Ch. 4: ICD-10-CM Coding Guidelines
Exam/57 Accurate Q’s and A’s
General ICD-10-CM diagnosis guidelines are to be used as a companion to
the official version of the ICD-10-CM coding manual, which contains
_________________________ to ensure accurate coding. - -coding conventions
-ICD-10-CM disease and injury codes describe causes of illnesses or clinical
symptoms exhibited by the patient, and codes assigned must be supported
by ______________________ in the patient's record. - -documentation (medical
necessity; physician's queries)
-TPPs require that claims submitted for reimbursement demonstrate
____________________________ for treatment, which means that a diagnosis
code must be reported for each procedure or service code included on the
claim. - -medical necessity
-HCPCS level II and CPT codes are reported on _____________________ claims. -
-outpatient
-ICD-10-PCS procedure coding guidelines apply to _________________
hospitalizations only. - -inpatient
-CMS and NCHS are agencies in the DHHS that develop official guidelines for
coding and reporting using _______________________. - -ICD-10-CM
-The "Official Guidelines for Coding and Reporting" are approved by four
organizations that make up the ___________________________ for the ICD-10-
CM. They include: AHA, AHIMA, CMS, and NCHS. - -Cooperating Parties
-AHA stands for: - -American Hospital Association
-AHIMA stands for: - -American Health Information Management Association
-CMS stands for: - -Centers for Medicare and Medicaid Services
-NCHS stands for: - -National Center for Health Statistics
-"Official Guidelines for Coding and Reporting" are a set of rules developed
to accompany and complement the official ____________________ and
instructions provided within ICD-10-CM. - -conventions
, -The health care provider is responsible for complete and accurate
___________________________________________________. - -patient record
documentation
-The coder is responsible for providing complete and accurate
________________________________ and reporting diagnoses and procedures. - -
code assignment
-Section I, of the ICD-10-CM "Official Guidelines for Coding and Reporting",
includes the structure and conventions of the ___________________________ and
general guidelines that apply to the entire ___________________________ and
chapter-specific guidelines that correspond to the chapters as they are
arranged in the ___________________________. - -classification
-Section II, of the ICD-10-CM "Official Guidelines for Coding and Reporting",
includes guidelines for selection of the principal diagnosis for
_________________________ settings. (____________________________ settings
include acute care hospitals, long-term care facilities, home health care
agencies, nursing homes, and so on.) - -non-outpatient
-Appendix I, of the ICD-10-CM "Official Guidelines for Coding and Reporting",
includes _________ reporting guidelines. - -POA
-POA stands for: - -present on admission
-______________ regulations for electronic transactions require providers and
TPPs, including MACs, to adhere to the "Official Guidelines for Coding and
Reporting". Thus, a violation of coding guidelines is technically a ____________
violation. - -HIPAA
-The ICD-10-CM "Official Guidelines for Coding and Reporting" are approved
by the __________________ for ICD-10-CM to accompany and complement the
official conventions and instructions provided within ICD-10-CM. - -
Cooperating Parties
-Coding guidelines use the term ____________________ to mean physician or
any qualified health care practitioner who is legally accountable for
establishing the patient's diagnosis. - -provider
-Coding guidelines use the term _____________________ for all health care
settings, including inpatient hospital admissions. - -diagnosis
-Section I, of the ICD-10-CM "Official Guidelines for Coding and Reporting",
includes the _________________________ of the classification and general
guidelines that apply to the entire classification and chapter-specific
Exam/57 Accurate Q’s and A’s
General ICD-10-CM diagnosis guidelines are to be used as a companion to
the official version of the ICD-10-CM coding manual, which contains
_________________________ to ensure accurate coding. - -coding conventions
-ICD-10-CM disease and injury codes describe causes of illnesses or clinical
symptoms exhibited by the patient, and codes assigned must be supported
by ______________________ in the patient's record. - -documentation (medical
necessity; physician's queries)
-TPPs require that claims submitted for reimbursement demonstrate
____________________________ for treatment, which means that a diagnosis
code must be reported for each procedure or service code included on the
claim. - -medical necessity
-HCPCS level II and CPT codes are reported on _____________________ claims. -
-outpatient
-ICD-10-PCS procedure coding guidelines apply to _________________
hospitalizations only. - -inpatient
-CMS and NCHS are agencies in the DHHS that develop official guidelines for
coding and reporting using _______________________. - -ICD-10-CM
-The "Official Guidelines for Coding and Reporting" are approved by four
organizations that make up the ___________________________ for the ICD-10-
CM. They include: AHA, AHIMA, CMS, and NCHS. - -Cooperating Parties
-AHA stands for: - -American Hospital Association
-AHIMA stands for: - -American Health Information Management Association
-CMS stands for: - -Centers for Medicare and Medicaid Services
-NCHS stands for: - -National Center for Health Statistics
-"Official Guidelines for Coding and Reporting" are a set of rules developed
to accompany and complement the official ____________________ and
instructions provided within ICD-10-CM. - -conventions
, -The health care provider is responsible for complete and accurate
___________________________________________________. - -patient record
documentation
-The coder is responsible for providing complete and accurate
________________________________ and reporting diagnoses and procedures. - -
code assignment
-Section I, of the ICD-10-CM "Official Guidelines for Coding and Reporting",
includes the structure and conventions of the ___________________________ and
general guidelines that apply to the entire ___________________________ and
chapter-specific guidelines that correspond to the chapters as they are
arranged in the ___________________________. - -classification
-Section II, of the ICD-10-CM "Official Guidelines for Coding and Reporting",
includes guidelines for selection of the principal diagnosis for
_________________________ settings. (____________________________ settings
include acute care hospitals, long-term care facilities, home health care
agencies, nursing homes, and so on.) - -non-outpatient
-Appendix I, of the ICD-10-CM "Official Guidelines for Coding and Reporting",
includes _________ reporting guidelines. - -POA
-POA stands for: - -present on admission
-______________ regulations for electronic transactions require providers and
TPPs, including MACs, to adhere to the "Official Guidelines for Coding and
Reporting". Thus, a violation of coding guidelines is technically a ____________
violation. - -HIPAA
-The ICD-10-CM "Official Guidelines for Coding and Reporting" are approved
by the __________________ for ICD-10-CM to accompany and complement the
official conventions and instructions provided within ICD-10-CM. - -
Cooperating Parties
-Coding guidelines use the term ____________________ to mean physician or
any qualified health care practitioner who is legally accountable for
establishing the patient's diagnosis. - -provider
-Coding guidelines use the term _____________________ for all health care
settings, including inpatient hospital admissions. - -diagnosis
-Section I, of the ICD-10-CM "Official Guidelines for Coding and Reporting",
includes the _________________________ of the classification and general
guidelines that apply to the entire classification and chapter-specific
