Ch. 1 Review- ICD-10-CM Exam 2024 Questions And Answers

Ch. 1 Review- ICD-10-CM Exam 2024 Objective evidence of a disease or condition - ANS Sign The paperwork in the patient's file that corroborates the codes presented on the claim form for a particular encounter. - ANS Supporting documentation Using a code on a claim form that indicates a higher level of service, or a more severe aspect of disease or injury, than that which was actual and true. - ANS Upcoding The determination that the healthcare professional was acting according to standard practices in providing a particular procedure for an individual with a particular diagnosis. - ANS Medical necessity The acronym for International Classification of Diseases, Tenth Revision, Clinical Modification. - ANS ICD-10-CM Coding the individual parts of a specific diagnosis or procedure rather than one combination or bundle that includes all of those components. - ANS Unbundling Choosing a code on the basis of what the insurance company will cover (pay for) rather than accurately reflecting the truth. - ANS Coding for coverage A subjective sensation or departure from the norm as related by the patient. - ANS Symptom Sending a claim for the second time to the same insurance company for the same procedure or service, provided to the same patient on the same date of service. - ANS Double billing A physician's determination of a patient's condition, illness, or injury. - ANS Diagnosis Medical terminology used to provide the location of a health problem or an approach for a surgical procedure. - ANS Anatomical direction Medical terminology that describes the patient's position (on the surgical or examination table). - ANS Anatomical position The structure of the human body - ANS anatomy Medication (drugs) - ANS pharmaceuticals The study of physiological processes of disease - ANS pathophysiology The study of the causes of disease - ANS pathology The study of a disease - ANS etiology A space or area that is hollow and often houses organs and vessels - ANS anatomical cavity A specific location within the anatomy (body). - ANS anatomical site Meaning of pain (a condition or something wrong) - ANS dynia meaning incision (an action) - ANS tomy meaning to view (an action) - ANS scopy meaning fused or stiffened (a condition or something wrong) - ANS ankyl meaning seizure (a condition or something wrong) - ANS lepsy meaning large (a condition or something wrong) - ANS macro A profession al coding specialist needs to have a complete understanding of: a. Medical terminology b. anatomy c. etiology d. all of these. - ANS d. all of these The most important factor in coding is: a. speed of coding process b. accuracy of codes. c. quantity of codes d. level of codes. - ANS b. accuracy of codes Diagnostic codes identify: a. what the provider did for the patient b. who the policyholder is c. at which facility the patient was seen by the provider d. why the provider cared for the patient - ANS d. why the provider cared for the patient. Procedure codes identify: a. what the provider did for the patient b. who the policy holder is c. at which facility the patient was seen by the provider d. why the provider cared for the patient - ANS a. what the provider did for the patient ICD-10-CM coding guidelines do what? - ANS identify specific rules for coding. ICD-10-CM guidelines can be found where? - ANS in the front of the ICD-10-CM manual. When ICD-10-CM codes support medical necessity, this means what? - ANS there was a valid health care reason to provide services. The paperwork in the pt.'s file that corroborates the codes presented on the claim form for a particular encounter is known as? - ANS supporting documentation. Changing a code to one you know the insurance company will pay for is called? - ANS coding for coverage. Unbundling is an illegal practice that has coders do what? - ANS bill using several individual codes instead of one combination code. Upcoding is an illegal practice that has coders do what? - ANS bill using a code for a higher level of service than what was actually provided. When reading the physician's notes to abstract key words with regard to diagnostic coding, you must look for what? - ANS confirmed diagnoses relating to WHY the physician is caring for the patient at this visit, signs and symptoms relating to why the physician is caring for the patient at this visit.