A coder is required to have a working knowledge of the CPT, HCPCS Level II, ICD-10-CM, and _____ coding systems - answer-ICD-10-PCS
The intensity of services and severity of illness associated with the provision of inpatient care are captured as part of ______ (or facility) coding. - answer-Inst...
321 CODE IT; CHAPTER 1 EXERCISES
A coder is required to have a working knowledge of the CPT, HCPCS Level II, ICD-10-CM,
and _____ coding systems - answer-ICD-10-PCS
The intensity of services and severity of illness associated with the provision of inpatient care
are captured as part of ______ (or facility) coding. - answer-Institutional
The complexity and intensity of procedures performed and services provided during an
outpatient or physician office encounter are captured as part of _____ coding. - answer-
Professional
When a multi-hospital system provides physician office services along with traditional inpatient,
outpatient, and emergency department hospital care, the concept of ______ coding is adopted to
facilitate professional and institutional billing. - answer-single-path
A profession that is closely related to that of a coder is health ________ specialist (or claims
examiner) who review health-related claims to determine whether the costs are reasonable and
medically necessary based on the patient's diagnosis reported for procedures performed and
services provided. - answer-insurance
Students who become members of ______ association(s) usually pay a reduced membership fee
and receive most of the same benefits as active members - answer-professional
Attending professional association conferences and meetings provides opportunities to ______
(or interact) with other professionals, which can facilitate being placed for internship or job
placement. - answer-network
A medical assistant usually joins the American Medical Technologists (AMT) or the _______ -
answer-American Association of Medical Assistants (AAMA)
An Internet-based discussion forum that covers a variety of professional topics and issues is
called an online discussion board or ________ - answer-listserv
A coder usually joins either the American Health Information Management Association
(AHIMA) or the ________ - answer-AAPC (previously called the American Academy of
Professional Coders)
A medical nomenclature that is organized according to similar conditions, diseases, procedures,
and services, and contains codes for each is called a __________ (or classification) system. -
answer-coding system
All diagnoses, whether patients are treated as inpatients or outpatients, or at physician offices,
are coded using the ______ classification system. - answer-ICD-10-CM
, Inpatient hospital procedures and services are coded using the _______ classification system. -
answer-ICD-10-PCS
A public or private entity that processes or facilitates the processing of health information and
claims from a nonstandard to a standard format is called a health care _______ - answer-
clearinghouse
Routinely assigning lower-level CPT codes for convenience instead of reviewing patient record
documentation and the coding manual to determine the proper code to be reported is called
_______ - answer-downcoding
Reporting codes that are not supported by documentation in the patient record for the purpose of
increasing reimbursement is called _______ - answer-upcoding
Reporting codes for signs and symptoms in addition to the established diagnosis code is called
______ - answer-overcoding
Routinely assigning an unspecified ICD-10-CM disease code instead of reviewing the coding
manual to select the appropriate code is called ______ - answer-jamming
Reporting multiple codes to increase reimbursement when a single combination code should be
reported is called _______ - answer-unbundling
Coders should always avoid assumption coding, and can do so by generating a physician
________ when documentation needs clarification prior to the assignment of codes. - answer-
automated physician query process,
Software that automatically generates medical codes by analyzing clinical documentation in the
electronic health record or electronic medical record is called ______ - answer-encoders
The classification of neoplasms used by cancer registries throughout the world to record
incidence of malignancy and survival rates is called the - answer-ICD-10-CM Chapter 2:
Neoplasms (C00-D49)
Specific sets of patient characteristics (or case-mix groups) on which payment determinations
are made under several prospective payment systems is represented by the - answer-Health
Insurance Prospective Payment System (HIPPS) Rate Codes
Example:
The home health prospective payment system (HHPPS) requires entry of the Outcome and
Assessment Information Set (OASIS) data set into grouper software, which generates the five-
digit alphanumeric HIPPS code that is entered on the UB-04 claim. For example, HIPPS code
HAEJ1 is entered on the UB-04 claim.
The set of files and software that allows many health and biomedical vocabularies and standards
to enable interoperability among computer systems is called the - answer-Unified Medical
Language System (UMLS)
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