Anatomy
What is anatomy?
a study of the structure of the human body
Heal Insurance Portability and Accountability Act
What is HIPAA
THE CATEGORY OF A DIAGNOSTIC CODE
WHAT ARE THE FIRST THREE CHARACTERS OF A DIAGNOSIS CODE?
1. Review complete medical documentation
2. Abstract the medical conditions from the visit documentation
3. Identify the main term for each condition
4. Locate the main term in the alphabetic index
5. Verify the code in the tabular list
6. Check compliance with any applicable Official Guidelines and list codes in appropriate order
What are the six steps to coding?
Straightforward Level of MDM
What is
Minimal diagnosis
Minimal risk
Minimal complexity of data
Heart, Veins, Arteries, Blood, Blood Vessels and Capillaries
What is the Cardiovascular System?
Allows for the consultation of providers to ensure that the patient is receiving the best care possible and for third-party payers to send payment to the provider.
What is T.P.O?
Treatment, Payment, Healthcare Operations
What are the 7 possible extensions in an ICD 10 CM code when dealing with fractures?
What are (GIVE A BRIEF DESCRIPTION OF EACH ONE)
A
B
D
G
K
P
S
Made up of the main text, sections of codes and followed by appendixes and an index.
What is Current Procedural Terminology?
Low Level of MDM
What is
Limited diagnosis
Limited/low risk to patient
Limited data
The most important organ in the body.
What is the brain?
What are the three safeguards of the Security Rule.
Technical, Administrative, and Physical Safeguards
Ensuring that all possible characters are used, based on the diagnostic statement found in the patient's documentation.
What is Coding to the Highest Level of Specificity?`
Private payers or government agencies review selected records of a practice for compliance.
What is an External Audit?
Problem Focused
Expanded Problem Focused
Detailed
Comprehensive
What are the Levels of History and Examination?
It breaks down foods into nutrients that can be used by the body.
What is the function of the Digestive System?
Federal Agency that uses audits, interviews, and investigations to combat the misuse of Medical Insurance.
How is the Office of the Inspector General?
Ensuring that the code used is defined as certain. All procedures have proven that there is an actual illness in an Ambulatory Setting.
What is a Primary Diagnosis?
1. Billing non-covered services
2. Billing over limit services
3. Upcoding- using a procedure code that provides a higher reimbursement rate than the correct code.
4. Billing without signatures
5. Using outdated codes
What are common errors in billing?
Description of its development from the first sign or symptom that the patient experienced to the present time
What is the History of the Present Illness?
The skin (epidermis)
What is the largest organ found in the human body?
All medical office's rules and regulations of how employees are to act and treat patients with respect. Regulations that must be followed regarding Privacy and Security.
What is the Compliance Handbook?
Used in both the index and tabular list to enclose supplementary words - non-essential modifiers.
What are the Parentheses?
Conducted after the claim has been send the remittance advice has been received
What is a retrospective audit?
High Level of MDM
What is
Extensive diagnoses
High risk to patient
Extensive amount and complexity of data