Tulloch

In order to work competently as a medical claims specialist in a physician's office, one needs - To know procedural and diagnostic coding In addition to medical data, the medical record may include: - personal data, financial data & social data Medical ethis will typically address standards of: - conduct Everything that a medical claims specialist learns about a patients condition must remain: - confidential Which of the following skills would NOT be required for accurate filing of claim...

All are eligible under Medicare health insurance except: a) retiree of the Civil Service Retirement System b) persons of 65 years or older, retired on Social Security benefits c) those diagnosed with end-stage renal disease (ESRD) d) All kidney donors - d) All kidney donors Which provider/network must accept the payer's allowable amount as 100% payment for procedures or services provided? a) Out of Network provider b) Participating provider c) Non-participating provider d) Both a & b ...

The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - Addon codes As of April 1, 2014 what is the maximum number of diagnoses that can be reported on the CMS-1500 claim form before a further claim is required? - 12 What is considered proper supportive documentation for reporting CPT and ICD codes for surgical procedures? - Operative...

Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs) are similar in that they are both: a. Determined by HCPCS codes b. Focused on hospital outpatients c. Focused on hospital inpatients d. Prospective payment systems - d. Prospective payment systems ** Both are types of prospective payment systems (Casto and Forrestal 2015, 6). A patient is treated for esophageal varices with hemorrhage due to cirrhosis. The diagnostic codes that would be assigned are: I85.01 E...

One of the most important pieces of communication equipment in a medical practice is the: A. facsimile machine B. telephone C. pager D. typewriter - B. telephone the main means of communication with other doctors, hospitals, and laboratories is the: A. telephone B. adding machine C. typewriter D. photocopier - A. telephone A benefit of a voicemail system is that: A. a receptionist routes calls to the appropriate extension B. a person answers the telephone C. callers never receive a ...

Carcinoma in situ - Tumor cells that are undergoing malignant changes but are still confined to the point of origin without invasion of the surrounding normal tissue Examples of carcinoma in situ - Intraepithelial infiltrating The patient was admitted from the emergency department because of chest pain. Following blood work, it was determined that the patient had elevated CPKs and MB enzymes. The EKG shows nonspecific ST changes. What type of diagnosis might this indicate? a. Unstable ang...

The insured may not necessarily be the patient seen for the medical service. - True Personal insurance is usually less expensive than other health insurance. - False Time limits stated in individual health insurance policies about an insurance company's obligation to pay benefits are the same for all insurance companies. - False There is standardization of format for the explanation of benefit document for all private insurance carriers. - False What organization publishes diagnostic and ...

What are Medical Ethics? - Standards of conduct based on moral principle. they are generally accepted as a guide for behavior towards pt's, dr's, coworkers, the gov, and ins co's What does acting within ethical behavior boundaries mean? - Carrying out one's responsibilities with integrity, dignity, respect, honesty, competence, fairness, and trust Compliance regulations - Most billing-related cases are based on HIPAA and False Claims Act Health Insurance Portability & Accountability Act...

A 7-year-old patient was admitted in the emergency department for treatment of shortness of breath. The patient is given epinephrine and nebulizer treatments. The shortness of breath and wheezing are unabated following treatment. What diagnosis should be suspected? - Asthma with status asthmaticus A patient is admitted with a high temperature, lethargy, hypotension, tachycardia, oliguria, and elevated WBC. The patient has more than 100,000 organisms of Escherichia coli per cc of urine. The ...

Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs) are similar in that they are both: a. Determined by HCPCS codes b. Focused on hospital outpatients c. Focused on hospital inpatients d. Prospective payment systems - d. Prospective payment systems ** Both are types of prospective payment systems (Casto and Forrestal 2015, 6). A patient is treated for esophageal varices with hemorrhage due to cirrhosis. The diagnostic codes that would be assigned are: I85.01 E...

True or False Vitamins: - cannot be made in the body - noncaloric - required in small amounts (mg and mcg) - TRUE Vitamins: - cannot be made in the body - noncaloric - required in small amounts (mg and mcg) What 3 forms can vitamin A take? - - retinol (alcohol) - retinal (aldehyde) - retinoic acid (acid form from retinal) What form of vitamin A is normally found in blood and tissues? - Retinyl Palmitate What form of vitamin A is found in plants? - Previtamin A - carotenoid structure...

When water soluble vitamins are consumed in excess of body needs, generally the excess is: A. excreted in the feces; B. stored in liver, bone, and adipose tissue; C. excreted in the urine; D. not absorbed; E. none of these. - excreted in the urine Vitamin C acts as a coenzyme by maintaining iron in a reduced state in: A. collagen synthesis B. methylation of homocysteine C. release of energy from nutrients D. heme synthesis - collagen synthesis As little as 10 mgs/day of vitamin C may ...

What are the most prevalent saturated fatty acids in the average US diet? A. palmitic and stearic acid B. oleic and linoleic C. linoleic and linolenic D. acetic and butyric - A. palmitic and stearic acid What is formed when fatty acids are oxidized in the mitochondria? A. glycerol B. pyruvate C. triacylglyceride D. acetyl CoA - D. Acetyl CoA What is the normal product of fatty acid synthase? A. Triacylglyceride B. Palmitate C. n-3 fatty acid D. n-6 fatty acid - B. Palmitate Which ...

What are the most prevalent saturated fatty acids in average US diet? A. palmitic and stearic acid B. oleic and linoleic C. linoleic and linolenic D. acetic and butyric - Palmitic and stearic acid What is formed when fatty acids are oxidized in the mitochondria? A. glycerol; B. pyruvate; C. triacylglyceride; D. acetyl CoA; - Acetyl CoA What is the normal product of the fatty acid synthase? A. Triacylglyceride; B. Palmitate; C.n-3 fatty acid; D.n-6 fatty acid; - Palmitate Which fat...

What 4 major elements make up the human body? - - Oxygen 63% - Carbon 18% - Hydrogen 9% - Nitrogen 3% Of the major 4 elements that make up the human body, __________ makes up the largest portion. - Oxygen - 63% The human body is made up of oxygen, carbon, hydrogen, & nitrogen. But what do these elements compose? - Water Proteins Lipids Carbohydrates Nucleic acids Approximately how much water makes up the human body? - 55 - 65% of body mass Combined, how much does protein & lipids ma...

Assistive devices are used when a caregiver is required to lift more than 35 lbs/15.9 kg true or false - True During any patient transferring task, if any caregiver is required to lift a patient who weighs more than 35 lbs/15.9 kg, then the patient should be considered fully dependent, and assistive devices should be used for transfer If a draining wound tests positive for MRSA, the patient is placed on contact precautions True or False - True Patients with abscess or draining wounds who ...

A visitor walks through the work area and picks up a flash drive from an employee's desk. What security controls should have been implemented to prevent this security breach? a. Device and media controls b. Facility access controls c. Workstation use controls d. Workstation security controls - Correct Answer: B Facility access controls include establishing safeguards to prohibit the physical hardware and computer system itself from unauthorized access while ensuring that proper authorize...

In what book does a character get his nickname from a Jazz song? - The Crossover by Kwame Alexander In what book does a father advise his son to "remember the greatest"? - The Crossover by Kwame Alexander In what book does a character own one pair of Michael Jordan sneakers for every month of the year? - The Crossover by Kwame Alexander In what book does a character like his long hair because it is like having wings? - The Crossover by Kwame Alexander In what book is the main character...

The nurse is caring for a 100-kg patient being monitored with a pulmonary artery catheter. The nurse assesses a blood pressure of 90/60 mm Hg, heart rate 110 beats/min, respirations 36/min, oxygen saturation of 89% on 3 L of oxygen via nasal cannula. Bilateral crackles are audible upon auscultation. Which hemodynamic value requires immediate action by the nurse? a. Cardiac index (CI) of 1.2 L/min/m3 b.Cardiac output (CO) of 4 L/min c.Pulmonary vascular resistance (PVR) of 80 dynes/sec/cmd...

A patient asks a medical assistant to explain the difference between a liniment and a medicated lotion. Which of the following responses should the assistant make? - liniments contain a higher portion of oil than medicated lotions A medical assistant is speaking with a patient who recently received a terminal diagnosis. The patient states, "I regret not taking better care of myself. Now, I won't be able to accomplish what I wanted to do with my life. "The assistant should identify that t...