Shared Flashcard Set

Details

Health Insurance
Health insurance terminology
13
Health Care
Professional
11/09/2011

Additional Health Care Flashcards

 


 

Cards

Term

1. list the volumes of the ICD-9- CM

Definition

·      Volume 1: Tabular List

·      Volume 2: Alphabetic Index

Term

2. Explain medicare’s definition of medical necessity

Definition

·      the determination that a service or procedure rendered is reasonable and necessary for the diagnosis or treatment of a illness or injury’s .

Term

3. list four settings in which an outpatient is treated.

Definition

·      Hospital/ ER

·      Same day surgery

·      Ambulatory

·      Doctors office

Term

4. what is the difference between a first-listed diagnosis and a principal diagnosis.

Definition
first listed diagnosis is used in the outpatient setting and a principal diagnosis is used in an inpatient setting. 
Term

5. where are V codes located and When are they assigned?

Definition

·      Located in the Volume 1: tabular list

·      Med. care for a reason other than illness or injury, such as annual checkups, immunization

Term
6. Where are E codes located and when are they assigned? 
Definition

·      Volume 1: tabular list

·      Identify the external causes of injuries and poisoning. car accidents, falls, fires, accidental poisoning of drugs or other substance.

Term

7. What is a principal procedure?

Definition

·      is a procedure performed or definitive treatment rather that diagnostic purposes

Term

8. What is the definition of a complication?

Definition

·       a condition that develops after outpatient care has been provided or during an inpatient admission.

Term

9. why are evaluation and management codes located out of sequence at the beginning of CPT?

Definition

·      because E/M codes are reported by all specialties.

Term

10. State the purpose of CPT modifiers

Definition

·      shows that one or more special circumstance applies to the service or procedure the physician performed.

Term

11. to code surgeries properly, what three questions must be asked?

Definition

·      1. What body system was involved

·      2. What anatomical site was involved

·      3. What type of procedure was performed

Term

12. when coding an excision of a lesion what 3 elements must be known.

Definition

·      1. Size of lesion

·      2. Number of lesions

·      3. Benign versus malignant  status.

Term

13. Briefly explain how to properly code multiple lacerations that are in the same CPT coding classification.

Definition

·      1. Add together the lengths for each laceration

·      2. And report the total as a single code.

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