Aapc

What document is referenced to when looking for potential problem areas identified by the government indicating scrutiny of the services within the coming year?: A) OIG Compliance Plan Guidance B) OIG Security Summary C) OIG Work Plan D) OIG Investigation Plan C (Rationale: Twice a year, the OIG releases a Work Plan outlining its priorities for the fiscal year ahead. Within the Work Plan, potential problem areas with claims submissions are listed and will be targeted with special scrutiny...

Medical coding process of translating a healthcare provider's documentation of a patient encounter into a series of numeric or alphanumeric codes Health information coders, medical record coders, coder/abstractors, coding specialists coders who specialize in coding inpatient hospital services MS-DRG Medical Severity-Diagnosis Related Groups MS-DRG are used to: determine the amount the hospital will be reimbursed if the patient is covered by Medicare or other insurance programs using...

When coding in operative report what action would NOT be recommended? Coding from the header with out reading the body of the report If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient who determines coverage? Medicare administrative contractor (MAC) MAC stands for what!? Medicare administrative contractor What is the definition of coding? Translating documentation into numerical/alphabetical codes used to obtain reimbursement. How many comp...

Which statement is TRUE for reporting external cause codes of morbidity (V00-Y99)? A. All external cause codes do not require a seventh character. B. Only report one external cause code to fully explain each cause. C. Report code Y92.9 if the place of occurrence is not stated. D. External cause codes should never be sequenced as a first-listed or primary code D. External cause codes should never be sequenced as a first-listed or primary code Multiple choice D is the correct answer. The...

What is the patient's right when it involves making changes in the personal medical record? A. Patient must work through an attorney to revise any portion of the personal medical information. B. They should be able to obtain copies of the medical record and request corrections of errors and mistakes. C. It is a violation of federal health care law to revise a patient medical record. D. Revision of the patient medical record depends solely on the facility's compliance program policy. B...

A 46-year-old female had a previous biopsy that indicated positive malignant margins anteriorly on the right side of her neck. A 0.5 cm margin was drawn out and a 15 blade scalpel was used for full excision of an 8 cm lesion. Layered closure was performed after the removal. The specimen was sent for permanent histopathologic examination. What are the CPT® code(s) for this procedure? A. 11626 B. 11626, 12004-51 C. 11626, 12044-51 D. 11626, 13132-51, 13133 C. 11626, 12044-51 A 30-yea...

ABN Advanced Beneficiary Notification AMA American Medical Association APC Ambulatory Payment Classification ARRA American Recovery and Reinvestment Act of 2009 ASC Ambulatory Surgical Center CF Conversion Factor CMS Centers for Medicare and Medicaid Services CPC Certified Professional Coder

What type of health insurance provides coverage for low-income families? Medicaid Rationale: Medicaid is a health insurance assistance program for some low-income people (especially children and pregnant women) sponsored by federal and state governments. The minimum necessary rule applies to Covered entities taking reasonable steps to limit use or disclosure of PHI Rationale: The Privacy Rule generally requires covered entities to take reasonable steps to limit the use or disclosure ...

In ICD-10-CM what condition is reported as the default code when the provider documents urosepsis? The provider must be queried before an ICD-10-CM code can be applied. According to the ICD-10-CM guidelines, how is bilateral glaucoma of the same type and stage reported? A bilateral code can be used to report the type of glaucoma and the stage of glaucoma. According to ICD-10-CM guidelines, what is the maximum length of time for a myocardial infarction to be considered acute? Four weeks...

The provider documents CKD stage 5 and ESRD. What ICD-10-CM code(s) is/are reported? N18.6 What does the abbreviation CKD stand for? Chronic Kidney Disease What would be considered an adverse effect? Rash developing when taking penicillin. What does the 7th character A indicate in Chapter 19? Initial encounter Which statement is TRUE for reporting burn codes? The highest degree of burn is reported as the primary code. A patient presents for an initial encounter for swelling, ten...