ICD-10 Detective
This ICD-10 code category is used to report Type 2 Diabetes Mellitus.
What is the E11 category?
What CPT code range is generally used for Evaluation and Management (E/M) office visits?
What is 99202-99215?
HCPCS Level II codes typically begin with what type of character?
What is a letter?
A diagnosis appears in the assessment but has no supporting documentation. What is the auditor's concern?
What is lack of coding support?
What section within the note is the diagnosis generally not coded during an audit?
What is the Problem List?
Documentation states "essential hypertension." What ICD-10 code should be assigned?
What is I10?
What does CPT stand for?
What is Current Procedural Terminology?
Wheelchairs, diabetic supplies, and durable medical equipment are often reported using what code set?
What is HCPCS Level II?
This acronym refers to coding only diagnoses that are documented and addressed during the encounter.
What is MEAT or DSP?
What is the most common reason a diagnosis is removed during an audit?
What is lack of supporting documentation or evidence that the condition was addressed?
A provider documents acute systolic heart failure. What code category would you review?
What is I50.21 (Acute Systolic Heart Failure)?
A provider performs a preventative medicine visit. Would you typically choose an E/M sick visit code or a preventive medicine code?
What is a preventive medicine code?
What HCPCS modifier is commonly used to indicate a waiver of liability statement is on file?
What is Modifier GA?
An auditor reviews records to determine whether documentation supports code assignment. This process is called what?
What is validation?
What is an auditor's favorite phrase?
What is "Show me where it's documented."?
This documentation element is required to support coding a chronic condition during a risk adjustment audit.
What is MEAT (Monitor, Evaluate, Assess/Address, Treat) or DSP (Diagnosis, Status, Plan)?
When selecting an E/M level based on time, what must be documented?
What is total time spent on the date of service?
Medicare frequently requires billing of medications administered in-office using what type of code set?
What is HCPCS Level II J-codes?
The provider copied and pasted a diagnosis from a prior note but never addressed it. What is the audit risk?
What is unsupported coding/documentation?
What is the unofficial golden rule of medical coding and auditing?
What is "If it isn't documented, it didn't happen."?
A provider documents "history of stroke" with no residual deficits. What type of code would likely be assigned?
What is a personal history code (Z86.73)?
This key factor determines whether a procedure code can be billed separately from another service performed the same day.
What is whether the services are distinct and supported by coding guidelines/modifiers?
HCPCS Level II codes are maintained by which federal agency?
What is CMS (Centers for Medicare & Medicaid Services)?
A coding auditor's ultimate goal is not maximizing reimbursement but ensuring what?
What is coding accuracy and compliance?
What is a red flag during a risk adjustment audit?
What is if the provider documents a diagnosis but includes no assessment, treatment, monitoring, or discussion of it?