question

The consequences of inacurate assigment of diagnostic codes include

answer

a delay in payment of a claim, denial of claim, change in level of reimbursement

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Diagnosis codes should be reported to the highest level of

answer

Specificity

question

When a provider makes a hospital visit, the encounter should be reporte with a diagnosis code that represents

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The condition of provider evaluated and treaated during the encounter

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To determine the diagnosis codes that would support medical necessity of a specific procedure such as magnetic resonance imagin (MRI), under Medicare guidelines, the coder should consult care guidelines, the coder should consult

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local coverage determination (LCD'S) and natiobnal coverage determinations (NCD'S)

question

Passage of which legislationin 1988, placed requirements on physicians to report appropriate diagnosis codes on all claims to Medicare?

answer

Medicare Catastrophic Coverage Act

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General Equivalency Mappings (GEMS) is a common translation tool used to

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Convert ICD9-CM codes to ICD 10 CM codes, convert ICD 10 CM codes to ICD 9 CM codes

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ICD 10 PCS (procedural coding system) was developed by 3M Health Information Systems under contract with the

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Centers for Medicare and Medicaid Services

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Anual updates to ICD 10 CM are published

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By the AHA, AHIMA and US Printing Office

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The alphabetic Index to Diseases and Injuries in placed

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First in the coding manual

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How many chpters does the Tabular List contain?

answer

21

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When two diagnoses are classified with a single code, it is reffred to as

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a combination code

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An essential modifier is also referred to as a

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subterm

question

The equivalent of unspecified is

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NOS

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Signs and symptoms are acceptable for reporting purposes

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When a definitive diagnosis has not been determined

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When conditions documented as "threatened" referenced in Alphabetic Index and there is no entry for the threatened condition report

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The existing underlying conditon

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When reporting laterality, the final character "3" is reported to indicate

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bo;atera;

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When reporting an encounter for testing of human immunodeficiency virus (HIV), the code should be assigned as

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Z11.4

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When fractures are documented but there is no indication of whether the fracture is open or closed

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report as closed

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When identifying the total body surgface area of a burn, the front rorso is considered as

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18%

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Wxternal cause codes are used to

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Establish injury prevention programs

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diagnoses that relate to the patient's previous medical problem must always be reported

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false

question

The concept of "principal diagnosis" is applicable to outpatient and inpatient cases.

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false

question

the diagnosis coding system is designed to provide statistical mortality rate date that include information about causes fo diseases.

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false

question

The process for looking up a diagnosis code in the ICD 9 CM coding system is the same as in the ICD 10 CM coding system

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true

question

ICD 10 was published by the World Health Organization (WHO) and clinically modified by the Centers for Medicare and Medicaid Services (CMS)

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false

question

The Alphabetic Index contains the Table of Drugs and Chemicals.

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true

question

ICD 10CM codes can contain up to seven characters

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true

question

signs and symptoms that are not typically associated with a disease process should be reported when documented.

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true

question

When a person who is not currently sick encounters health services for some specific purpose, such as to receive a vaccination, a Z code is used

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true

question

Code conventions are rules or principles for determining a diagnostic code when using a diagnostic code book

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true

question

Because there are annual ICD 10 CM code revisions there is a 3 month grace period to implement these changes and revisions

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false

question

An external cause code may never be sequenced a the primary diagnois in the first position

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true

question

The codes used to bill ambulance services, surgical supplies and durable medical equipment are

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CPT codes

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A complex reimbursement system in which three fees are considered in calculating payment is known as

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usual, customary, and reasonable (UCR)

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Medicre defines postoperative gloal periods as

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10 or 90 days

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To code, a bilateral procedure as two separate codes that include the same surgicla approah may be referred to as

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unundling

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When two surgeons work together as primary surgeons performing distinct parts of a procedure, and each doctor bills for performing his or her distinct part of the procedure, the CPT surgical code is listed with modifier

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-62

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procedure coding is the transformation of written descriptions of procedure and professional services into numeric designations (code numbers)

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true

question

category II codes describe clinical components that may be typically included in evaluation and management services or clinical services.

answer

true

question

when multiple lacerations have been repaired using the same technique and are in the same anatomic category, each repair should be assigned a code when billing an insurance claim

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false

question

when listing a sterile tray for an in-office surgical procedure, the tray is bundled with the procedure unless other supplies are needed in addition to those usually used.

answer

true

question

HCPCS Level II modifiers consist of only two alphanumeric characters.+

answer

false

Diagnostic coding chapter 5 – Flashcards

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