AP Notes, Outlines, Study Guides, Vocabulary, Practice Exams and more!

Coding for Medical Necessity Flashcards

Terms : Hide Images
2703897637Why does a provider use and encounter formTo record treated diagnoses and services rendered to the patient during the current encounter0
2703897638What is the primary purpose of the patient recordTo ensure continuity of care1
2703916696What is the purpose of the auditing processReviewing patient records and CMS1500 & UB-04 claims, to assess coding accuracy and completeness2
2703916699List the information hospital and ambulatory surgical centers need to compile for their operative reportDate of surgery, patient ID, pre & post op diagnosis, list of procedures performed, name of primary and secondary surgeons3
2703916700Name four areas of information that the body of the operative report containsSignature of surgeon, condition of patient when they left the operating room, position and draping of patient for surgery, achievement of anesthesia4
2703970267What is the reason an insurance specialist should be careful to never assign multiple separate codes to describe a procedure when the CPT manual has a single code that classifies all the individual components of the procedure performed by the physicianTo avoid bundling, because each code has a monetary value5
2703970268Preoperative assessment surgery postoperative careGlobal Surgery6
2703970269Physicians medical management of casePlan7
2703970270Outpatient claims editing softwareOCE8
2703970271Waiver required for outpatient and physician's office for procedures / services not covered by Medicare programABN9
2703970272Primary purpose of the patient recordContinuity of care10
2703970273Veterans Health Information System and technology architectureVista11
2703970274Narrative description of procedureOperative report12
2703970275Patient's chief complaintSubjective13
2703970276Reviewing patient records CMS 1500 UB 04 claims for accuracyAuditing process14
2703970277Clinical circumstances of service is covered and codedLocal coverage determinations15
2703970278Physicians medical management of casePlan16
2703970279Documentation of Physician observations of measurable or objective observations made during the physical exam and diagnostic testingObjective17
2703970280Diagnostic statement and may include the Physician rationale for the diagnosisAssessment18
2703972409CMS outpatient claim formCMS 150019
2703997070What is meant by the statement to link the diagnosis with the procedure servicesLinking Diagnosis to procedure to prove medical necessity20
2704085875Diagnostic test results are documented in how many locations221
2704093780What is outpatient code editor software and what is it used forSoftware that edits outpatient claims submitted by hospitals, community mental health care centers, comprehensive outpatient rehab facilities and home health agencies22

Need Help?

We hope your visit has been a productive one. If you're having any problems, or would like to give some feedback, we'd love to hear from you.

For general help, questions, and suggestions, try our dedicated support forums.

If you need to contact the Course-Notes.Org web experience team, please use our contact form.

Need Notes?

While we strive to provide the most comprehensive notes for as many high school textbooks as possible, there are certainly going to be some that we miss. Drop us a note and let us know which textbooks you need. Be sure to include which edition of the textbook you are using! If we see enough demand, we'll do whatever we can to get those notes up on the site for you!