GUARANTEED PASS!!
Documentation (content) - Accurate Answers✔✔✔ Proper code
assignment is determined both by _____________ in the medical record
and by the unique rules that govern each code set in that instance
An auditor - Accurate Answers✔✔✔ The role a coder may take on to
verify that the documentation supports the codes the physician has
selected
Query the physician - Accurate Answers✔✔✔ If the medical record is
inaccurate or incomplete, it will not translate properly to the language of
codes. What can a coder do in order for the medical record to be
complete and accurate so they can bill properly?
Quarterly (usually) - Accurate Answers✔✔✔ How often are codes and
insurance payment policies updated?
NPP - Accurate Answers✔✔✔ Non-Physician Provider (also known as
mid-level providers or physician extenders)
PA - Accurate Answers✔✔✔ Physician assistant
NP - Accurate Answers✔✔✔ Nurse practitioner
, Commercial and Government - Accurate Answers✔✔✔ The two types
of primary insurances
Commercial Carriers - Accurate Answers✔✔✔ Private payers that may
offer both group and individual plans
Medicare - Accurate Answers✔✔✔ The most significant government
insurer; a federal health insurance program
People over 65, blind or disabled individuals, and people with
permanent kidney failure or end-stage renal disease - Accurate
Answers✔✔✔ Medicare provides coverage for what kind of people?
ESRD - Accurate Answers✔✔✔ end-stage renal disease
Medicare Part A - Accurate Answers✔✔✔ Helps cover inpatient
hospital care, as well as care provided in skilled nursing facilities,
hospice care, and home healthcare,
Medicare Part B - Accurate Answers✔✔✔ Covers medically necessary
physicians' services, outpatient care, and other medical services
(including some preventive services) not covered under Medicare Part
A. It can be an optional benefit.
Medicare Part C - Accurate Answers✔✔✔ Also called Medicare
Advantage, combines the benefits of Medicare Part A, Part B, and-