Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
CBCS Exam
Certified Billing and Coding Specialist
| Term | Definition |
|---|---|
| Improper code combinations | Describes the reason for a claim rejection because of Medicare NCCI edits |
| Appeal the decision with a provider's report | Action taken if an insurance company denies a service as not medically necessary |
| Gross examinaion | A coroner's autopsy is comprised of examination by which specimens are inspected with the bare eye |
| Down's syndrome | conditions associated with microcephaly, a smaller than normal head circumference. |
| Appeal | is the process used to challenge a payer’s decision to deny, reduce or downcode a claim |
| 10-pitch PICA font | font is the standard font that should be used for paper claims |
| Excision (Any term that ends in –ectomy indicates an excision) | The subsection in the CPT manual, an esophagectomy can be found in |
| Attending physician | is responsible for the patient’s care, as well as discharge decisions, therefore, he should be notified of abnormal lab results before the nurse can proceed with discharge planning. |
| Pathology and Laboratory | section of the CPT manual that lists the appropriate code for white blood count (WBC) with differential automated |
| Check for a fourth or fifth digit | To assign a diagnosis code to the highest level of specificity |
| Proper coding sequence of a patient who suffers 2nd degree burn of the left axilla and 3rd degree burn of wrist. 12% was burned, with 3% of the burns designated as third-degree. | 3rd-degree burn of wrist; 2nd-degree bur of axilla, burn involving 10 to 19% of the body surface with less than 10% of that being third-degree burns. |
| Coinsurance | Describes when a plan pays 70% of the allowed amount and the patient pays 30% |
| Clinical Laboratory Improvement Amendments (CLIA) | is the accreditation agency for office laboratories, & therefore, can review manuals & interview staff |
| Medicine section of CPT manual | where the code for hemodialysis is found |
| V codes | are used as the first-listed diagnosis to identify health encounters that occur for reasons other than illness or injury. |
| Reporting test results to a family member via phone does | HIPAA violation description |
| Private third-party payers | Medigap coverage offered to Medicare beneficiaries |
| Endocrinologist | Medical specialist who the primary care provider (PCP)) refer the patient who has a new onset of diabetes mellitus to further treat the disease |
| Informing the supervisor of the observation | an action a billing and coding specialist takes when she observes a coworker drinking alcohol during work hours |
| Health care clearinghouses | are covered entities (the middle man between the provider & the payer) affected by HIPAA security rules. |
| The claim is overdue for payment | describes a deliquent claim |
| Aorta | transports oxygenated blood from the heart |
| The DOB is entered incorrectly | reason the claim was rejected because the patient Jane Austin's DOB was entered 052245 not 05221945 |
| National Provider Identifier (NPI) | is required to identify the rendering provider on the CMS-1500 in Block 24J According to HIPAA standards |
| Military Identification | are required cards that pertain to retirees, active duty sponsor, and their eligible family members 10 years of age or older as a means of identification for TRICARE |
Created by:
CUAHIT
Popular Health & Social Care sets