AAPC - PRACTICE MANAGEMENT QUESTIONS WITH 100% VERIFIED ANSWERSAAPC - PRACTICE MANAGEMENT QUESTIONS WITH 100% VERIFIED ANSWERSAAPC - PRACTICE MANAGEMENT QUESTIONS WITH 100% VERIFIED ANSWERS
What is Coding? - ANSWER-Translating Med. Docs into Codes
What determines Code Assignment? - ANSWER-The M...
AAPC - PRACTICE MANAGEMENT
QUESTIONS WITH 100% VERIFIED
ANSWERS
What is Coding? - ANSWER-Translating Med. Docs into Codes
What determines Code Assignment? - ANSWER-The MR Content (doc) & the Rules
that Governs Each Code
Who codes in a medical practice? - ANSWER-The Doctor or the Coder
If the Dr. codes, what is the coder's responsibility? - ANSWER-To audit and verify codes
w/supporting docs
What is the coder's responsibility if she codes? - ANSWER-- Evaluate MR for
completeness & accuracy
- Communicate with Dr. & other HC pros to clarify Dx or to get additional pt. info.
What does outpatient coding focus on? - ANSWER-Drs. & Outpatient Facility Coding
Where will outpatient coders work? - ANSWER-Drs. offices, outpatient clinics, * facility
outpatient depts. also with APCs
What is APC? - ANSWER-Ambulatory Payment Classifications
What does hospital inpatient coding focus on? - ANSWER-Coding for hospital inpatients
using ICD-10-CM & PCS and MS-DRGs (Medical severity Dx Related groups)
What do coders require in order to stay abreast of changes in the medical field? -
ANSWER-continuing education
What is a PA and NP? - ANSWER-Physician Assistant - Nurse Practitioner
Do PAs and NPs get paid the same as MDs? - ANSWER-No - require physician
oversight
What are the 2 primary types of Insurers? - ANSWER-Private and Government
What is the Private Insurance Carrier known as? - ANSWER-Commercial Carrier
What types of plans do Private carrier's provide? - ANSWER-Group and Individual
Plans
, What is the most notable government insurer? - ANSWER-Medicare
What is GPCI used for? - ANSWER-To realize the varying cost based on geographic
location
What is CF used for? - ANSWER-to translate the RVUs into fees - fixed dollar amount
What is (MN) Medical Necessity? - ANSWER-If a procedure or service is considered
appropriate in a given circumstance
What determines the need for Medical Necessity? - ANSWER-the least radical
service/procedure that allows for effective treatment of patient's CC
What is Medicare? - ANSWER-Federal HI Program administered by CMS and provides
coverage for people over 65, blind or disabled, permanent kidney failure or ESRD
What is CMS? - ANSWER-Centers for Medicare & Medicaid Services
What is ESRD? - ANSWER-End Stage Renal Disease
What does Medicare Part A cover? - ANSWER-inpatient hospital care, skilled nursing
facilities, hospice and home healthcare
What does Medicare Part B cover? - ANSWER-Med Nec Drs. services, outpatient care,
other medical (preventive) services not covered under Part A
Do patients have to pay premiums for Medicare Part B? - ANSWER-Yes - requires
yearly deductible & coins
What does Medicare Part C cover? - ANSWER-aka Medicare Advantage
Combines Medicare Part A, B & sometimes D benefits
Who manages Medicare Part C insurance? - ANSWER-The private insurers approved
by Medicare
charge different copays, coins', and deductibles apply
What does Medicare Part D cover? - ANSWER-prescription drugs
What companies manage coverage for MCR Part D? - ANSWER-Private insurers
approved by MCR
What is Medicaid? - ANSWER-State funded HI for Low Income, children, pregnant
women
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