IHMO ch 5 worksheet 1 – Flashcards
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proper coding can mean financial success or failure of a medical practice
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true
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all diagnosis that affect the current status of the patient and are documented can be assigned a code
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true
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it is possible for the primary diagnosis and the principal diagnosis to be the same
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true
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when the physician makes hospital visits, code the reason for the visit, which may not necessarily be the reason the patient was admitted to the hospital
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true
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the international classification of disease (ICD) had its beginnings in England during the seventeenth century
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true
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ICD-10 was adopted and approved for use nationally by private insurance carriers as of January 2014
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false
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the general equivalence mapping (GEMs) are an exact crosswalk from ICD-9-CM to ICD-10-CM and vice versa
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false
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ICD-10-PCS replaces the CPT code book used in outpatient billing
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false
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the annual update of the ICD-10-CM occurs January 1
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false
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coding from an out of date diagnostic codebook can delay payment, result in denial claims, or cause costly mistakes that can lead to financial disaster
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true
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The presence of essential modifiers or their absence does not affect the code assigned
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false
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a term used as the name of a disease, structure, operation, or procedure, usually derived from the name of a place or a person who discovered or describes it first, is an acronym
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false
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the tabular list is referred to as volume 1 and is placed before the alphabetic index (volume 2) in most ICD-10-CM manual publication
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false
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ICD-10-CM codes listed in volume 1 of the ICD-10-CM manual contain seven characters
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false
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the first three characters of an ICD-10-CM diagnostic code indicate the etiology, anatomic site, and severity
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false
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A working knowledge of __ and a course in anatomy and physiology are essential to becoming a topnotch coder of diagnoses
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medical terminology
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the two types of physicians fee profile are called __ and __
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individual astrometry, prevailing
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A principal diagnosis is only applicable to the __ place of service
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inpatient hospital
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ICD-10-CM classifies __ and __ information for statistical purposes
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morbitity, mortality
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during the transition to ICD-10-cm, the __ will determine if a claim should be reported using an ICD-9-cm code or an ICD-10-cm
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date of service
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the common translation took developed by the U.S. government to translate ICD-9-cm codes to icd-10-cm codes is referred to as the
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general equivalence mappings
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annual updates to the icd-10-cm coding system are published in the __ by the us government printing office
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federal register
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volume 2, the alphabetic index to disease and injuries is place __ in most coding manuals
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first
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a term used as the name of disease, structure, operation, or procedure, usually derived from the name of a place or a person who discovered or described it first, is called a
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eponym
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icd-10-cm codes have from __ to __ characters
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3,7
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symbols, punctuation marks, indentations, and other similar rules for determining the appropriate diagnosis code are referred to as
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conventions
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diagnostic codes on an insurance claim explain the
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condition that is being treated during that visit
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in locating a diagnosis, look up the main term which is the __ and __
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condition and disease
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the diagnosis listed first in the submitting insurance claims for patients seen in a physicians office is the
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primary diagnosis
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diagnosis that relate to a patients previous medical problem and that have no bearing on the patients present condition should be __ when coding
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excluded
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diagnosis obtained following review of studies for the condition that prompted inpatient hospitalization is the __ diagnosis
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principle
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the international classification of disease, tenth revision, clinical modification (ICD-10-CM) was published by the world health organization in year
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1992
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what is the consequence when a medical practice does not use diagnostic codes?
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1. claims can be denied 2. fines or penalties can be levied 3. sanctions can be imposed
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why is the correct sequence of codes on an insurance claim important
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1 to make the chronology of patient care events understood 2. to make the severity of disease understood
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what are some examples of diagnosis-related procedures?
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imaging services, cardiovascular services neurologic services, many laboratory services and vitamin B12 injections
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ICD-10-PCS used in hospital billing replaces which volume of icd-9-cm
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volume 3