CPC 2021(updated) Exam Study Guide correctly answered

CPC 2021(updated) Exam Study Guide correctly answered Documentation (content) Proper code assignment is determined both by _____________ in the medical record and by the unique rules that govern each code set in that instance An auditor The role a coder may take on to verify that the documentation supports the codes the physician has selected Query the physician If the medical record is inaccurate or incomplete, it will not translate properly to the language of codes. What can a coder do in order for the medical record to be complete and accurate so they can bill properly? Quarterly (usually) How often are codes and insurance payment policies updated? NPP Non-Physician Provider (also known as mid-level providers or physician extenders) PA Physician assistant NP Nurse practitioner Commercial and Government The two types of primary insurances Commercial Carriers Private payers that may offer both group and individual plans Medicare The most significant government insurer; a federal health insurance program People over 65, blind or disabled individuals, and people with permanent kidney failure or end-stage renal disease Medicare provides coverage for what kind of people? ESRD end-stage renal disease Medicare Part A Helps cover inpatient hospital care, as well as care provided in skilled nursing facilities, hospice care, and home healthcare, Medicare Part B Covers medically necessary physicians' services, outpatient care, and other medical services (including some preventive services) not covered under Medicare Part A. It can be an optional benefit. Medicare Part C Also called Medicare Advantage, combines the benefits of Medicare Part A, Part B, and-sometimes- Part D. The plans are managed by private insurers approved by Medicare. Medicare Part D A prescription drug program available to all Medicare beneficiaries. Medicaid A health insurance assistance program for some low-income people (especially children and pregnant women) sponsored by federal and state governments.