Upcoding - Study guides, Class notes & Summaries

Administrative Health Assistant (NRCAHA) Chapter 3 Questions and Answers There are two types of CPT codes one is add on the other is: A: Adjustment B: Stand alone C: Additions D: Single digit - Correct Answer ️️ -B: Stand alone Basic CPT codes use how many digits: A: 2 digits B: 3 digits C: 4 digits D: 5 digits - Correct Answer ️️ -D: 5 digits Services provided by a specialist such as neurosurgeons and intensive care units would be termed as what type of care: A: Skilled ca...

When coding a benign neoplasm of skin of the left upper eyelid, which of the following codes should be used? a. D23.12 - Other benign neoplasm of skin of left eyelid, including canthus b. D17.0 c. D23.121 - Other benign neoplasm of skin of left upper eyelid, including canthus d. D23.122 - Other benign neoplasm of skin of left lower eyelid, including canthus correct answersc. D23.121 - Other benign neoplasm of skin of left upper eyelid, including canthus A Clinical Documentation Improvem...

B: Stand alone - There are two types of CPT codes one is add on the other is: A: Adjustment B: Stand alone C: Additions D: Single digit D: 5 digits - Basic CPT codes use how many digits: A: 2 digits B: 3 digits C: 4 digits D: 5 digits C: Tertiary care - Services provided by a specialist such as neurosurgeons and intensive care units would be termed as what type of care: A: Skilled care B: Binary care C: Tertiary care D: Primary care A: Blue shield - Which of the ...

Medical Billing and Coding Lesson 1: Reimbursement, HIPAA, and Compliance Already Passed The Medical Coder's Responsibility Each coding system plays a critical role in reimbursement. The role of the medical coder is to optimize payment while adhering to coding guidelines. The coder must accurately code the services, procedures, and diagnosis rendered so that the office is properly reimbursed. Coders may encounter ethical issues about upcoding a procedure or changing a diagnosis to ob...

B: Stand alone - correct answer There are two types of CPT codes one is add on the other is: A: Adjustment B: Stand alone C: Additions D: Single digit D: 5 digits - correct answer Basic CPT codes use how many digits: A: 2 digits B: 3 digits C: 4 digits D: 5 digits C: Tertiary care - correct answer Services provided by a specialist such as neurosurgeons and intensive care units would be termed as what type of care: A: Skilled care B: Binary care C: Tertiary care D: Primary ca...

True or False: The ACA requires that all providers adopt a compliance plan as a condition of enrollment with Medicare, Medicaid, and Children's Health Insurance Program (CHIP). - Answer- True ref. ACA section 6102 According to HHS-OIG - what are three important reasons for proper documentation in Compliance? (hint: protections) - Answer- 1.Protect our programs 2.Protect your patients 3.Protect the Provider At which level of the Medicare Part A or Part B appeals process is the app...

There are two types of CPT codes one is add on the other is: A: Adjustment B: Stand alone C: Additions D: Single digit - Answer-B: Stand alone Basic CPT codes use how many digits: A: 2 digits B: 3 digits C: 4 digits D: 5 digits - Answer-D: 5 digits Services provided by a specialist such as neurosurgeons and intensive care units would be termed as what type of care: A: Skilled care B: Binary care C: Tertiary care D: Primary care - Answer-C: Tertiary care Which of the following is ...

CPMA EXAM PREP TESTED QUESTIONS WITH REVISED ANSWERS When providing a prescription for a patient, the education of the patient (including side effects and supporting documentation) in the medical record that the information was reviewed is based on which of the following standards? A. Privacy standards B. OSHA standards C. Joint Commission standards D. PHI standards - ANSWER C. Joint Commission standards A deliberate misrepresentation of facts to gain unauthorized b...

HMO plans require the enrollee to: - To have referrals to see a specialist that is generated by the patient's PCP What are PPOs (preferred provider organizations)? - Organizations in which medical professionals and facilities provide services to subscribed clients at reduced rates. What is a covered entity? - Health plans, clearinghouses, and any entity transmitting health information is considered to be as is stated by the Privacy Rule. What are the three steps to be taken when there is a br...

NCCT REVIEW LAW AND ETHICS EXAM QUESTIONS AND ANSWERS 1. Which of the following activities is an example of abuse rather than fraud? A. upcoding B. misrepresenting the diagnosis C. inadvertent coding errors D. billing for services not rendered - Answer-inadvertent coding errors Rationale Abuse is an unintentional mistake. Fraud is an intentional misrepresentation for gain. Upcoding, misrepresenting the diagnosis, and billing for services not rendered are examples of fraud. Inadvertent ...