CPC Certification Study Guide

CPC Certification Study Guide When should an ABN be signed? - ANS When a service is not expected to be covered by Medicare. What are NCD's interpreted at the MAC level considered? - ANS LCD What is medical billing? - ANS Translating medical documentation into codes. What part of Medicare should be billed for the pain medication by the pharmacy? - ANS Part D The amount on an ABN should be within how much of the cost to the patient? - ANS $100 or 25% of cost. An entity that processes nonstandard health information they receive from another entity into a standard is considered what? - ANS Clearinghouse. What is PHI? - ANS Personal Health Information. Intentional billing of services not provided is considered? - ANS Fraud. What OIG document should a provider reveiw for potential problem areas that will receive special scrutiny in the upcoming year? - ANS OIG Work Plan. Each year in October. What is ABN? - ANS Advance Beneficiary Notification What is AMA? - ANS American Medical Association. What is CPC? - ANS Current Procedural Terminology. What was done into codes. What is ICD-9-CM? - ANS International Classification of Disease, 9th Clinical Modification. Why was done in codes. What is HIPAA? - ANS Health Insurance Portability and Accountability Act of 1996. Law passed by Congress to improve the portability and continuity of healthcare coverage. What is OIG? - ANS Office of Inspector General. Makes sure everyone is in compliance What is CMS? - ANS Centers for Medicare & Medicaid Services. Basic guidelines for private prctice and rules. a-,an- - ANS Without, lack of, absent, deficient Ab-,abs- - ANS From, away Ad- - ANS Near, toward -algia,-algesia - ANS Pain Ambi- - ANS Both Angio - ANS Vessle (blood or lymph) Ano - ANS Anus Ante- - ANS Before Anti- - ANS Against Arterio - ANS Artery Arthro - ANS Joint Asthenia - ANS Weakness. Auto- - ANS Self Bi- - ANS Two, twice Brady- - ANS Slow Broncho - ANS Bronchus Cardio - ANS Heart -cele - ANS Tumor, swelling, hernia, sac -centesis - ANS Puncture Cephalo - ANS Head Chole - ANS Gall Cholecysto - ANS Gall bladder Choledocho - ANS Common bile duct Chondro - ANS Cartilage -cide - ANS Kill Circum - ANS Around -cise - ANS Cut Colo - ANS Colon Colpo - ANS Vagina Contra - ANS Against Costo - ANS Rib Cranio - ANS Skull Cyano - ANS Blue Cysto - ANS Urinary bladder De- - ANS Down, from Denti - ANS Tooth Dermo, dermato - ANS Skin Di- - ANS Two Dia- - ANS Through, between, across, apart Dis- - ANS Apart Dys- - ANS Painful, difficult, disordered Ecto- - ANS Outer, or on the outside -ectomy - ANS Surgical removal -emesis - ANS Vomiting -emia - ANS Blood En- - ANS In, inside Encephalo - ANS Brain Endo - ANS Within inner, on the inside Entero - ANS Intestine Epi- - ANS Above, over Erythro - ANS Red -esthesia - ANS Sensation Ex- - ANS Out Febr - ANS Fever Fibro - ANS Connective tissue Gastro - ANS Stomach -gene,-genic - ANS Production, origin Glosso - ANS Tongue Gluco, glyco - ANS Sugar, sweet -gram - ANS Record -graph - ANS Machine -graphy - ANS Practice, process Gyne - ANS Woman Hema, hemato, hemo - ANS Blood Hemi- - ANS Half Hepa, hepato - ANS Liver Herni - ANS Rupture Histo - ANS Tissue Hydro - ANS Water Hyster - ANS Uterus -iasis - ANS Condition of Ictero - ANS Jaundice Ileo - ANS Ileum (part of small intestine) Ilio - ANS Illium (bone) Inter- - ANS Between Intra- - ANS Within -itis - ANS Inflammation Laparo - ANS Abdomen -lepsy - ANS Seizure, convulse Leuko - ANS White Lipo - ANS Fat Lith - ANS Stone, calculus -lysis - ANS Loosen, dissolve Macro- - ANS Large, long Mal- - ANS Bad, poor, disordered -mania - ANS Insanity Mast - ANS Breast Mega- - ANS Large Men - ANS Month Meso- - ANS Middle -meter - ANS Measure Metro - ANS Uterus Micro - ANS Small Mono- - ANS Single, one Muco - ANS Mucous membrane Myelo - ANS Spinal cord, bone marrow Myo - ANS Muscle Narco - ANS Sleep Naso - ANS Nose Necro - ANS Death Neo- - ANS New Nephro - ANS Kidney Neuro - ANS Nerve Non- - ANS No, not Oculo - ANS Eye -ology - ANS Study of -oma - ANS Tumor Oophor - ANS Ovary Ophthalmo - ANS Eye -opia - ANS Vision Orchi - ANS Testicle -rrhaphy - ANS To repair a defect, suture Ortho- - ANS Straight -oscopy - ANS Look into, see -osis - ANS Condition of Osteo - ANS Bone -ostomy - ANS Surgical opening Oto - ANS Ear -otomy - ANS Incision, to cut into Para- - ANS Along side Path - ANS Disease Ped (latin) - ANS Foot Ped (greek) - ANS Child -penia - ANS Two few peri- - ANS Around, covering -pexy - ANS to sew up in position, fixation pharyngo - ANS Throat phlebo - ANS Vein -phobia - ANS Fear, dread -plasty - ANS Shape, mold, repair, operative revision, plastic repair plegia - ANS Paralysis -pnea - ANS Breathing Pneum - ANS Air, lungs Poly- - ANS Much,many Post- - ANS After Procto - ANS Rectum Pre- - ANS Before -ptosis - ANS Falling Pyelo - ANS Pelvis of kidney Pyo - ANS Pus Pyro - ANS Heat, temperature Renal - ANS Kidney Retro- - ANS Behind, backward -rrhage - ANS Hemorrhage, flow Salpingo - ANS Oviduct Semi- - ANS Half Septic - ANS Poison, infection Stomato - ANS Mouth Sub- - ANS Under Super- - ANS Above -therapy - ANS Treatment -thermy - ANS Heat Thoraco - ANS Chest Thrombo - ANS Clot Thyro - ANS Thyroid gland Trans- - ANS Across Uro - ANS Urine -uria, -uric - ANS Condition of, presence in urine Uni - ANS One Vaso - ANS Blood vessel Where is the great saphenous vein located? - ANS Leg. What is the function of the pancreas? - ANS Supplies digestive enzymes. Sebaceous glands are part of which anatomical system? - ANS Integumentary. What causes refraction function in eye? - ANS Lens. Myocardium is thickest arount which chamber of the heart? - ANS Left ventricle. Tunica vaginalis is part of which system? - ANS Male reproductive. Compete this series: Incus, stapes, ? - ANS Malleus. Hemiplegia is a disorder caused by a defect in which anatomical system? - ANS Nervous. What is the result of a ureteral blockage? - ANS Urine will not be able to flow from the kidney to the bladder. Renal calculus is? - ANS Nephrolithiasis. What is Part A? - ANS Medicares's Hospital Insurance; covers hospital/facility care. What is Part B? - ANS Medicare's Supplemental Medical Insurance; covers physician services and durable medical equipment that are not paid for under Part A. What is Part C? - ANS Medicare's Advantage is a set of health care options from which beneficiaries choose health care providers. What is Part D? - ANS Medicare's prescription drug program. What is WHO? - ANS World Health Organization. A group that deals with health care issues on a global basis. Volume 1 of ICD-9-CM contains what? - ANS Tabular List: Diagonosis codes organized in order by code. Volume 2 of ICD-9-CM contains what? - ANS Index to Diseases: Diagnosis codes organized in an alphabetic index. Volume 3 of ICD-9-VM contains what? - ANS Alphabetic Index and Tabular Index of Procedures: Procedures performed in the inpatient setting. Acute - ANS A condition with a rapid onset with a short course. Chronic - ANS A condition that develops slowly and lasts a long period of time. Closed Fracture - ANS A fractured bone that does not pierce the skin. E Codes - ANS Codes reported to indentify how an injury occurred and the location when it occurred. Never sequenced first. First Degree Burn - ANS Superficial burns through only the epidermis. Late Effect - ANS An inactive, residual effect or condition produced after the acute portion of an injury or illness has passed. Open Fracture - ANS A fracture bone that pierces the skin. Second Degree Burn - ANS A partial-thickness burn involving the epidermis and the dermis. Specticemia - ANS A systemic disease that is associated with microorganisms or toxins in the blood. These toxins are caused by bacteria, viruses, fungi, or other organisms. Systemic Inflammatory Response Syndrome (SIRS) - ANS Sytemic response to infection, burns, trauma, or cancer. Severe Sepsis - ANS Sepis with associated acute organ dysfunction. Sepsis - ANS Whole body inflammatory state. It generally refers to SIRS that is due to an infection. Third Degree Burn - ANS A full-thickness burns that involve the epidermis, dermis, and varying levels of the subcutaneous and underlying structures. V codes - ANS Codes used to describe circumstances or condition that could influence patient care.