Coding for Medical Necessity Flashcards

2703897637	Why does a provider use and encounter form	To record treated diagnoses and services rendered to the patient during the current encounter	0
2703897638	What is the primary purpose of the patient record	To ensure continuity of care	1
2703916696	What is the purpose of the auditing process	Reviewing patient records and CMS1500 & UB-04 claims, to assess coding accuracy and completeness	2
2703916699	List the information hospital and ambulatory surgical centers need to compile for their operative report	Date of surgery, patient ID, pre & post op diagnosis, list of procedures performed, name of primary and secondary surgeons	3
2703916700	Name four areas of information that the body of the operative report contains	Signature of surgeon, condition of patient when they left the operating room, position and draping of patient for surgery, achievement of anesthesia	4
2703970267	What 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 physician	To avoid bundling, because each code has a monetary value	5
2703970268	Preoperative assessment surgery postoperative care	Global Surgery	6
2703970269	Physicians medical management of case	Plan	7
2703970270	Outpatient claims editing software	OCE	8
2703970271	Waiver required for outpatient and physician's office for procedures / services not covered by Medicare program	ABN	9
2703970272	Primary purpose of the patient record	Continuity of care	10
2703970273	Veterans Health Information System and technology architecture	Vista	11
2703970274	Narrative description of procedure	Operative report	12
2703970275	Patient's chief complaint	Subjective	13
2703970276	Reviewing patient records CMS 1500 UB 04 claims for accuracy	Auditing process	14
2703970277	Clinical circumstances of service is covered and coded	Local coverage determinations	15
2703970278	Physicians medical management of case	Plan	16
2703970279	Documentation of Physician observations of measurable or objective observations made during the physical exam and diagnostic testing	Objective	17
2703970280	Diagnostic statement and may include the Physician rationale for the diagnosis	Assessment	18
2703972409	CMS outpatient claim form	CMS 1500	19
2703997070	What is meant by the statement to link the diagnosis with the procedure services	Linking Diagnosis to procedure to prove medical necessity	20
2704085875	Diagnostic test results are documented in how many locations	2	21
2704093780	What is outpatient code editor software and what is it used for	Software that edits outpatient claims submitted by hospitals, community mental health care centers, comprehensive outpatient rehab facilities and home health agencies	22