Introduction to
Medical
Coding
WGU D521-Introduction to Medical Coding|PA and
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D521-Introduction to Medical Coding
293 Correct terms
Questions and answers
etc)
,1/25/25, 7:50 PM D521-
Introduction to
Medical
Coding
The loss of revenue when a healthcare provider fails to get timely payment for
services.
This can be caused by incorrect billing/coding, patient leakage (loss), patient's
being unable to pay, denied claims, underpayments, wrong documentation, and
non-compliance.
A report that includes all patients who have been discharged from the facility but
for whom, for one reason or another, the billing process is not complete.
(a measure of patient accounts that are held up due to either coding delays or
other issues that prevent claim submission)
any person or organization who performs a service for a covered entity while
having access to protected health information (PHI)
Don't know?
2 of 294
Term
What are some ways the diagnosis coding can go wrong?
(in other words why can't a computer do it)
Not quite. You're still learning!
mcr reimburses based on DRGs
a statement from the payer that summarizes the costs of healthcare
services billed, what is (and isn't) covered by the insurance plan, and how
,1/25/25, 7:50 PM D521-
Introduction to
much the patient is responsible for paying
Medical
Coding
1. illegible provider handwriting
2. illogical provider documentation
3. lack of documentation
4. transcription errors
5. medical record doesn't support the DX
6. lack of specificity
- use outside auditors to review coding practices and patterns to increase
objectivity
- Use billing system edits and payer rejection data to prompt education for
coders
- monitor and improve coding and documentation practices continually to
ensure payment accuracy
- can use comparative data (comparing DRG, APC, and other payment category
national and regional results)
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3 of 294
Definition
Transplantation
Reattachment
Transfer
Reposition
Give this one a go later!
And - what does this mean in ICD- What root operations involve
10-CM guidelines? examination only?
, 1/25/25, 7:50 PM D521-
Introduction to
Medical
Coding
What root operations are for
What is included in Objective
putting in/back or moving a
findings in SOAP notes
body part?
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4 of 294
Term
What is the defined disciplinary action of AHIMA that refers to loss
of certification status and removal from registry?
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Termination of Employment Revocation of Credential
Loss of Voting Privileges Censure
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5 of 294
Definition
2 DXs or dx with manifestation or complication
Give this one a go later!