CPC Certification Study Guide fully solved & updated

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