Procedural Coding
Five Digit Code
What is the format of most CPT codes?
One letter followed by two digits
How are the first three characters structured in an ICD-10 code?
Medicaid
What insurance plan provides care for low-income individuals and children?
Group Insurance
What type of insurance plan covers most full-time employees?
To link procedure codes to correct diagnosis codes
Why do MA's have to know medical coding guidlines?
Four digits and one letter
How are Category II and Category III CPT codes structured?
Type, Size, Location, & Method of removal of the lesion
When removing a lesion, what might influence selecting the correct diagnosis code?
Medicare
Which federal insurance plan provides for services for the elderly and disabled?
It is a list of approved medications often published by managed care organizations to list prescription drug benefits.
What is a formulary?
Replacing names to numbers and letters.
How does a classification system become a coding system?
HCPCS Level II
What types of codes are used for Medicare and Medicaid Services, including equipment?
To track diseases, classify diseases, & collect data for medical research.
What is the purpose of a diagnosis code?
CHAMPVA
What insurance plan covers a disabled service member's wife and children?
Insurance that covers wages for employees due to injury, illness, or accidents in the workplace.
What is Worker-comp insurance?
Benefit
What is a service covered by insurance called?
Anatomic Location
What specification of a procedure would require an MA to switch from the index to the tabular list of a CPT manual?
10th edition
What does "10" stand for in ICD-10?
Hospital Stays
What services are covered under Medicare Part A?
Assignment of Benefits
What form does the physician have to fill out to directly receive reimbursement from an insurance company?
Deductible
What is the term for the amount of money that must be paid each year for services before the insurance company begins to pick up the payments?
A two-digit modifier
What would be added to a procedure code if it unexpectedly required an assistant?
To decide whether the care given corresponds to the patient's disease
How do insurance companies use diagnosis codes?
80%
What is the percentage that Medicare pays after reaching your annual deductible?
Utilization Review
What is the process for when insurance companies determine medical necessity?
Coinsurance
What is the term used for the payment a patient makes to pay a percentage of their medical services?