Ch. 10 Coding For Necessity Ins

Front 1

TRUE

Back 1

MEDCIALLY MANAGED DIAGNOSES ARE ALSO KNOWN AS SECONDARY DIAGNOSES OR COEXISTING DIAGNOSES.

Front 2

FALSE

Back 2

UP TO 6 DIAGNOSES MAY BE REPORTED ON THE CMS-1500 CLAIM FORM.

Front 3

TRUE

Back 3

TO LINK THE DIAGNOSIS WITH THE PROCEDURE/SERVICE MEANS TO MATCH THE APPROPRIATE DIAGNOSIS WITH THE PROCEDURE/SURVACE THAT WAS RENDERED TO TREAT OR MANAGE THE DIAGNOSIS.

Front 4

FALSE

Back 4

IT IS RECOMMENDED THAT AN AUTHENTICATION LEGEND BE GENERATED WHEN THE PATIENT IS DISCHARGED.

Front 5

FALSE

Back 5

A WAIVER IS REQUIRED BY MEDICARE FOR ALL OUTPATIENT AND PHYSICIAN OFFICE PROCEDURES/SERVICES THAT ARE COVERED BY THE MEDICARE PROGRAM

Front 6

TRUE

Back 6

AUDITING PROCESSES INVOLVE PATIENT RECORDS AND CMS-1500 OR UB-04 CLAIMS TO PROCESS CODES ACCURACY AND COMPLETENESS OF DOCUMENTATION

Front 7

TRUE

Back 7

CHARGEMASTERS ARE USED TO SELECT PROCEDURES, SERVICES, AND SUPPLIES PROVIDED TO HOSPITAL EMERGENCY DEPARTMENT PATIENTS AND OUTPATIENTS

Front 8

TRUE

Back 8

LOCAL COVERAGE DETERMINATIONS (LDCS) SPECIFY UNDER WHAT CLINICAL CIRCUMSTANCES A SERVICE IS COVERED

Front 9

FALSE

Back 9

OCE IS A SOFTWARE USED TO EDIT INPATIENT CLAIMS SUBMITTED BY HOSPITALS

Front 10

FALSE

Back 10

A RESPONSIBLE HEALTH INFORMATION EXPERT ALWAYS USES A HIGHLIGHTER OR OTHER MARKER ON ORIGINAL DOCUMENTS TO ENSURE ACCURACY WHEN CODING CASE REPORTS

Front 11

TRUE

Back 11

THE PRIMARY PURPOSE OF THE PATIENT RECORD IS TO PROVIDE CONTINUITY OF CARE

Front 12

TRUE

Back 12

SOAP NOTES ARE WRITTEN IN OUTLINE FORMAT

Front 13

TRUE

Back 13

OPERATIVE REPORTS MAY VERY FROM SHORT NARRATIVE DESCRIPTIONS TO FORMAL DICTATED REPORTS

Front 14

TRUE

Back 14

GLOBAL SURGERY INCLUDES THE PREOPERATIVE ASSESSMENT, THE PROCEDURE, ANESTHESIA (WHEN USED), AND NORMAL, UNCOMPLICATED FOLLOW-UP CARE.

Front 15

TRUE

Back 15

A CODER SHOULD COMPARE THE BIOPSY REPORT WITH THE POSTOPERATIVE DIAGNOSIS TO DETERMINE IF THE TISSUE IS BENIGN OR MALIGNANT.

Front 16

LCD

Back 16

LOCAL COVERAGE DETERMINATIONS

Front 17

HOW MANY DIAGNOSIS CODES MAY BE REPORTED ON EACH CMS-1500 CLAIM

Back 17

UP TO 4

Front 18

THE PROCEDURE OR SERVICE PROVIDED IS LINKED WITH THE _________ THAT PROVIDED MEDICAL NECESSITY FOR PERFORMING THE PROCEDURE OR SERVICE

Back 18

DIAGNOSIS/CONDITION

Front 19

PATIENT RECORD _____ MUST JUSTIFY AND SUPPORT THE MEDICAL NECESSITY OF PROCEDURES AND SERVICES REPORTED TO PAYERS

Back 19

DOCUMENTATION

Front 20

____ IS A WAIVER FORM REQUIRED BY MEDICARE FOR ALL OUTPATIENT AND PHYSICIAN OFFICE PROCEDURES/SERVICES THAT ARE NOT COVERED BY THE MEDICARE PROGRAM

Back 20

ADVANCE BENEFICIARY NOTICE

Front 21

A ____ SERVES AS A BUSINESS RECORD FOR A PATIENT ENCOUNTER AND IS MAINTAINED IN A PAPER OR AUTOMATED FORMAT

Back 21

PATIENT RECORD

Front 22

HEALTH INSURANCE SPECIALISTS REVIEW THE PATIENT RECORD WHEN ASSIGNING CODES TO

Back 22

DIAGNOSES, PROCEDURES, AND SERVICES

Front 23

HEALTHCARE PROVIDERS USE ____ MAJOR FORMATS FOR DOCUMENTING CLINIC NOTES

Back 23

TWO

Front 24

NARRATIVE CLINIC NOTES ARE WRITTEN IN WHAT FORMAT?

Back 24

PARAGRAPH

Front 25

THE ____ PART OF THE SOAP NOTE CONTAINS THE CHIEF COMPLAINT AND THE PATIENT'S DESCRIPTION OF THE PRESENTING PROBLEM

Back 25

SUBJECTIVE

Front 26

DIAGNOSTIC TEST RESULTS ARE DOCUMENTED IN HOW MANY LOCATIONS?

Back 26

TWO

Front 27

MEDICALLY MANAGED

Back 27

DIAGNOSIS THAT MAY NOT RECEIVE TREATMENT DURING ENCOUNTER

Front 28

OCE

Back 28

OUTPATIENT CLAIMS EDITING SOFTWARE

Front 29

NARRATIVE

Back 29

CLINICAL NOTES IN PARAGRAPH FORM

Front 30

CMS-1500

Back 30

CMS OUTPATIENT CLAIM FORM