ICD-10
How long are ICD-10 codes?
What is 3-7 characters in length
What does it mean when a patient signs an assignment of benefits?
What is paying the provider with payments from the payer directly
True or False: Participating providers can accept Medicaid patients on a case by case basis
What is False
CPT stands for
What is current procedural terminology
Copay?
To code for an ovarian cyst, what would you first look up?
What is cyst
Form completed using the patient's data from their electronic health record
What is CMS 1500
What does Medicare Part B cover?
What is preventive services and medically necessary services
Separating the components of a procedure and coding them separately
What is unbundling
Codes that provide a uniform language to describe medical, surgical, and diagnostic services
What is HCPCS
How many exclude notes does the ICD-10-CM coding system have?
What is 2
Does signing an advance beneficiary notice (ABN) insure that the insurance will pay for the procedure?
What is no
What Medicare program covers hospital charges?
What is Medicare Part A
The coding book used for specifying services and procedures performed in the medical office
What is CPT
Coding term used for the level of care that involves multiple systems
What is comprehensive
ICD-10-CM book has 21 chapters that are located where
What is Tabular List
Before submitting a health insurance claim form most providers will have a patient sign this first.
What is signing an authorization to release medical records information
True or False: Medicare does not cover lab test considered medically necessary to treat a disease or condition.
What is false
To code correctly, a medical assistant should understand elements of anatomy and physiology, procedures, and ________
What is medical terminology
-rrhexis means ____
What is rupture
Character used in ICD-10-CM codes when expansion/extension code is needed to meet highest level of specificity requirement
What is placeholder character
Concept of medical necessity means services are covered if
What is Diagnose and Treat
Medicare and Medicaid EHR Incentive Programs provide incentives payments eligible to eligible healthcare professionals and eligible hospitals as they implement, upgrade, or demonstrate meaningful use of _____
What is certified EHR technology
CPT code that has the full description of the procedure
What is a stand-alone code
For ICD-10-CM coding, after you find the main term in the Alphabetic Index, you should than cross-reference the code in the _______
What is the Tabular List
Word that identifies a disease and appears in bold face.
What is the main term
Another term for precertification
What is prior authorization
When billing to CMS programs, this will happen to the claim if the most specific code available is not used
What is claim will be recjected
Determining the need for modifiers
What is the last step in the coding process for CPT
Code linkage
What is the connection between diagnostic and procedural information on a claim
First step in coding in ICD-10-CM
What is locate the main term in alphabetic index
Encounter form
What a provider completes during/after a patient's visit to summarize their billing information
Consequences of incorrect coding and incorrect billing
What is denied claims, fines, prison sentences, and reduced payments
Comprehensive examination
What is the most extensive and complete of the examinations
Uses a lower level code
What is downcoding
Code set standards for ICD-10-CM are mandated by
What/Who is HIPAA
Coordination of benefits
What is explaining how insurance policies will pay if more than one policy applies
The definition of the revenue cycle
What is all administrative and clinical functions which ensure that sufficient monies flow into the practice to pay bills
Codes that are used for DMEs
What is HCPCS codes
CPT Level 1 modifiers have how many digits
What is two
How many characters are in a category code in ICD-10-CM
What is 3
80/20 percentage of each claim that the insured pays
What is coinsurance
Name 3 common billing errors
What are billing for noncovered services, upcoding, and unbundling
CPT codes are used to report
What is lab tests, surgical procedures, and anesthesia
The key to receiving coverage and payment from a payer is the payer's definition of
What is medical necessity