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Various aspects of medical coding, including the roles of coding professionals, areas of a medical record, coding specialists, and the education required for physician assistants. It also discusses the different parts of the medicare program, coding manuals, and the determination of coverage. Additionally, it touches on hipaa, the minimum necessary rule, and compliance programs.
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Many coding professionals go on to find work as: - correct answer Consultant A medical record contains information on all but what areas? - correct answer Financial records Technicians who specialize in coding are called: - correct answer Coding specialists EHR stands for: - correct answer Electronic health record What type of provider goes through approximately 26.5 months of education and is licensed to practice medicine with the oversight of a physician? - correct answer Physician Assistant (PA) The Medicare program is made up of several parts. Which part is most significant to coders working in physician offices and covers physician fees without the use of a private insurer? - correct answer Part B The Medicare program is made up of several parts. Which part is affected by the Centers for Medicare and Medicaid Services' - hierarchal condition categories (CMS-HCC)? - correct answer Part C What does CMS-HCC stand for? - correct answer Centers for Medicare and Medicaid Services - Hierarchal Condition Category When coding an operative report, what action would NOT be recommended? - correct answer Coding from the header without reading the body of the report Outpatient coders focus on learning which coding manuals? - correct answer CPT, HCPCS Level II, and ICD-9-CM Volumes 1 and 2
If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient, who determines coverage? - correct answer Medicare Administrative Contractor (MAC) The __ describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare. - correct answer National Coverage Determinations Manual National Coverage Determinations serve what purpose? - correct answer To spell out CMS policies on when Medicare will pay for items or services MAC stands for what? - correct answer Medicare Administrative Contractor Local Coverage Determinations are administered by __? - correct answer Each regional MAC LCD's only have jurisdiction in their __ area. - correct answer Regional ABN stands for - correct answer Advance Beneficiary Notice When are providers responsible for obtaining an ABN for a service not considered medically necessary? - correct answer Prior to providing a service or item to a beneficiary HIPAA stands for - correct answer Health Insurance Portability and Accountability Act HIPAA was made into law in what year? - correct answer 1996 A covered entity does NOT include - correct answer Patient
HHS/OCR has investigated and resolved over __ cases by requiring changes in privacy practices and other corrective actions by the covered entities since its inception in 2003. - correct answer 14, According to the OIG, internal monitoring and auditing should be performed by what means? - correct answer Periodic audits Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or ___, but also by showing that the physician practice is making additional good faith efforts to submit claims appropriately. - correct answer Fraudulent claims How many components should be included in an effective compliance plan? - correct answer 7 According to AAPC's Code of Ethics, a member shall use only __ and ___ means in all professional dealings. - correct answer Legal and ethical Medicare Part D is what type of insurance? - correct answer Prescription drug coverage available to all Medicare Beneficiaries What type of health insurance provides coverage for low-income families? - correct answer Medicaid What is PHI? - correct answer Protected health information What form is used to send a provider's charge to the insurance carrier? - correct answer CMS- Which option below is NOT a covered entity under HIPAA? - correct answer Worker's Compensation
Which of the following is a BENEFIT of electronic transactions? - correct answer Timely submission of claims What is the value of a remittance advice? - correct answer It tells you what you will be paid and why ay changes to charges were made. The OIG recommends that the physician's practice enforcement and disciplinary mechanisms be - correct answer Consistent Each October the OIC releases a __ outlining its priorities fo the fiscal year ahead - correct answer Work Plan The 2012 OIG work Plan prioritizes which of the following topics for review? - correct answer E/M services during the global surgery periods The AAPC was founded in what year? - correct answer 1988 According to the 2012 AAPC ___, which it shows coders salaries rose 2 percent to an average of $47, 870 for credential coders. - correct answer Salary survey AAPC credentialed coders have NOT proven mastery of: - correct answer Administrative regulations The AAPC offers over 440 local chapters across the country and in the Bahamas for the purpose of - correct answer Networking