N605 Exam 1 questions with 100% correct
answers
CPT code - CORRECT ANSWERS ✔✔A system of procedure codes
and descriptions published annually by the American Medical
Association (AMA);
standard system of reporting medical services
-accepted by all commercial health insurance carriers and req by
medicare/medicaid
-need documentation to support the selection of a code
CPT - CORRECT ANSWERS ✔✔current procedural terminology
DSM - CORRECT ANSWERS ✔✔diagnostic and statistical manual
of mental disorders
ICD - CORRECT ANSWERS ✔✔international statistical
classification of diseases and related health problems
HEAT - CORRECT ANSWERS ✔✔health care fraud prevention
,and enforcement action team
T/F: Surgeries, lab tests, preventative medicine, counseling, and
imaging studies are covered under E&M documentation guidelines
- CORRECT ANSWERS ✔✔F: have separate documentation rules
NPI - CORRECT ANSWERS ✔✔national provider identification;
unique identifier for providers for health care claims, prescriptions.
Must enroll to bill medicare/medicaid
Medical necessity - CORRECT ANSWERS ✔✔care that is
considered to be necessary and reasonable in addition to being
appropriate care that is based on evidence-based clinical standards
of care
E&M codes - CORRECT ANSWERS ✔✔easily recognizable
medical services; these services have multiple levels which
correspond to different levels of medical complexity -select correct
level to be paid appropriately (5 digit code)
-evaluates the complexity of care delivered
,New patient - CORRECT ANSWERS ✔✔not been seen for 3 years
by you or another member of your group in the same speciality
Established patient - CORRECT ANSWERS ✔✔patient who has
been seen within the last 3 years by you or another member of your
group in the same specialty
Selecting the correct level of code depends on documenting what 3
key elements of the visit? - CORRECT ANSWERS ✔✔History
PE
Medical decision-making
(new patients require all 3 elements, established require 2 of 3)
E&M: New patient - CORRECT ANSWERS ✔✔a patient who has
not been seen for 3 years by you or another member of your
group in the same specialty
E&M: Established patient - CORRECT ANSWERS ✔✔a patient
who has been seen within the last 3 years by you or another
member of your group in the same specialty
, Documenting Hx - CORRECT ANSWERS ✔✔CC/HPI, PFSH, ROS
and categorized as problem focused, expanded problem focused,
detailed, and comprehensive
Problem- focused hx - CORRECT ANSWERS ✔✔chief complaint,
brief history of present illness or problem (1-3 elements)
Expanded problem focused hx - CORRECT ANSWERS ✔✔chief
complaint, brief history of present illness (1-3), system review
relevant to patient's problems
Detailed hx - CORRECT ANSWERS ✔✔chief complaint; extended
(>4 elements) history of present illness; system review relevant to
patient's problem(s) and extended to include review of limited
number of additional systems (2-9 systems or pertinent positive and
neg findings); relevant past, family, or social history directly related
to patient's problem(s)
Comprehensive hx - CORRECT ANSWERS ✔✔chief complaint;
extended (>4) history of present illness; review of systems directly
related to patient's problem(s) extended to include review of all
answers
CPT code - CORRECT ANSWERS ✔✔A system of procedure codes
and descriptions published annually by the American Medical
Association (AMA);
standard system of reporting medical services
-accepted by all commercial health insurance carriers and req by
medicare/medicaid
-need documentation to support the selection of a code
CPT - CORRECT ANSWERS ✔✔current procedural terminology
DSM - CORRECT ANSWERS ✔✔diagnostic and statistical manual
of mental disorders
ICD - CORRECT ANSWERS ✔✔international statistical
classification of diseases and related health problems
HEAT - CORRECT ANSWERS ✔✔health care fraud prevention
,and enforcement action team
T/F: Surgeries, lab tests, preventative medicine, counseling, and
imaging studies are covered under E&M documentation guidelines
- CORRECT ANSWERS ✔✔F: have separate documentation rules
NPI - CORRECT ANSWERS ✔✔national provider identification;
unique identifier for providers for health care claims, prescriptions.
Must enroll to bill medicare/medicaid
Medical necessity - CORRECT ANSWERS ✔✔care that is
considered to be necessary and reasonable in addition to being
appropriate care that is based on evidence-based clinical standards
of care
E&M codes - CORRECT ANSWERS ✔✔easily recognizable
medical services; these services have multiple levels which
correspond to different levels of medical complexity -select correct
level to be paid appropriately (5 digit code)
-evaluates the complexity of care delivered
,New patient - CORRECT ANSWERS ✔✔not been seen for 3 years
by you or another member of your group in the same speciality
Established patient - CORRECT ANSWERS ✔✔patient who has
been seen within the last 3 years by you or another member of your
group in the same specialty
Selecting the correct level of code depends on documenting what 3
key elements of the visit? - CORRECT ANSWERS ✔✔History
PE
Medical decision-making
(new patients require all 3 elements, established require 2 of 3)
E&M: New patient - CORRECT ANSWERS ✔✔a patient who has
not been seen for 3 years by you or another member of your
group in the same specialty
E&M: Established patient - CORRECT ANSWERS ✔✔a patient
who has been seen within the last 3 years by you or another
member of your group in the same specialty
, Documenting Hx - CORRECT ANSWERS ✔✔CC/HPI, PFSH, ROS
and categorized as problem focused, expanded problem focused,
detailed, and comprehensive
Problem- focused hx - CORRECT ANSWERS ✔✔chief complaint,
brief history of present illness or problem (1-3 elements)
Expanded problem focused hx - CORRECT ANSWERS ✔✔chief
complaint, brief history of present illness (1-3), system review
relevant to patient's problems
Detailed hx - CORRECT ANSWERS ✔✔chief complaint; extended
(>4 elements) history of present illness; system review relevant to
patient's problem(s) and extended to include review of limited
number of additional systems (2-9 systems or pertinent positive and
neg findings); relevant past, family, or social history directly related
to patient's problem(s)
Comprehensive hx - CORRECT ANSWERS ✔✔chief complaint;
extended (>4) history of present illness; review of systems directly
related to patient's problem(s) extended to include review of all
