Determining coverage
Under what rule is a child's primary coverage under the father's plan when both parents have coverage?
gender rule
ICD-10-CM diagnosis codes have how many characters?
3-7
21 chapters of disease descriptions and their codes
Tabular List
When selecting an Evaluation and Management code, three components are considered:
history
physical examination
medical decision making.
Durable medical equipment (DME) is reported using
HCPCS
Under what rule is a child's primary coverage determined based upon which parent's day of birth is earlier in the calendar year?
birthday rule
A category in ICD-10-CM is how ___ characters
three
provides code numbers for neoplasms based on their anatomical site
Neoplasm Table
E/M codes have four types of examinations that a physician can perform
Problem focused
Expanded Problem Focused
Detailed
Comprehensive
coding system that describes specific products, supplies, and services
HCPCS
The first health plan to pay when more than one plan is in effect
primary insurance.
subcategory code in ICD-10-CM is _____ characters
4-5
a list of drugs and chemicals
Table of Drugs and Chemicals
CPT codes from the Anesthesia section have what two types of modifiers?
standard modifiers and physical status modifiers
List the E/M code key components
Extent of History
Extent of Examination
Medical Decision Making
Another common term for encounter forms
superbills
routing slips
charge slips
ICD-10-CM stands for
International Classification of Diseases, tenth revision, Clinical Modification
Alphabetic Index is organized by
condition.
In CPT, a plus sign (+) next to a code indicates
add-on code.
In CPT the surgery section is organized by
body system
The steps in establishing financial responsibility
Verify the patient’s eligibility for insurance benefits.
Reason for encounter covered by policy
Preauthorization required
Patients responsibility $$
physician’s description of the main reason for a patient encounter
diagnostic statement.
a list of the disease descriptions
Alphabetic Index
CPT codes are used to report the following
medical services.
surgical procedures.
diagnostic procedures.
Using a single payment for two or more related procedure codes
bundling