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Ch4Medical Insurance
Medical Insurance: An Integrated Claims Approach Process
| Question | Answer |
|---|---|
| E-Code | An alphanumeric code used to identify the external cause of an injury or poisoning |
| Unspecified | Refers to a code that should be used for an incompletely described condition. |
| Addenda | Annual updates to the ICD-9-CM diagnostic coding system. |
| Category | A 3-digit code that covers a single disease or related condition |
| V-Code | An alphanumeric code used for an encounter that is not due to illness or injury. |
| Manifestation | The Characteristic signs and symptoms associated with a disease. |
| Eponym | A condition or procedure that is named for the physician who discovered it. |
| Convention | Typographic technique or standard practice that provides visual guidelines for understanding printed material. |
| Main Term | The medical term in boldfaced type that identifies a disease or condition in the Alphabetic index. |
| Supplementary term | A nonessential word or phrase that helps define a diagnosis code. |
| T/F IN selecting correct diagnosis codes, the chapters of the Tabular List are first searched, and the code is then verified in the Alphabetic Index. | False |
| T/F Subcategories are 4-digit diagnosis codes that define the etiology, site, or manifestation of a disease. | True |
| T/F In the alphabetic index, a see cross-reference must be followed. | True |
| T/F The etiology of a disease is the reason the patient presents for treatment. | True |
| T/F The 5th-digit requirement refers to the need to show a subclassification code for a particular diagnosis. | True |
| T/F A code that appears in italics is a secondary code and is not sequenced first. | True |
| T/F The Coding instruction "use an additional code" means that supplying another code is optional. | False |
| T/F A patient has an appointment for complaint of flulike symptoms. While the patient is in the office, the physician decides to conduct a complete physical examination. A V code is used as the primary diagnosis code for the encounter. | True |
| T/F When a diagnosis is being confirmed by tests or other procedures, only the patient's sign, symptoms, or vague condition are coded, not the possible or suspected disease. | True |
| T/F A patient's past, cured conditions have no applicability to the coding of current encounters except when late effects are noted. | True |
| Outpatient coding is based on which volume or volumes of the ICD-9-CM? | A. Volume 1 B. Volumes 1 & 2 C. Volumes 1,2, & 3 D. Volumes 2 & 3 |
| The Medical terms in the alphabetic index are arranged by: | A. The condition or problem B. The anatomical site C. The etiology and the manifestation D. The Signs and Syptoms |
| An Unintentional, harmful reaction to a correct dosage of a drug is called: | A. a late effect B. a coexisting condition C. an adverse effect D. a manifestation |
| A condition that remains or recurs after an acute illness has finished is called: | A. a late effect B. a coexisting condition C. an adverse effect D. a manifestation |
| A colon after a term in an excludes or includes note indicates that: | A. term is not complete w/o 1 or more of the additional terms listed. B. term requires a manifestation code C. synonyms/alternate wordings/explanations that follow may appear in the diagnostic statement D. term requires a code for the underlying diseas |
| To code an encounter for chemotherapy, list the codes in the following order: | A. E code, condition code B. condition code, E code C. V code, condition code D. Condition code, V code |
| The diagnostic statement "patient presents for removal of a cast" requires the use of which of the following types of codes. | A. E B. V C. R D. M |
| If a patient is treated for both an acute and a chronic condition, each of which has a separate code, how should the codes by listed? | A. V code, condition code B. Chronic code, acute code C. Acute code, V Code D. Acute code, chronic code |
| A late effect may be indicated in documentation by the use of the expression(s): | A. due to an old...or due to previous... B. malignant C. missile, puncture, with foreign body D. primary or secondary |
| If fracture is not documented as closed or open, it is coded as: | A. open B. fissured C. greenstick D. closed |
| What are the 3 steps in the diagnostic coding process? | 1. Determine reason for encounter 2. Locate the term in the alphabetic index 3. Verify the code in the tabular list |
| What are the 3 key coding guidelines for selecting correct diagnosis codes? | Code... 1. the primary diagnosis, followed by current coexisting conditions. 2. to the highest level of certainty. 3. to the highest level of specificity. |
| What does ICD-9-CM stand for? | International Classification of Diseases, 9 revision, Clinical Modification |
| How is the ICD-9-CM coding book organized? | Volume 2; Alphabetic Index Volume 1; Tabular List Volume 3; Procedures |
| What does volume 1 ad 2 entail? | Disease and Injuries |
| What year did the law under HIPAA pass for mandated diagnosis coding from ICD-9-CM? | 1996 |
| When does the USA switch to ICD-10-CM? | Oct. 1, 2013 |
Created by:
crazedsmyle
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