TAUC PF PRE-SCRIBE U QUESTIONS AND CORRECT ANSWERS 2025/2026

TAUC PF PRE-SCRIBE U QUESTIONS AND CORRECT ANSWERS 2025/2026 What should be consistently documented in the Procedures section for billing purposes? - Answer -Prescription medication discussions Review of outside diagnostic results Discussions with external professionals Independent historians needed What is included in the prescription medication discussions? - Answer - Document ll discussions regarding any prescription medicine that the patient is already taking whenever it is relevant to the current condition - Ex. BP meds for pt who is hypertensive Document when a pt refuses a prescription medicine recommended What is included in review of outside diagnostic results? - Answer - Whenever a patient shows you outside labs or radiology results and asks you questions about them... Document: outside lab results reviewed and showed (insert interpretation) When documenting discussions with external professionals what must you include? - Answer -Document any conversations you have with external sources such as:-ER triage nurse -Urgent specialist -External provider involved w/ pts care -Non-healthcare professionals involved in pts management What do you document when independent historians are needed? - Answer -When a pt is unable to provide a complete or reliable hx document discussions with another historian When selecting a dx modifier what should you not do? - Answer -Do not select any of the three choices in the top under "uses for coding" -uncomplicated -systemic symptoms -poses a threat to life or bodily functions What do you select instead when selecting a dx modifier? - Answer - Choose the numbered choices from the bottom section (top 4) -Acute -Chronic -Incidental lesion/mass Bottoms 6 are additions to top 4 What should all fractures be referred to as? - Answer -Clinical not possible and you must include an associated fracture dx Should you document any refused procedures in the procedure note? - Answer -yes