Nha New Cbcs Practice Tests

NHA NEW CBCS PRACTICE TESTS-
STUDY


MedicalooEthicsoo-ooans--
Standardsooofooconductoobasedooonoomoralooprinciples.ooGenerallyooacceptedooasooaoogu
ideooforoobehaviorootowardsoopatients,oophysicians,ooco-
workers,ootheoogovernment,ooandooinsuranceoocompaines.

ComplianceooRegulationsoo-ooans--billing-
relatedoocasesooareoobasedooonooHIPAAooandooFalseooClaimsooAct.

HealthooInsuranceooPortabilityooandooAccountabilityooActooofoo1996oo(HIPPA)oo-ooans--
CreatedootheooHealthooCareooFradooandooAbuseooControlooPrpgramooenactedoontoocheck
ooforoofraudooandooabuseooinootheooMedicareooandooMedicaidooprograms,ooandooprivateoo
payers.

TwoooprovisionsooofooHIPPAoo-ooans--TitileooI:ooInsuranceooReform
TitleooII:ooAdministrativeooSimplification

InsuranceooReform.oo-
Primaryoopurposeootoooprovideoocontinuousooinsuranceoocoverageooforooworkersooandoot
heiroodependentsoowhenootheyoochangeooorooloseootheiroojobs.oo-ooans---
Limitsootheoouseooofoopreexistingooconditionsooexclusions
-Prohibitsoodiscriminationooforoopartoooroopresentoopooroohealth
-
Guaranteesoocetraomooemployeesooandooindividualsootheoorightootooopurchaseoohealthooi
nsuranceoocoverageooafteroolosingooaoojob
-
ooAllowsoorenewalooofoohealthooinsuranceoocoverageooregardlessooofooanooindividual'sooh
ealthooconditionoothatooisoocoveredoounderootheooparticularoopolicy

AdministrativeooSimplification-
Theoogoalooisootooofocusooonootheoohealthoocareoopracticeoosettingootoooreduceooadministr
ativeoocostooandooburdens.oo-ooans--Twoooparts:
1.ooDevelopmentooandooimplementationooofoostandardizedoohealth-
relatedoofinancialooandooadministrativeooactivitiesooelectronically.
2.ooImplementationooofooprivacyooandoosecurityooproceduresootooopreventootheoomisuseoo
ofoohealthooinformationoobyooensuringooconfidentiality.

,FalseooClaimooActoo(FCA)oo-ooans--
Federaloolawoothatooprohibitsoosubmittimgooaoofraudulentooclaimoooroomakingoostatemento
ooroorepresentationooinooconnectionoowithooaooclaim.


NationalooCorrectooCodingooInitiativeoo(NCCI)oo-ooans--
DevelopedoobyootheooCMSootooopromoteoonationaloocorrectoocodingoomethodologiesooan
dootooocontrolooimproperoocodingoothatooleadsootoooinappropriateoopaymentooofoopartooBoo
healthooinsuranceooclaims.

TwoootypeooofooNCCAooeditsoo-oo1.ooColumnoo1oo/
Columnoo2ooorooComprehensiveooComponentooEdits:ooidentifiesoocodeoopairsoothatoosho
uldoonotoobeoobilledootogetheroobecauseoooneoocode.ooColumnoo1ooincludesooallootheooser
vicesoodescribedoobyooanotheroocodeooinooColumnoo2.oo-ooans--
2.ooMutuallyooExclusiveooEdits:ooidentifiesoocodeoopairsoothat,ooforooclinicalooreason,ooareo
ounlikelyootooobeooperformedooonootheoosameoopatientooonootheoosameooday.


OfficeooofooInspectorooGeneraloo(OIG)oo-ooans--
Investigatesooandooprosecuteoohealthoocareoofraudooandooabuse.

Fraudoo-ooans--
Knowinglyooandoointentionallyoodeceivingoooroomisrepresentingooinformationoothatoomayoo
resultooinoounauthorizedoobenefits.

Abuseoo-ooans--
Definedooasooincidentsoooroopractices,oonotoousuallyooconsideredoofradulaentoothatooareooi
nconsistantoowithootheooacceptedoomedicaloobusinessoooroofiscaloopracticesooinootheooind
ustry.

PatientooConfidentiality-
ooAlloopatientsoohaveootheoorightootoooprivacy,ooandooallooinformationooshouldooremainoopri
vileged.oo-ooans--
Discussoopatientooinformationoowithooonlyootheoopatient'soophysicianooorooofficeoopersonn
eloothatooneedoocetainooinformationootooodoootheiroojob.ooObtainedooaoosignedooconsentoof
ormootoooreleaseoomedicalooinfomationootoootheooinsuranceoocompanyoooroootherooindivid
ual.

UnderooHIPPAooPrivacyooRule,ooprovidersoomayoouseoopatient'sooProtectedooHealthooInfo
rmationoo(PHI)oowithoutoospecificooauthorizationooforoo-ooans--
Treatment:ooprimarilyooforootheoopurposeooofoodiscussionoofoootheoopatient'soocaseoowitho
ootherooproviders.
Payment:ooprovidersoosubmitooclaimsooonoobehalfooofoopatients.
Operations:ooforoopurposesoosuchooasoostafffootrainingooandooqualityooimprovment.

EmployernooLiabilityoo-ooans--
Physiciansooareoolegallyooresponsibleooforootheirooownooconductooandooanyooactionooofoot
heirooemployeesoo(theiroodesignee)ooperformoowithinootheoocontextooofootheirooemployme

,nt.ooReferedootoooasoo"vacariousooliability"alsoooknownooasoo"respondentoosuperior"oowhi
choomeansoo"letootheoomasterooanswer".

EmployeeooLiabiltiyoo-
ooans--"Errorsooandooomissionsooinsurance"ooisooprotectionooagainstoolossooofoomoniesoo
byoofailureoothroughooerroroooroounintentionalooomissionooonootheoopartooofootheooindividu
alooorooserviceoosubmittingootheooinsuranceooclaim.

MedicalooRecordsoo-ooans--
Documentaitonooofootheoopatient'soosocialooandoomedicaloohistory,oofamilyoohistory,oophys
icalooexaminationoofindings,ooprogressoonotes,ooradiology,ooandoolabooresults,ooconsultati
onooreports,ooandoocorrespondenceootooopatient.

Informationooneededoowhenoobillingootheooinsuranceoocompanyoo-ooans--
Dateooofooserviceoo(DOS),ooplaceooofooserviceoo(POS),ootypeooofooserviceoo(TOS),oodiagn
osisoo(dxooorooDX),ooandooprocedures.

RetentionooofooMedicalooRecordsoo-ooans--
Governedoobyoostateooandoolocaloolawsooandoomayoobaryoofromoostate-to-
state.ooMostoophysiciansooareoorequiredootoooretainoorecordsooindefinitley;oodeceasedoopa
tientoorecordsooshouldoobeookeptooforooatooleastoo(5)ooyears.

Newoopatientoo-ooans--
oneoowhooohasoonotooreceivedooanyoomedicalooservicesoowithinootheoolastoo3ooyears

Establishedoopatientoo-ooans--
someoneoowhooohasooreceivedoomedicalooservicesooinootheoolastoo3ooyearsoofromootheoop
hysicianooorooanotheroophysicianooofootheoosameoospecialtyoowhooobelongootoootheoosam
eoogroupoopractice.

cheifoocomplaintoo-ooans--
briefoostatementoodescribingootheyoosymptom,ooproblem,oodiagnosis,ooorooconditionoothat
ooisootheooreasonooaoopatientooseeksoomedicaloocare.


3oovolumnsooofooICD-9oomanaloo-ooans--Volumnoo1-Diseases:ooTabularooListoo
Volumnoo2-Diseases:ooAlphabeticooIndex
Volumnoo1ooandoo2ooareoousedooinootheooinpatientooandoooutpatientoosetting
Volumnoo3-ooProcedures:TabularooListooandooAlphabeticooIndex

Volumnoo1oo-ooDiseases:ooTabularooListoo-ooans---
containsootheoodieaseooandooconditionoocodeooandootheoodescriptions
-ooalsooocontainsootheooVoocodesooandooEoocodes

Volumnoo2oo-ooDiseases:ooAlphabeticooIndexoo-ooans--alphabeticooindexooofoovolumnoo1

, Volumnoo3oo-ooTabularooListooandooAlphabeticooIndexoo-ooans--
containsoocodesooforoosurgical,ootherapeutic,ooandoodiagnosticooprocedures;oousedooprim
arilyoobyoohospitals

Hypertensionooclassifications:oo-ooans--Maligant-
ooanooaccelerated,oosevereooformooofoohypertensionoowithoovascularoodamageooandooaood
iastolicoopressureooofoo130mmHgoooroogreater.
Benign-
ooMildoooroocontrolledoohypertensionooandoonooodamageootoootheoovascularoosystemoooroo
organs.
Unspecified-
oonotoospecifiedooasoobenginoooroomalignantooinootheoodiagnosisoooroomedicaloorecord.


malignantooneoplasmoo-ooans--
furtherooclassifiedooasootoooprimaryoo,oosecondary,oooroocacinomaooinoositu

primaryoomalignancyoo-ooans--
originaloocanceroosite.ooMalignantootumorsooareooconsideredooprimaryoounlessoodocumen
tedooasoosecondaryoooroometastatic

carcinomaooinoosituoo-ooans--
canceroothatooisoolocalizedooandoohasoonotoospreadootoooadjacentootissueoooroodistantoopa
rtsooofootheoobody

secondaryoomalignacyoo-ooans--
canceroothatoohasoometasizedoo(spread)ootoooaoosecondaryoositeooeitherooadjacentoooroor
emoteooregionooofootheoobody

3oosectionsooofooAlphabeticooindexoo-ooans--
Sectionoo1:ooIndexootoooDiseases:ooeachootermooisoofollowedoobyootheoocodeoooroocodesoo
thatooapplyootooothatooterm
Sectionoo2:ooTableooofooDrugsooandooChemiclas:oocontainsoolistooofoodrugsooandoochemic
alsoowithoocorrespondingoopoisoningoocodesooandooEoocodes.

CurrentooProceduralooTerminologyoo(CPT)oo-ooans--
Codesoousedootoooreportooservicesooandooproceduresoobyoophysicians.
PublishedooandooupdatedooanuallyoobyootheooAmericanooMedicalooAssociationoo(AMA)oo
withooaoonewoooneoocomingoooutooeachooNovemberooandoobecomingooeffectiveooonooJan
uaryoo1stooofootheoofollowingoocalendarooyear.

CategoryooIoocodesoo-ooans--
respresentooservicesooandooproceduresoowidelyoousedoobyoomanyoohealthoocareooprofess
ionalooinooclinicaloopracticeooinoomultipleoolocationsooandoohaveoobeenooapprovedoobyooth
eooFDA