CPC 2022 Exam Study Guide
1. Documentation (content): Proper code assignment is determined both
by
in the medical record and by the unique rules that
govern each code set in that instance
2. An auditor: The role a coder may take on to verify that the
documentation supports the codes the physician has selected
3. Query the physician: If the medical record is inaccurate or
incomplete, it will not translate properly to the language of codes.
What can a coder do in order for the medical record to be complete
and accurate so they can bill properly?
4. Quarterly (usually): How often are codes and insurance payment
policies updated?
5. NPP: Non-Physician Provider (also known as mid-level providers or
physician extenders)
6. PA: Physician assistant
7. NP: Nurse practitioner
8. Commercial and Government: The two types of primary insurances
9. Commercial Carriers: Private payers that may offer both group and
individual plans
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, 10.Medicare: The most significant government insurer; a federal health
insurance program
11.People over 65, blind or disabled individuals, and people with
permanent kidney failure or end-stage renal disease: Medicare provides
coverage for what kind of people?
12.ESRD: end-stage renal disease
13.Medicare Part A: Helps cover inpatient hospital care, as well as care
provided in skilled nursing facilities, hospice care, and home
healthcare,
14.Medicare Part B: Covers medically necessary physicians' services,
outpatient care, and other medical services (including some
preventive services) not covered under Medicare Part A. It can be an
optional benefit.
15.Medicare Part C: Also called Medicare Advantage, combines the
benefits of Medicare Part A, Part B, and-sometimes- Part D. The plans
are managed by private insurers approved by Medicare.
16.Medicare Part D: A prescription drug program available to all
Medicare bene- ficiaries.
2/
1. Documentation (content): Proper code assignment is determined both
by
in the medical record and by the unique rules that
govern each code set in that instance
2. An auditor: The role a coder may take on to verify that the
documentation supports the codes the physician has selected
3. Query the physician: If the medical record is inaccurate or
incomplete, it will not translate properly to the language of codes.
What can a coder do in order for the medical record to be complete
and accurate so they can bill properly?
4. Quarterly (usually): How often are codes and insurance payment
policies updated?
5. NPP: Non-Physician Provider (also known as mid-level providers or
physician extenders)
6. PA: Physician assistant
7. NP: Nurse practitioner
8. Commercial and Government: The two types of primary insurances
9. Commercial Carriers: Private payers that may offer both group and
individual plans
1/
, 10.Medicare: The most significant government insurer; a federal health
insurance program
11.People over 65, blind or disabled individuals, and people with
permanent kidney failure or end-stage renal disease: Medicare provides
coverage for what kind of people?
12.ESRD: end-stage renal disease
13.Medicare Part A: Helps cover inpatient hospital care, as well as care
provided in skilled nursing facilities, hospice care, and home
healthcare,
14.Medicare Part B: Covers medically necessary physicians' services,
outpatient care, and other medical services (including some
preventive services) not covered under Medicare Part A. It can be an
optional benefit.
15.Medicare Part C: Also called Medicare Advantage, combines the
benefits of Medicare Part A, Part B, and-sometimes- Part D. The plans
are managed by private insurers approved by Medicare.
16.Medicare Part D: A prescription drug program available to all
Medicare bene- ficiaries.
2/
