Coding
Guidelines designed to help in the selection of the appropriate diagnosis code
What is instructional notes
True or False: If a patient's condition has not been specifically diagnosed, the health insurance professional must code the signs and/or symptoms
What is true
What is healthcare provider, heath plans, and healthcare clearing house
Manifestation
What is a sign or symptom of a disease
Codes located at the beginning of CPT manuals that identify services, but not actual procedures, provided to patient during an encounter
What is Evaluation/Management codes
Residual conditions produced after the acute phase of illness/injury has ended
What is sequela/sequelae
What are the 3 components of determining the appropriate level of E and M codes
What is history, physical exam, and medical decision making
Cause of the disease
What is etiology
Code listed next to main term in the ICD 10 CM that indicates the condition most commonly associated with the main term
What is default code
5 digit codes developed by the AMA that are used to report services performed by the health care professionals
What is Level 1 codes
Identifying word that aids in locating the correct diagnosis code
What is main term
True or False: Calling the insurance company and obtaining a precertification will guarantee payment of the claim
What is false
Worker's compensation covers
What is expenses resulting from work related illness or injury while on the job
Etiology
What is cause or origin of a disease or condition
Utilization review committee
What is health care professionals that may provide care
Sections of coding manuals that fall under categories
What is subcategory
True or False: CPT level 1 and HCPCS level 2 can be used interchangeably when coding for services
What is false
Choledocholithiasis
What is presence of stones in the common bile duct
Main condition treated or investigated ruing outpatient encounter, especially in the absence of a definitive diagnosis
What is first listed diagnosis
What suffix means rupture
What is -rrhexis
Data element used to uniformly document reasons patients are seen during health care encounters
What is code set
Nonavailability statements allow TRICARE participants to
What is obtain services from a nonmilitary medical facility as needed
When coding for immunizations for a well-child visit, what code book would you refer to
What is ICD-10-CM
Descriptive words indented under main term that provide further description of a procedure or service
What is modifying terms
5 reasons a claim is held or rejected by an insurance company
What is incorrect date, missing date, diagnosis not supporting the procedure, coding errors, and patient illegible for services