NSU FNP Adult 1 Exam 1 Review Questions With Complete
Solutions
Responsibility for billing
3 components
-History
-Examination
-Medical decision making
ROS is part of what component in Responsibility for Billing?
History
Level 2 through 5 (problem focused to comprehensive) is part of
what component in Responsibility for Billing?
Examination
Taking into account DX, risks, complications and level 2
through 5 (straight forward to high complexity) is part of what
component in Responsibility for Billing?
Medical Decision Making
Medical Decision making Complexity levels
Level 2
Level 3
Level 4:
Level 5:
,-Straightforward
-Low complexity
-Moderate complexity
-High complexity
A new patient is one who is
New to practice or not seen in 3 years
Type of Exam (level)?
-Limited to affected body system/area
-Brief 1 to 5 elements
Problem focused (lev 2)
Type of Exam (level)?
-Affected body area/system AND other symptomatic/related
system
-Focused & brief at least 6 elements
Expanded problem (lev 3)
Type of Exam (level)?
-Extended exam of affected area/system & other related
-2 Elements from 6 areas/systems or at least 12 elements on 2 or
more areas/systems
Detailed (lev 4)
Type of exam (level)?
-General multisystem
-All elements and at least 2 elements from nine areas/systems
Comprehensive (lev 5)
Prior to ________:
, 1. Appropriate diagnosis must be identified
2. Type of patient encounter needs to be identified
3. What procedures were performed
4. Medication administered if any and supplies used
5. Clear and accurate documentation validating diagnoses &
procedural codes for billing
Billing
______ is:
-Translation of original medical record documentation into a
standardized manner using a series of code numbers for patient
diagnoses and procedures.
-Coded information used in patient care, research,
reimbursement and evaluation of services
Medical coding
-Developed by the World Health Organization (WHO)
-Codes cover specific illnesses/diseases including signs and
symptoms from the patient encounter
-Used for classifying morbidity and mortality data from
inpatient and outpatient settings
-Reflects "why it was done"
International Classification of Disease
(ICD codes)
-Describes services &/or procedures for reimbursement
-Published by the American Medical Association (AMA)
starting 1966
Solutions
Responsibility for billing
3 components
-History
-Examination
-Medical decision making
ROS is part of what component in Responsibility for Billing?
History
Level 2 through 5 (problem focused to comprehensive) is part of
what component in Responsibility for Billing?
Examination
Taking into account DX, risks, complications and level 2
through 5 (straight forward to high complexity) is part of what
component in Responsibility for Billing?
Medical Decision Making
Medical Decision making Complexity levels
Level 2
Level 3
Level 4:
Level 5:
,-Straightforward
-Low complexity
-Moderate complexity
-High complexity
A new patient is one who is
New to practice or not seen in 3 years
Type of Exam (level)?
-Limited to affected body system/area
-Brief 1 to 5 elements
Problem focused (lev 2)
Type of Exam (level)?
-Affected body area/system AND other symptomatic/related
system
-Focused & brief at least 6 elements
Expanded problem (lev 3)
Type of Exam (level)?
-Extended exam of affected area/system & other related
-2 Elements from 6 areas/systems or at least 12 elements on 2 or
more areas/systems
Detailed (lev 4)
Type of exam (level)?
-General multisystem
-All elements and at least 2 elements from nine areas/systems
Comprehensive (lev 5)
Prior to ________:
, 1. Appropriate diagnosis must be identified
2. Type of patient encounter needs to be identified
3. What procedures were performed
4. Medication administered if any and supplies used
5. Clear and accurate documentation validating diagnoses &
procedural codes for billing
Billing
______ is:
-Translation of original medical record documentation into a
standardized manner using a series of code numbers for patient
diagnoses and procedures.
-Coded information used in patient care, research,
reimbursement and evaluation of services
Medical coding
-Developed by the World Health Organization (WHO)
-Codes cover specific illnesses/diseases including signs and
symptoms from the patient encounter
-Used for classifying morbidity and mortality data from
inpatient and outpatient settings
-Reflects "why it was done"
International Classification of Disease
(ICD codes)
-Describes services &/or procedures for reimbursement
-Published by the American Medical Association (AMA)
starting 1966
