Category I
What scale is used to calculate payment for professional services.
resources-based relative value scale (RBRVS).
Where is the patients’ encounter documented?
EHR
What is the info need to assign codes and submit claims its an acronym
SOAP
What else can code sets be used for other than billing
Research and population health management
CPT code set are divided into how many categories
Three categories
RBRVS assigns value to
CPT and HCPCS Level II codes
What does the documentation of the encounter include?
The encounter, history, physical exam, lab test, treatment plan
What does this acronym stand for?
Subjective Objective Assessment Plan
What are the code sets used for billing
Cpt, icd-10 and HCPCS/ SNOMED-CT Logical Observation Identifiers Names and Codes (LOINC)/National Drug Code (NDC)- (CDC) (CVX)
The largest category and most commonly used group
Category I
What are the three components does RBRVS assigns value to CPT and HCPCS Level II codes.
time or amount/ overhead cost / expenses of medical malpractice or professional liability coverage.
If a treatment is not documented it is considered ______ done?
Not done
What is key information for coding?
Clinical documentation
Which code identify individual drug products
NDC
Which category is used to Collect data for reporting and for reporting performance measurement. These codes are not used for reimbursement
Category II
What is the purpose of SNOMED-CT
Allows data to be abstracted regardless of the language and put them in a language everyone can understand
Documentation is done by the __________ and is expected to be done in a timely manner, and must be ______________
Provider, medically necessary
What does the clinical documentation include
Services and procedures performed
Report inpatient procedure
ICD-10-PCS
Which category is Services not offered in category I. These codes are either retired or incorporated into a section of category I after 5 years
Category III
Identify products supplies, and services
HCPCS Level II
What is medical necessity?
Provider diagnosis codes that support services rendered to the patient. (diagnosis codes and services must match)
What is the medical term for a heart attack
myocardial infarction
Report professional services and procedure
CPT
What are the six sections of category I
Evaluation and management anesthesia, surgery ( largest group) . Radiology, pathology & laboratory& Medicine