CPC Exam Study Guide (A+ Graded)

Documentation (content) correct answers Proper code assignment is determined both by _____________ in the medical record and by the unique rules that govern each code set in that instance An auditor correct answers The role a coder may take on to verify that the documentation supports the codes the physician has selected Query the physician correct answers If the medical record is inaccurate or incomplete, it will not translate properly to the language of codes. What can a coder do in order for the medical record to be complete and accurate so they can bill properly? Quarterly (usually) correct answers How often are codes and insurance payment policies updated? NPP correct answers Non-Physician Provider (also known as mid-level providers or physician extenders) PA correct answers Physician assistant NP correct answers Nurse practitioner Commercial and Government correct answers The two types of primary insurances Commercial Carriers correct answers Private payers that may offer both group and individual plans Medicare correct answers The most significant government insurer; a federal health insurance program People over 65, blind or disabled individuals, and people with permanent kidney failure or end-stage renal disease correct answers Medicare provides coverage for what kind of people? ESRD correct answers end-stage renal disease Medicare Part A correct answers Helps cover inpatient hospital care, as well as care provided in skilled nursing facilities, hospice care, and home healthcare, Medicare Part B correct answers Covers medically necessary physicians' services, outpatient care, and other medical services (including some preventive services) not covered under Medicare Part A. It can be an optional benefit.