Documentation
Evaluations
Fraud & Abuse
True or False?
Grab Bag
100

What are the 6 questions of Documentation that one should attempt to answer for each encounter?

Who, What When, Where, Why, and How

100

What type of exam is a D0140 - limited oral evaluation?

Problem -focused

100

What is used to support allegations of fraud, abuse, or malpractice?

Weak or missing documentation


100

Which translation service is IUSD contracted with?

Language Line

100

What do radiographs support in the medical record?

 Medical Necessity

200

What is considered "timely and reasonable" for documenting and approving your chart entries?

24-48 hours

200

Which type of exam for a new or established patient MUST include an examination for Oral Cancer in order to be billed?

D0150 - Comprehensive Oral Exam - new or established patient

200

__________ is one example of Fraud?

  • Billing for services not rendered
  • Misrepresenting dates of service
  • Misrepresentation of services
  • Misrepresenting patient identities
  • Unbundling of procedures
  • Over-coding & under-coding of services
  • Performing unnecessary procedures
200

True or False?  Family members are allowed to translate for the patient.

False!  

ONLY IUSD certified translators may be used in place of Language Line Services 

200

Which animal has the same number of teeth (32) as an adult human?

A giraffe 

300

What is the most common audit finding when charts are reviewed?

Inadequate supporting documentation

300

D0140 is reported when... (name one)

Trauma

Acute Infection

Emergency

Referred for a specific problem by another provider

300

Once a provider has been made aware of  “Abuse” but doesn’t correct the error while ignoring the potential consequences, he or she then crosses the line into _______________ and the violation of abuse can then elevate to Fraud.

Reckless Disregard

300

D4910 Periodontal Maintenance routinely follows a Comprehensive Oral Evaluation

False!  

D4910 routinely follows Scaling and Root Planing (SRP)

D4341 SRP - 4 or more teeth, per quadrant

D4342 SRP - 1-3 teeth, per quadrant

300

Who is the elf in Rudolph the Red Nosed Reindeer that wants to be a dentist?

Hermy the Elf

400

What can happen if you use unrecognized abbreviations, symbols, acronyms, or misspelled words in your charting?

Harm or unfavorable outcomes to the patient

400

What type of evaluation is done to determine an established patient's oral health status since their last check-up?

D0120 periodic oral evaluation - established patient

400

_________ states that over-coding and under-coding are equal and clear violations.

False Claims Act

400

Scaling is the definitive procedure during a scaling and root planing (SRP)

False!  Root planing is the definitive procedure.

Document the specific teeth that were root planed to support SRP code set nomenclature in order to appropriately bill this service

400

What type of radiograph allows for a comprehensive all-in-one view of the oral structures to be seen?

D0330 - Panoramic radiograph

500

What must be proven in your documentation and drives the need for services rendered for each encounter?

Medical Necessity

500

Which CDT code is used to report a re-evaluation - post-operative office visit?

D0171


500

What type of document is a dental record?

The dental record is a legal document


"If it isn't documented, it didn't happen"

500

2 periapical (PA) radiographs taken of #21 and #22 would be coded as:

D0220 intraoral - PA first radiographic image #21

D0220 intraoral - PA first radiographic image #22

False!  Correct coding is:

D0220 intraoral - PA first radiographic image #21

D0230 intraoral - PA each additional radiographic image #22

500

This animated dentist is known as Nemo's captor in "Finding Nemo"

Dr. P. Sherman

M
e
n
u