claim
Which is the face-to-face contact between a patient and a health care provider who
assesses and treats the patient's condition? - Answer-encounter
