Books
What is the name of the diagnosis code book?
ICD-10-CM
A/R Cycle
process for looking up a Dx Code
Index then Tabular
how many mod's are in the MBIC program
7, excluding externship
What does timely filing mean?
to submit a claim with in the time frame that the insurance company dictates
What is the name of the procedure code book?
CPT
What does HIPAA stand for?
Health insurance portability and accountability act
how many Dx codes are there?
over 70,000
How often are you to be in class?
twice a week
what is a claim denial?
A claim denial occurs when a health insurance company refuses to pay for a service or procedure that has been provided to a patient. This happens after the insurance company or payer has processed the claim and determined it is not eligible for payment, often due to errors, coverage issues, or other reasons
What is the name of the the Level II procedure code book?
HCPCS
What is the form used for billing claims?
CMS 1500 or HCFA
When did ICD-10-CM become effective
Oct 2015
What is Ms. Cindy's dog's name?
Vader
who is the largest medical/health care payer in the US?
Medicare is the single largest payer for health care services in the United States
Who publishes the Dx book in the US?
Specifically, the WHO develops and maintains the international version of ICD-10, while the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS) within the U.S. Department of Health and Human Services (HHS) adapt and publish the ICD-10-CM for use in the United States
What is the max number of Dx that can be put on a claim form?
12
When does the ICD-10-CM become effective each year?
Oct 1st of each year
If you attend zoom but do not do a quiz or an attendance giving item in SOAR, how many hours of attendance will you get?
1
What is dual coverage?
when an individual is covered by two insurances
Who publishes the the procedure code book?
The American Medical Association (AMA) publishes the CPT (Current Procedural Terminology) manual for procedure codes. The AMA developed and continues to maintain the CPT code set, ensuring it reflects current medical practice and innovations
When is a clean claim considered completed?
when full payment is made less the charge/write off
What is the last section of codes in the Dx code book?
U
does homework count towards attendance?
no
what is the birthday rule with dual coverage?
While birth years are not considered, the day and month of a parent's birthday determine the coverage.