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MED 210 FINAL
STUDY GUIDE-MEDICAL CODING
48
Medical
Undergraduate 1
05/15/2013

Additional Medical Flashcards

 


 

Cards

Term

A Medical Assistant should always familiarize them with the coding part of the job so they can

Definition
help others, increase their skill levels, and help with reimbursement and avoid fraud by the physician
Term

The physician is ultimately responsible for the

Definition
ICD-9, CPT, and HCPCS that are sent to the insurance companies
Term

If the patient is having an emergency such as a myocardial infarction, the emergency room physician cannot

Definition
refuse the patient services needed regardless if they have insurance or not
Term

The updating of insurance cards are vital to insure that the office bills the

Definition
correct insurance, the physician takes that insurance, and what services they can perform so the insurance pays the costs
Term

A physician can refuse to see a new or long term patient by 

Definition
sending them a letter stating they no longer want to see that patient.  They do not have to give a reason
Term

HCPCS have two levels of codes,

Definition
I & II
Term

15 minute increments                                                         

Definition
Anesthesia time unit
Term

Person has been a patient to one Doctor for 3 years 

Definition
Established patient
Term

Two-digit numeric codes                                         

Definition
Modifiers
Term

Unlisted service code                                                         

Definition
Special report
Term

Seen by 2 physicians in one day                                        

Definition
Concurrent care
Term

Mammograms and prostate exam                                      

Definition
Preventative care
Term

Medical intervention                                                          

Definition
Iatrogenic
Term

Disorder diagnosed at birth                                                

Definition
Congenital
Term

External causes of burns/injuries   

Definition
                                    E codes
Term

Late effect of injury/illness                                                

Definition
Sequelae
Term

Automates coding with computers                                     

Definition
Encoder
Term

Condition after testing in the hospital         

Definition
              Principal diagnosis
Term

Condition after testing in outpatient                                   

Definition
Complication
Term

Comorbidities and complications                                       

Definition
Secondary diagnosis
Term

Codes for other than diseases/injuries               

Definition
       V codes
Term

Rule of nines                                                                     

Definition
Burns
Term

Current procedural terminology codes are considered

Definition
HCPCS codes #I
Term

Guidelines define terms and explain codes for services or procedures located in the

Definition
CPT manual
Term

A star is not located anywhere in the

Definition
CPT manual
Term

Medicine, pathology, radiology, and laboratory are all part of the .

Definition
CPT manual in specific sections
Term

All services and procedures must be submitted on a claim from the

Definition
ICD-9 CM code book to be reimbursed as they will be a justified service
Term

Codes for neoplasms must be submitted from the

Definition
pathology report to be reimbursed.
Term

Guidelines are in the front of the CPT book and should always be carefully reviewed before

Definition
actually coding a service or procedure
Term

E codes are used for

Definition
environmental events, criminal activities, or industrial accidents
Term

The Medical Assistant who is employed by a physician may assign procedural codes for reimbursement when

Definition
written by the physician
Term

An Advanced Beneficiary Notice is not necessary to sign by the patient to show that

Definition
the healthcare provider accepts Medicare
Term

An inpatient is considered a patient with the expectation that they will be admitted into the hospital for at least

Definition
24 hours
Term

Codes that describe signs and symptoms of the patient are acceptable when

Definition
the physician has not established or definite diagnoses
Term

Preadmission testing is done to

Definition
facilitate patient treatment and decrease the hospital stay for the patient
Term

A principal procedure is done for a definitive procedure rather than 

Definition
diagnostic treatment
Term

A neoplasm lesion is always a malignancy in the

Definition
organ or tissue
Term

The CPT manual uses uniform language to describe medical, surgical, or diagnostic services to maintain communication among

Definition
providers, patients, and insurers
Term

Unbundling is where you assign multiple codes to specific tests/services rather than

Definition
using a comprehensive code which should be reported
Term

The radiological code is for 

Definition
the completion of the x-ray, physician reading the x-ray and writing a report describing the findings and the examination.  All are included in one code
Term

Single number codes are assigned to 

Definition
specific organs and the routine blood chemistry’s that are expected.  This panel is very specific and cannot be changed or have any substitutions
Term

Chemotherapy, along with other cancer treatments such as radiology/and or surgery, is considered

Definition
an adjuvant chemotherapy.
Term

Evaluation and management of the patient services by the physician is in the CPT manual under

Definition
Evaluation and management regardless of where the physician see’s the patient
Term

Per Medicare, the determination that a service or procedure is necessary and reasonable is called

Definition
a medical necessity
Term

An outpatient facility taking care of patients can be in the

Definition
hospital observation unit, outpatient clinic, and physician’s office
Term

History of breast cancer and tuberculosis is an example of

Definition
a V code
Term

E codes are for

Definition
external cause of injury or poisoning or other adverse reactions from the patient
Term

 

A physician or free standing clinic may refuse patient care that is not an emergency because

Definition
you don’t have insurance
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