NHA CBCS Questions And Answers A level Based

NHA CBCS E Codes - For durable medical equipment for use in home Chief Complaint (CC) - The reason the patient came to see the physician. Past, Family and Social History (PFSH) - Consists of patients personal experiences with illnesses, surgeries, and injuries; Information of illnesses predominant in family; Patients educational background, occupation, marital status and other factors Add on Codes - Used for procedures that are always performed during the same operative session, as another surgery in addition to the primary service/procedure and is never performed separately. What act mandated the reporting of ICD-9-CM diagnosis codes? - The Medicare Catastrophic Coverage Act of 1988 Electronic Data interchange (EDI) - Transmitting electronic medical insurance claims from providers to payers using the necessary information systems is called Medical Ethics are - Standards of conduct based on moral principals. Acting within ethical behavior boundries means carrying out one's responsibilities with integrity, decency, respect, honesty, competence, fairness and trust. Three Components for E*M Codes - 1.History 2.Physical Exam 3.Medical Decision-Making Guidelines are Found? - At the beginning of each section and used to provide specific coding rules for that section. Co-payment - A fixed fee collected at the time of the patients visit. Review Linkage Protocol - Appropriateness of Codes, Payers rules about linkage, Documentation to support codes, Compliance with regulation and guidelines What is confidentiality? - Involves restricting patient information access to those with proper authorization and maintaining the security of patient information. What are the names of the three tables that appear in the Index to Diseases? - Hypertension Neoplasm Table of Drugs and Chemicals Level 2 codes - National codes for physician and non-physician service not found in the CPT Level 1 Inpatient - A/An ___________ is a person admitted to a hospital or long-term care facility(LTCF) for treatment with the expectation that the patient will remain in the hospital for a period of 24 hours or more. HIPAA is an acronym for - Health Insurance Portability and Accountability Act of 1996. Life Cycle of a Claim - Submission, Processing, Adjudication, Non-covered, Unauthorized, Medical Necessity Checks, Payment / RA / ERA Level 1 codes - Codes found in the CPT manual Deductible - The out-of-pocket payment amount that a policyholder must meet before insurance covers the service(s) is called? Coinsurance - A fixed percentage of covered charges applied to the patients bill after the deductible has been met. Liability Insurance - Covers injuries caused by insured that occurred on the insured's property. Unspecified - "No notation of benign or malignant status is found in the diagnosis or in the patient's chart." subpoena - A writ requiring the appearance of a person at a trial or other proceeding is a ___________. Medicare - What is the single largest healthcare program in the United States? Parentheses - Used to enclose supplementary words; non essential modifiers Indemnity insurance - Health indemnity insurance is a fee for service insurance that is sometimes used when a person is in between health plans, and will cover some (but not all) expenses Rejected Claim - A rejected claim is an electronically submitted claim that is unprocessable due to missing or invalid information required by the payer. - Radiology Medicaid Medically Needy - provide Medicaid to certain groups not otherwise eligible for M cover: •Pregnant women: •Children under 18: •States have option to cover: •Children up to 21: •Parents and other caretaker relatives: •Elderly: