Medical Coding exam PREP STUDY
QUESTIONS
HIPAA (part 1) - with Answers:Health Insurance Portability and Accountability Act
ICD - with Answers:International Classification of Diseases required by Medicaid and Medicare
CPT - with Answers:Current Procedural Terminology (
CDM - with Answers:Charge Description Manager
Has all the info about health care services that patients have received and financial transactions
that have taken place
Makes sure that the provider accurately charges the patient for routine services and supplies
Claim - with Answers:A claim is a complete record of all the services provided to a patient
forms of info needed for a claim - with Answers:full name and demographic information.
account number - with Answers:Number on an invoice that identifies specific episode of care,
date of service or patient
Medicare summary notice (MSN) - with Answers:document that outlines the amounts billed by
the provider and what the patient must pay the provider
what does HIPAA mean? (part 2) - with Answers:Fed Act to ensure the privacy of Protected
Health Information (PHI)
defines the permitted uses and disclosures of PHI
Enforces rules and regs set forth in this Act by civil and criminal penalties
What is Protected Health Information? - with Answers:PHI is all individually identifiable
healthcare information in all forms: (VOWE)
, -Visual
-Oral
-Written
-Electronic
Individually Identifiable Information - with Answers:Info is individually identifiable if:
-It id's the individual or offers a reasonable basis for id
-It is created or received by a covered entity or an employer
-Relates to the past, present or future physical or mental health or condition, the provision of
health care, or the payment for heath care
Permitted uses and disclosures of PHI - with Answers:-Directly to the individual who is the
subject of the PHI
-To any person for purposes of Treatment, Payment or health care Operations (TPO)
-for reporting purposes as permitted by law or regulation
-Family/friends acting as caregivers
-Any person providing a HIPAA valid authorization
PHI Use vs Disclosure - with Answers:Use = the way PHI is handled internally be a covered
entity or its BA
Disclosure =The way PHI is disseminated from a covered entity or its BA to an outside person or
organization. The privacy Rule applies to PHI requests by covered entities and their BAs
HIPAA Valid Authorization - with Answers:-contains description of the info to be released
-name/id of person requesting the disclosure
-name/id of person whom the PHI will be released
-description of the purpose of the use or disclosure
-Expiration date- limit of time for the authorization
-signature and date
-a statement notifying the individual of the right to revoke at anytime
QUESTIONS
HIPAA (part 1) - with Answers:Health Insurance Portability and Accountability Act
ICD - with Answers:International Classification of Diseases required by Medicaid and Medicare
CPT - with Answers:Current Procedural Terminology (
CDM - with Answers:Charge Description Manager
Has all the info about health care services that patients have received and financial transactions
that have taken place
Makes sure that the provider accurately charges the patient for routine services and supplies
Claim - with Answers:A claim is a complete record of all the services provided to a patient
forms of info needed for a claim - with Answers:full name and demographic information.
account number - with Answers:Number on an invoice that identifies specific episode of care,
date of service or patient
Medicare summary notice (MSN) - with Answers:document that outlines the amounts billed by
the provider and what the patient must pay the provider
what does HIPAA mean? (part 2) - with Answers:Fed Act to ensure the privacy of Protected
Health Information (PHI)
defines the permitted uses and disclosures of PHI
Enforces rules and regs set forth in this Act by civil and criminal penalties
What is Protected Health Information? - with Answers:PHI is all individually identifiable
healthcare information in all forms: (VOWE)
, -Visual
-Oral
-Written
-Electronic
Individually Identifiable Information - with Answers:Info is individually identifiable if:
-It id's the individual or offers a reasonable basis for id
-It is created or received by a covered entity or an employer
-Relates to the past, present or future physical or mental health or condition, the provision of
health care, or the payment for heath care
Permitted uses and disclosures of PHI - with Answers:-Directly to the individual who is the
subject of the PHI
-To any person for purposes of Treatment, Payment or health care Operations (TPO)
-for reporting purposes as permitted by law or regulation
-Family/friends acting as caregivers
-Any person providing a HIPAA valid authorization
PHI Use vs Disclosure - with Answers:Use = the way PHI is handled internally be a covered
entity or its BA
Disclosure =The way PHI is disseminated from a covered entity or its BA to an outside person or
organization. The privacy Rule applies to PHI requests by covered entities and their BAs
HIPAA Valid Authorization - with Answers:-contains description of the info to be released
-name/id of person requesting the disclosure
-name/id of person whom the PHI will be released
-description of the purpose of the use or disclosure
-Expiration date- limit of time for the authorization
-signature and date
-a statement notifying the individual of the right to revoke at anytime
