Understanding Ch:10 Medical Billing Exam Guide |100% Correct| #Latest

Understanding Ch:10 Medical Billing Exam Guide |100% Correct| #Latest The term medically managed means that even though a diagnosis may not receive direct treatment during an encounter: *Ans* it must be considered when determining treatment for other conditions. What is the first listed diagnosis in the following list of symptoms and complaints? *Ans* Acute pharyngitis with negative rapid strep test What is the first listed diagnosis in the follow list of symptoms and complaints? *Ans* Musculoligamentous sprain, left ankle What is the first listed diagnosis in the follow list of symptoms and complaints? *Ans* Benign prostatic hypertrophy (BPH) with urinary retention What is the first listed diagnosis in the follow list of symptoms and complaints? *Ans* Bacterial endocarditis Prior to coding, it is important to ask if the diagnosis or condition supports a procedure or service provided during a previous encounter. *Ans* False Policies of the Centers for Medicare and Medicaid Services (CMS) that specify the clinical circumstances under which a service is covered and how it is to be coded are called: *Ans* local coverage determinations(LCD) Which is used by MACs and providers to determine whether a procedure is reasonable and necessary for the treatment of an illness or injury? *Ans* Medicare coverage database CMS develops national coverage determinations (NCDs): *Ans* on an ongoing basis OCE edits result in one of the following dispositions: *Ans* rejection, denial, return to provider, or suspension Up to ________ diagnosis codes can be reported on one CMS-1500, and the diagnosis code must be linked to the procedure or service provided. *Ans* twelve, 12 Which involves reviewing patient records and CMS-1500 or UB-04 claims to assess coding accuracy, and completeness of documentation? *Ans* auditing process Tim Johnson's primary care provider performed a level 3 E/M service in the office on June 1 to evaluate Tim's symptoms of upset stomach and vomiting without nausea. Tim's diabetes mellitus was medically managed during the encounter when venipuncture and a quantitative blood glucose test were performed; test