CCA

1. How does Medicare or other third party payers determine whether the patient has medical necessity for the tests, procedures, or treatment billed on a claim form?: by reviewing all the diagnosis codes assigned to explain the reasons the services were provided 2. What is the name of the organization that develops the billing form that hospitals are required to use?: National Uniform Billing Committee 3. What healthcare organization collect UHDDS data?: all non-outpatient set- tings including ...

1. A 32-year-old patient has a colonoscopy with removal of three polyps by snare. Moderate sedation was used and provided by the physician. The intraservice time was 30 minutes.: 45385, 99156, 99157 A code of 45385 should be used for the colonoscopy procedure with the removal of polpys. No additional codes needed for the colonscopy since it included the colonoscopy and removal of polyps. The moderate sedation also needs to be coded. A code of 99156 should be used to code the moderate sedation...

Audit trails Correct Answer: can provide tracking information such as who accessed which records and for what purpose AMA Correct Answer: CPT was developed and is maintained by: The discharge summary Correct Answer: is a concise account of the patient's illness, course of treatment, response to treatment, and condition at the time the patient is discharged.Ensuring the continuity of future care by providing information to the patient's attending physician, referring physician, and any...

Name the 4 Cooperating Parties for ICD-9-CM Correct Answer: 1) AHIMA, 2) AHA-American Hospital Association, 3) CMS-Centers for Medicare and Medicaid, and 4) NCHS-National Center for Health Statistics What is a POA Indicator? Correct Answer: The POA-Present on Admission Indicator is used to differentiate between conditins present at the time of admission and conditions that develop during an inpatient admission. The POA Indicator applies to diagnosis codes for claims involving inpatient admi...

A 32-year-old patient has a colonoscopy with removal of three polyps by snare. Moderate sedation was used and provided by the physician. The intraservice time was 30 minutes. Correct Answer: 45385, 99156, 99157 A code of 45385 should be used for the colonoscopy procedure with the removal of polpys. No additional codes needed for the colonscopy since it included the colonoscopy and removal of polyps. The moderate sedation also needs to be coded. A code of 99156 should be used to code the mode...

During an audit of health records, the HIM director finds that transcribed reports are being changed by the author up to a week after initial transcription. The director is concerned that changes occurring this long after transcription jeopardize the legal principle that documentation must occur near the time of the event. To remedy this situation, the HIM director should recommend which of the following? Correct Answer: Develop a facility policy that defines the acceptable period of time allow...

How does Medicare or other third party payers determine whether the patient has medical necessity for the tests, procedures, or treatment billed on a claim form? - by reviewing all the diagnosis codes assigned to explain the reasons the services were provided What is the name of the organization that develops the billing form that hospitals are required to use? - National Uniform Billing Committee What healthcare organization collect UHDDS data? - all non-outpatient settings including acute...