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FINAL EXAM
Question | Answer |
---|---|
1. HOW MANY DIAGNOSIS CAN BE LISTED ON THE UB-04 CLAIM FORM? | 10 |
2. WHAT IS LISTED ON A CHARGE DESCRIPTION MASTER? | Procedure Codes, procedure or service description, charges |
3. WHAT ARE REVENUE CODES? | Codes that identify the department or unit that supplies the services. |
4. WHAT IS AMBULATORY SURGICAL UNIT? | A department in a hospital that provides outpatient surgery services |
5. DEFINE COST OUTLIER | A case that cannot be assigned an appropriate DRG (Diagnosis Related Group) because of an atypical situation |
6. WHAT IS THE SOFTWARE PROGRAM THAT ALLOWS A FACILITY TO CALCULATE ITS DIAGNOSIS RELATED GROUP (DRG) PAYMENT GROUP? | Grouper |
7. WHO MAINTAINS THE AMBULATORY PAYMENT CLASSIFICATION (APC) LIST? | Centers of Medicare and Medicaid Services (CMS) |
8. AMBULATORY PAYMENT CLASSIFICATION (APC) SYSTEM BASE PAYMENT ON | Procedures |
9. WHAT IS PROSPECTIVE PAYMENT SYSTEM? | Established payment rates to hospitals prospectively, which means before services are rendered |
10. HOW OFTEN IS A PATIENT CONTROL NUMBER (PCN) ASSIGNED TO A PATIENT IN THE HOSPITAL? | The patient control number (PCN) is provided at each hospital admission |
11. DEFINE COMORBIDITY | A preexisting condition that, because of its effects on the specific principal diagnosis, results in more intensive therapy or a longer stay |
12. THE TYPE OF FACILITY THAT WOULD USE UB-4 CLAIM FORM INCLUDES? | Hospitals, institutional facilities, inpatient care, hospice and skilled nursing |
13. MAJORITY OF HOSPITAL REIMBURSEMENT COMES FROM? | Insurance Companies |
14. WHEN WILL A HOSPITAL BILL FOR PATIENT SERVICES? | After the discharge paperwork is completed and signed by the physician. |
15. THE METHOD OF REIMBURSEMENT THAT PAYS HOSPITALS A FIXED RATE PER DAY FOR ALL SERVICES PROVIDED? | Per diem |
16. WHAT DOES OPPS STAND FOR? | Outpatient Prospective Payment System |
17. DIAGNOSIS RELATED GROUP (DRG) SYSTEM IS A TYPE OF? | Prospective payment system |
18. THE PHYSICIAN WHO IS PRIMARILY RESPONSIBLE FOR A PATIENT'S CARE WHILE IN THE HOSPITAL IS REFERRED TO AS THE? | Attending Physician |
19.WHEN REFERRING TO DIAGNOSIS RELATED GROUP (DRG), THE ABBREVIATION CC IS USED TO INDICATE? | Complication or comorbidities |
20. IF THE TIME THAT THE PATIENT WAS ADMITTED TO THE HOSPITAL IS UNKNOWN, WHICH CODE WOULD BE ENTERED ON THE FORM (ON LOCATOR 13(? | Code 99 |
21. ON THE CMS-1500 CLAIM FORM, THE ABBREVIATION EIN REFERS TO? | Employer Identification Number |
22. ON THE CMS-1500 CLAIM FORM, THE ABBREVIATION NPI INDICATES THAT? | The National Provider Identifier must be entered |
23. ON THE CMS-1500 CLAIM FORM, THE ABBREVIATION EMG INDICATES THAT | It must be noted if emergency services were provided |
24. ACCORDING TO HIPAA, COVERED ENTITIES FOR COMPLIANCE ISSUES INCLUDE? | Health plans, clearing house, billing service, and providers |
25. THE SUBSECTION OF HIPAA THAT REGULATES ELECTRONIC BILLING IS KNOWN AS THE? | Administrative Simplification |
26. A CMS-1500 CLAIM FORM USED BY PHYSICIAN OFFICES WAS DEVELOPED BY? | The Centers for Medicare and Medicaid Services (CMS) |
27.A LIMITED INSURANCE POLICY PURCHASED TO COVER PART OF THE PATIENT'S EXPENSES, NOT COVERED BY THE PRIMARY INSURANCE POLICY | Supplemental Insurance |
28. IF A PATIENT HAS MORE THAN ONE INSURANCE PLAN, THE DETERMINATION OF HOW MUCH WILL BE PAID BY EACH IS KNOWN AS? | Coordination of Benefits |
29. ACCORDING TO THE BIRTHDAY RULE, IF BOTH PARENTS COVER DEPENDENT CHILDREN UNDER THEIR INSURANCE POLICIES, THE PRIMARY INSURANCE IS THE POLICY | Of the parent whose date of birth occurs earliest in the year |
30. THE EMPLOYER IDENTIFICATION NUMBER (EIN) OR FEDERAL TAX ID NUMBER IS ISSUED BY? | The internal Revenue Service (IRS) |
31. THE IDENTIFICATION NUMBER ISSUED TO PHYSICIANS WHO ARE AUTHORIZED TO PRACTICE MEDICINE IN A GIVEN STATE IS THE? | State License Number |
32. IF NEEDED INFORMATION IS MISSING FROM A CLAIM WHEN IT IS SUBMITTED TO AN INSURANCE CARRIER, IT IS REFERRED TO AS? | A dirty Claim |
33. SCRAMBLING ELECTRONIC INFORMATION DURING TRANSMISSION TO PREVENT IT FROM BEING INTERCEPTED OR READ BY UNAUTHORIZED USERS IS A PROCESS KNOWN AS? | Encryption |
34. A COMPANY THAT RECEIVES CLAIMS FROM PROVIDERS, AUDITS THEM, AND FORWARDS THEM ON TO INSURANCE CARRIERS IS? | Clearinghouse |
35. AN AUDIT/EDIT REPORT FROM A CLEARINGHOUSE WILL SHOW ALL OF THE FOLLOWING | Claims that need corrections, claims that are missing information, claims forwarded to the insurance carrier |
36. IF A PATIENT WISHES INSURANCE PAYMENTS TO BE MADE DIRECTLY TO THE PROVIDER, THE PATIENT MUST SIGN WHICH TYPE OF FORM? | Assignment of benefits form |
37. A CLAIM CAN ONLY BE SUBMITTED TO AN INSURANCE CARRIER ON THE PATIENT'S BEHALF IF THE PATIENT SIGNED A? | Release of information form |
38. THE POLICY IN MOST MEDICAL OFFICES IS TO REQUEST THAT THE PATIENT SIGN AND UPDATE A RELEASE OF INFORMATION FORM | Once a year |
39. THE PERSON WHO IS ULTIMATELY RESPONSIBLE FOR PAYMENT TO THE MEDICAL OFFICE IS CALLED THE | Guarantor |
40. AS IT PERTAINS TO THE CMS-1500 FORM, THE ACRONYM OCR REFERS TO? | Optical character recognition |
41. WHICH OF THE FOLLOWING IS NOT A FRACTURE TREATMENT? OPEN, CLOSED, PERCUTANEOUS, REPLANTATION. | Replantation |
42. WHICH OF THE FOLLOWING FLAPS DESCRIBES A BONE GRAFT THAT IS TAKEN ALONG WITH THE SKIN AND TISSUE THAT OVERLIES THE BONE? MYOCUTANEOUS, DERMIS/EPIDERMIS, FREE, FREE OSTEOCUTANEOUS. | Free osteocutaneous |
43. FRACTURE CODES ARE BASED ON? | Treatment type |
44. THE RESTORATION OF A FRACTURE OR DISLOCATION TO ITS NORMAL ANATOMIC ALIGNMENT BY THE APPLICATION OF MANUALLY APPLIED FORCE IS KNOWN AS? | Manipulation |
45. A HIP REPLACEMENT IS CODED BASED ON THE? | Medical reason for the surgery |
46. OPEN TREATMENT OF A FRACTURE IS WHEN THE? | Fracture site is surgically opened and visualized or opened remotely |
47. SURGICAL AND FRACTURE REPAIR CODES IN THE MUSCULOSKELETAL SUBSECTION INCLUDE? | The application and removal of the initial casts, splints, or strapping applied by the treating physician |
48. A BUNIONECTOMY IS A HALLUX CORRECTION | Valgus |
49. ARTHOSCOPY IS A DESIRABLE TREATMENT CHOICE BY PHYSICIANS AND PATIENTS BECAUSE THE? | Incisions are smaller, risk of infection is decreased, recovery time is quicker |
50. IS A DIAGNOSTIC ARTHROSCOPY ALWAYS INCLUDED IN A SURGICAL ARTHOSCOPY? | True |
51. WHICH OF THE FOLLOWING IS NOT A TREATMENT METHOD FOR A DISLOCATION? APPLYING GENTLE TRACTION, ROTATING LIMB WHILE APPLYING PRESSURE, ATTACHING A WEIGHT TO THE PATIENT, EXTERNAL FIXATION. | External fixation |
52. DEFINE ARTHROCENTESIS | An injection into a joint, an aspiration of fluid from a joint and a puncture of a joint cavity |
53. THE ACRONYM ORIF STANDS FOR? | Open reduction with internal fixation |
54. IS THE ATTACHMENT OF A SPINAL FIXATION DEVICE AT EACH END OF THE AREA BEING REPAIRED AND AT LEAST ONE OTHER ATTACHMENT IN THE AREA BEING REPAIRED | Segmental instrumentation |
55. ELECTRICAL OR ULTRASOUND STIMULATION IS USED TO? | Promote healing |
56. DESCRIBE REDUCTION | Manipulation |
57. WHICH OF THE FOLLOWING TERMS DESCRIBE TRACTION BY USING STRAPPING, ELASTIC WRAPS OR TAPE? | Skin |
58. THE APPLICATION OF A CRANIAL HALO IS A FORM OF? | External fixation |
59. THIS TYPE OF GRAFT IS OFTEN TAKEN FROM THE UPPER THIGH AREA. | Fascia Lata |
60. INSERTION OF A DEVICE INTO THE MUSCLE TO MEASURE THE PRESSURE WITHIN THE MUSCLE IS MONITORING OF? | Interstitial fluid pressure |
61. THE MEDICAL WORD FOR THE SHIN BONE IS THE? | Tibia |
62. THE MEDICAL WORD FOR AN INDIVIDUAL FINGER OR A TOE IS PHALANX? | True |
63. THE MEDICAL WORD FOR THE KNEECAP IS THE OLECRANON | False |
64. THE ULNA IS THE? | The forearm bone located along the little finger side of the lower arm |
65. THE HUMERUS IS THE? | Bone of the upper arm |
66. WHICH IS THE MEDICAL WORD FOR THE THIGH BONE? | Femur |
67. THE SMALL BONES OF THE WRIST JOINT ARE KNOWN AS THE? | Carpal bones |
68. WHICH IS THE MEDICAL WORD FOR THE TAIL BONE? | Coccyx |
69. WHICH IS THE MEDICAL WORD FOR COLLARBONE? | Clavicle |
70. THE BONES OF THE ANKLE ARE CALLED THE CARPAL BONES? | False |
71. THE CERVICAL VERTEBRAE ARE IN THE? | Neck |
72. WHICH IS THE MEDICAL WORD FOR THE BONE ON THE THUMB SIDE OF THE FOREARM? | Radius |
73. A CONTUSION DUE TO A BLUNT INJURY WITH BLEEDING IN THE MUSCLE IS COMMONLY KNOWN AS? | A bruise |
74. THE FLEXOR HALLUCIS BREVIS MUSCLE IS A MULSCLE IN THE HAND | False |
75. WHAT IS THE LARGE MUSCLE IN THE BUTTOCKS? | Gluteus maximus |
76. THE PECTORALIS MAJOR MUSCLE IS LOCATED IN THE? | Chest |
77. THE LATISMUS DORSI IS A MUSCLE OF THE? | Back |
78. THE BRACHIORADIALIS MUSCLE IS LOCATED IN THE? | Upper and lower arm |
79. THE ACTION OF THE MUSCLE BENDS THE HEAD TOWARD THE STERNUM | Stenocleidomastoid muscle |
80. THERE ARE APPROXIMATELY HOW MANY SKELETAL MUSCLES IN THE BODY? | 700 |
81. THE HUMAN BODY IN ANATOMICAL POSITION IS DESCRIBED AS? | The body standing erect, the head looking forward, arms to the sides, palms forward, feet pointing forward |
82. BODY PLANES DIVIDE THE BODY INTO? | Right and left, top and bottom, back and front |
83. PHYSIOLOGY IS THE STUDY OF THE STRUCTURE OF THE HUMAN BODY. | False |
84. TWO OF THE IMAGINARY PLANES THAT DIVIDE THE BODY DERIVE THEIR NAMES FROM? | Suture lines on the skull |
85. THE SAGITTAL PLANE DIVIDES THE BODY INTO? | Left and right |
86. WHICH STRUCTURE CAN ONLY BE SEEN THROUGH A MICROSCOPE? | Cell |
87. THE---------CAVITY IS A CONTINUATION OF THE CRANIAL CAVITY. | Spinal |
88. ANY CHANGE IN THE NORMAL STRUCTURE OF FUNCTION OF THE BODY IS? | Disease |
89. THE CAUSE OR ORIGIN OF A DISEASE IS THE? | Etiology |
90. A PATIENT WHO IS ASYMPTOMATIC. | Shows no symptoms or signs |
91. A PATIENT CANNOT RECOVER FROM AN ILLNESS THAT IS? | Terminal |
92. THE CORONAL PLANE DIVIDES THE BODY INTO? | Front and back |
93. WHAT HEALTHCARE SETTING IS THE MOST FREQUENTLY USED? | Physician's office |
94. THE PREDICTED OUTCOME OF A DISEASE IS CALLED A DIAGNOSIS? | False |
95. THERE ARE FOUR REGIONS OF THE ABDOMINOPELVIC AREA. | False |
96. THE LUNGS, HEART, ESOPHAGUS, AND TRACHEA WOULD ALL BE FOUND IN THE? | Thoracic cavity |
97. AN OPHTHALMOLOGIST WOULD STUDY THE? | Eyes |
98. THE STUDY AND TREATMENT OF CANCER IS KNOWN AS? | Oncology |
99. THE STUDY OF THE MEDICAL CARE OF THE ELDERLY IS KNOWN AS? | Gereatrics |
100. WHO ARE PHYSICIAN EXTENDERS? | Nurse midwives, nurse anesthetists and physician assistants. |
101. THE OFFICIAL GUIDELINES FOR CODING AND REPORTING ARE UPDATED BY CMS AND AMA. | False |
102. SECTION IV OF THE OFFICIAL GUIDELINES FOR CODING AND REPORTING CONTAINS INFORMATION REGARDING OUTPATIENT CODING. | True |
103. A LATE EFFECT IS THE RESIDUAL EFFECT AFTER ACUTE PHASE OF AN ILLNESS OR INJURY HAS PASSED. | True |
104. FOR BILATERAL SITES, THE FINAL CHARACTER OF THE CODES IN THE I-10 ALWAYS INDICATES LATERALITY. | False |
105. SYSTEMIC LUPUS ERYTHEMATOSUS WITH ASSOCIATED ENDOCARDITIS (M32.11) IS AN EXAMPLE OF DUAL CODING. | False |
106. MULTIPLE CODES ARE OFTEN REQUIRED FOR LATE EFFECTS, COMPLICATION CODES, AND OBSTETRIC CODES. | True |
107. YOU CANNOT REPORT CODES FOR OPEN WOUND EXPLORATION (20100-1013) IF THE WOUND IS SUFFICIENT IN SIZE TO ACCOMPLISH THE REPAIR AND THE WOUND DOES NOT NEED TO BE ENLARGED. | True |
108. USING CODES FROM THE WOUND EXPLORATION CATEGORY REQUIRES THE CODER TO ASSESS THE EXTENT OF THE PROCEDURE. | True |
109. 22585 IS AN ADD-ON CODE | True |
110. THERE ARE FOUR SUBHEADINGS IN THE RADIOLOGY SECTION | False |
111. WHICH TREATMENT OF FRACTURE REQUIRES THE FRACTURE TO BE EXPOSED TO VIEW OR OPENED AT A REMOTE SITE FOR NAILING ACROSS THE FRACTURE. | Open |
112. TERMS THAT DESCRIBES TRACTION BY USE OF STRAPPING, ELASTIC WRAPS, OR TAPE. | Skin |
113. WOUND EXPLORATION CODES HAVE WHAT SERVICES BUNDLED INTO THE CODES. | Exploration, including enlargement; debridement, removal of foreign body (ies), minor vessel ligation, repair. |
114. THE APPLICATION OF A CRANIAL HALO IS A FORM OF: | External fixation |
115. THIS TYPE OF GRAFT IS OFTEN TAKEN FROM THE UPPER THIGH AREA. | Fascia Lata |
116. INSERTION OF A DEVICE INTO THE MUSCLE TO MEASURE THE PRESSURE WITHIN THE MUSCLE IS MONITORING OF: | Interstitial Fluid Pressure |
117. FAST BECOMING THE TREATMENT OF CHOICE FOR MANY ORTHOPEDIC SURGICAL PROCEDURES IS | Endoscopy/arthroscopy |
118. NOT CONSIDERED A FRACTURE TREATMENT | Replantaion |
119. DESCRIBES A BONE GRAFT THAT IS TAKEN ALONG WITH THE SKIN AND TISSUE THAT OVERLIES THE BONE | Free Osteocutaneous |
120. FRACTURE CODES ARE BASED ON | Treatment type |
121. THE RESTORATION OF A FRACTURE OR DISLOCATION TO ITS NORMAL ANATOMIC ALIGNMENT BY THE APPLICATION OF MANUALLY APPLIED FORCE IS KNOWN AS | Manipulation |
122. A HIP REPLACEMENT IS CODED BASED ON THE | Medical reasons for the surgery |
123. OPEN TREATMENT OF A FRACTURE IS WHEN THE: | Fracture site is surgically opened and visualized or opened remotely. |
124. WHERE IS THE BIMALLEOLAR BONE LOCATED? | Wrist |
125. NOT A TREATMENT METHOD FOR A DISLOCATION: | External Fixation |
126. THE DIFFERENCE BETWEEN THE CODE FOR A SOFT TISSUE ABSCESS IN THE MUSCULOSKELETAL SYSTEM SECTION & THE CODES FOR ABSCESS IN THE INTEGUMENTARY SYSTEM SUBSECTION. | The code in the Musculoskeletal System subsection is associated with deep tissue possibly to the bone. |
127. ARTHROCENTESIS IS; | An injection into the joint, an aspiration of fluid from the joint, a puncture of a joint cavity. |
128. THE ACRONIM ORIF STANDS FOR: | Open reduction with internal fixation |
129. ELECTRICAL OR ULTRASOUND STIMULATION IS USED TO: | Promote healing |
130. A BUNIONECTOMY IS A HALLUX ------CORRECTION. | Valgus |
131. ARTHROSCOPY IS A DESIRABLE TREATMENT CHOICE BY PHYSICIANS AND PATIENTS BECAUSE. | The incisions are smaller, risk of infection is decreased, recovery time is quicker. |
132. A------ARTHROSCOPY IS ALWAYS INCLUDED IN A SURGICAL ARTHROSCOPY. | Diagnostic |
133. THIS IS NOT A TYPE OF BUNIONECTOMY. | Mumbord |
134. BONE GRAFTS FOR SPINAL SURGERY ARE OFTEN CODED IN CONJUNCTION WITH A SURGICAL PROCEDURE. WHAT IS THE APPROPRIATE MODIFIER FOR THE BONE GRAFT CODE. | No modifier |
135. A--------PROCEDURE IS ONE THAT IS PERFORMED INDEPENDENTLY OF, AND NOT IMMEDIATELY RELATED TO ANOTHER SERVICE. | Separate |
136. THE DIVISION OF THE RADIATION ONCOLOGY SECTION OF THE CPT MANUAL ARE DIVIDED INTO SUBSECTIONS BASED ON WHAT. | Type of service |
137. WHAT IS THE MODIFIER USED TO IDENTIFY THE TECHNICAL COMPONENT OF A RADIOLOGIC PROCEDURE. | TC |
138. WHAT ARE THE RADIOISOTOPES THAT ATTACH THEMSELVES TO RED BLOOD CELLS CALLED? | Tracer |
139. WHAT IS THE NAME OF THE HIGH-FREQUENCY SOUND WAVES IN AN IMAGING PROCESS THAT IS USED TO DIAGNOSE PATIENT ILLNESS? | Ultrasound |
140. ACCORDING TO CPT GUIDELINES, RADIATION ONCOLOGY CODES INCLUDE NORMAL FOLLOW-UP CARE DURING THE COURSE OF TREATMENT AND ----FOLLOWING ITS COMPLETION. | Includes 3 month global period |
141. CODES 76801 AND 76802 INCLUDE DETERMINATION OF THE NUMBER OF GESTATIONAL SACS AND FETUSES, GESTATIONAL SAC/FETAL MEASUREMENTS APPROPRIATE FOR GESTATION <14 WEEKS 0 DAYS, AND | Survey of visible fetal and placental anatomic structure, qualitative assessment of amniotic fluid/gestational sac shape, examination of the maternal uterus and adnexa. |
142. USE OF A NEEDLE AND SYRINGE TO WITHDRAW FLUID. | Aspiration, centesis |
143. FIVE GRAFT TYPES REPRESENTED IN THE MUSCULOSKELETAL SUBSECTION. | Bone graft, tissue graft, fascia lata graft, cartilage graft, tendon graft. |
144. NONINVASIVE DIAGNOSTIC TECHNIQUE THAT PRODUCES A CROSS-SECTIONAL IMAGE OF ORGANS AND OTHER INTERNAL BODY STRUCTURES. | Magnetic resonance |
145. X-RAY OF THE BILE DUCTS USING RADIOPAQUE CONTRAST. | Cholangiography |
146. X-RAY OF THE BLOOD VESSELS FOLLOWING INJECTION OF RADIOPAQUE SUBSTANCE. | Angiography |
147. ALSO KNOWN AS A PET SCAN, IT MEASURES METABOLIC OR BIOCHEMICAL ACTIVITY OF THE BRAIN AND OTHER ORGANS BY TRACKING ITS MOVEMENT AND CONCENTRATION. | Tomography |
148. X-RAY PHOTOGRAPH OF THE SPINAL CORD FOLLOWING ADMINISTRATION OF RADIOPAQUE SUBSTANCE INTO THE SUBARACHNOID SPACE. | Myelogram |
149. THE APPLICATION OF ULTRASONIC WAVES FOR DIAGNOSTIC IMAGING OF INTERNAL STRUCTURES | Ultrasound |
150. X-RAY OF THE VEIN OR VEINS FOLLOWING INJECTION OF A RADIOPAQUE SUBSTANCE. | Venography |
151. MEASUREMENT OF THE DIAMETERS OF THE FEMALE PELVIS, ESP. THE BIRTH CANAL | Pelvimetry |
152. ALSO KNOWN AS A CAT SCAN, THIS TECHNIQUE ALLOWS SAFE, PAINLESS, AND RAPID DIAGNOSIS IN PREVIOUSLY INACCESSIBLE AREAS OF THE BODY. | Computed tomography |
153. X-RAY VISUALIZATION OF LYMPH VESSELS AND NODES FOLLOWING INJECTION OF A CONTRAST MATERIAL. | Lymphangiography |
154. ANTERIOR (VENTRAL) | In front of |
155. POSTERIOR (DORSAL) | In back of |
156. SUPERIOR | Toward the head or the upper part of the body; also known as cephalad or cephalic |
157. INFERIOR | Away from the head or the lower part of the body; also known as caudad or caudal |
158. MEDIAL | Toward the middle of the body |
159. LATERAL | Away from the midline of the body (to the side) |