Medical Coding
How many characters can an ICD-10-CM code contain?
Up to 7 characters
What does EOB stand for?
Explanation of Benefits
What do you call a claim form that is submitted with no errors?
"Clean claim"
What is the length of all CPT codes?
5 digits
What does NP & EP stand for?
New patient & Established patient
What is a diagnosis code?
A diagnosis code describes the patient’s medical condition or disease. It's WHY the patients is having a procedure or being seen by a doctor
What does HIPAA stand for?
HIPAA stands for Health Insurance Portability and Accountability Act.
What is a claim form?
What is used to send to insurance companies to bill for procedures and services
99202 is an example of what type of code?
CPT; E & M-Evaluation and Management
What is the civilian health care program of the US Department of Defense (DOD) Military Health System
TRICARE
How are CPT codes maintained?
CPT codes are maintained by the American Medical Association (AMA).
What is a co-pay?
A co-pay is the fixed amount of money a patient owes for a medical visit.
A claim form can be sent to an insurance company two ways. What are they?
What is manually (in the mail) and electronically (by computer)
Codes that begin with a three character alphanumeric followed by a decimal point are?
ICD-10 codes
To determine whether a patient has health insurance coverage and will be able to receive health insurance benefits during a proposed time period is to?
What is Verify Eligibility?
What does CPT stand for?
Current Procedural Terminology
What is a deductible?
A deductible is the amount of money a patient must pay before insurance will cover an expense.
What does SOF mean on a claim?
Signature on file
Which organization supervises the ICD codes on an international level?
World Health Organization (WHO)
What are the 2 Medicare program established in 1965
Part A and Part B
What does ICD-10-CM stand for?
International Classification of Diseases, 10th Revision, Clinical Modification
What does COB stand for?
Coordination of Benefits
This is the name of the universal claim form used to submit outpatient charges.
What is CMS-1500.
5 digit alphanumeric coding system designated for specific services and equipment?
HCPCS (Healthcare Common Procedure Coding System)
What type of procedures are included in Category I CPT codes?
Services and procedures commonly performed by healthcare providers