Billing
Rules and Regulations
Physical exam
Medical Terminology
Rationale
100
How many symptoms are needed to bill a fast track ROS?
2
100
Is looking at your own medical chart a violation of HIPAA?
YES!
100
What is this checking for?
Radial pulse
100
What does oophorectomy mean?
Surgical removal of ovaries
100
What are the 5 key components of a rationale?
Initial impression, differential diagnosis, orders, results, disposition/plan
200
How many minutes are needed to bill critical care time?
30 minutes minimum
200
What does HIPAA stand for?
Health insurance portability and accountability act
200
What are some examples of neurologic deficits?
changes in sensation, changes in speech, unilateral weakness/motor weakness
200
What is the medical terminology for: a big spleen?
Splenomegaly
200
What are the orders needed to diagnose a PE?
D dimer and CT chest
300
What do you need to include if you are unable to obtain history as the patient was intubated by EMS prior to arrival?
History limitation in the HPI AND ROS due to intubation/clinical condition
300
What should you do if you think you violated HIPAA?
Report it to your chief scribe as soon as possible
300
What is the difference between McBurney's and Murphy's?
Murphy's: Gallbladder, RUQ McBurney's: Appendix, RLQ
300
What does CABG stand for?
Coronary artery bypass graft
300
What are some differentials for someone experiencing upper abdominal pain?
Hepatitis, cholecystitis, GERD, gastritis, pancreatitis, MI, musculoskeletal chest/rib pain/strain
400
How many elements should you document to make a clinical physical exam fully billable?
8
400
What information is protected health information (PHI)?
Name, DOB, lab results, MRN, and the fact that the patient was in the ED
400
What would you document if I did this and the patient had no pain/response?
No CVA tenderness bilaterally
400
Define: pruritic
Itchy
400
A patient presents with a headache. She has no focal neurologic deficits and her vitals are WNL. Her CT head and labs are normal. She likely is experiencing a typical migraine. What kind of things should you document as negative diagnoses in the rationale?
No signs of meningitis, no intracranial hemorrhage, no signs of CVA
500
What phrase do you need to add to EKG and cardiac monitor to make it billable?
Interpreted by myself
500
Dr. Roper asks you to silence a monitor, as it is beeping while you are in the room doing a patient evaluation. Would it be okay to perform this task?
No! It is beyond the scope of your job to touch anyone's monitors or any patients.
500
Which of these is a contradiction/doesn't belong? Skin tending around the medial malleolus consistent with an open fracture, surrounding edema and ecchymosis, no deformity.
No deformity! if there is an open fracture this is a deformity
500
Decode this sentence: Pt arrives diaphoretic and tachypneic. He is experiencing anterior sub-sternal chest pain. He was medicated with NTG and ASA. CXR, EKG and Troponin were ordered.
Patient arrives sweaty and with an elevated respiratory rate. His chest pain is located in the front of the chest, under the breast bone. He was medicated with nitroglycerin and aspirin. Chest x-ray, electrocardiogram and troponin were ordered.
500
Patient presents with left sided deficits and slurred speech. CT head was reported as negative. What was ruled out and what is still in the differential?
Acute hemorrhagic CVA and mass are ruled out. Ischemic stroke or TIA is still possible
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