comprehensive questions and verified
answers ( detailed & elaborated)
ACTUAL EXAM 2025 TEST!!
E Codes - CORRECT ANSWERS-For durable medical equipment for use in home
Chief Complaint (CC) - CORRECT ANSWERS-The reason the patient came to see the
physician.
Past, Family and Social History (PFSH) - CORRECT ANSWERS-Consists of patients
personal experiences with illnesses, surgeries, and injuries; Information of illnesses
predominant in family; Patients educational background, occupation, marital status and
other factors
Add on Codes - CORRECT ANSWERS-Used for procedures that are always performed
during the same operative session, as another surgery in addition to the primary
service/procedure and is never performed separately.
What act mandated the reporting of ICD-9-CM diagnosis codes? - CORRECT
ANSWERS-The Medicare Catastrophic Coverage Act of 1988
Electronic Data interchange (EDI) - CORRECT ANSWERS-Transmitting electronic
medical insurance claims from providers to payers using the necessary information
systems is called
Medical Ethics are - CORRECT ANSWERS-Standards of conduct based on moral
principals. Acting within ethical behavior boundries means carrying out one's
responsibilities with integrity, decency, respect, honesty, competence, fairness and
trust.
Three Components for E*M Codes - CORRECT ANSWERS-1.History
2.Physical Exam
, 3.Medical Decision-Making
Guidelines are Found? - CORRECT ANSWERS-At the beginning of each section and
used to provide specific coding rules for that section.
Co-payment - CORRECT ANSWERS-A fixed fee collected at the time of the patients
visit.
Review Linkage Protocol - CORRECT ANSWERS-Appropriateness of Codes, Payers
rules about linkage, Documentation to support codes, Compliance with regulation and
guidelines
What is confidentiality? - CORRECT ANSWERS-Involves restricting patient information
access to those with proper authorization and maintaining the security of patient
information.
What are the names of the three tables that appear in the Index to Diseases? -
CORRECT ANSWERS-Hypertension Neoplasm Table of Drugs and Chemicals
Level 2 codes - CORRECT ANSWERS-National codes for physician and non-physician
service not found in the CPT Level 1
Inpatient - CORRECT ANSWERS-A/An ___________ is a person admitted to a hospital
or long-term care facility(LTCF) for treatment with the expectation that the patient will
remain in the hospital for a period of 24 hours or more.
HIPAA is an acronym for - CORRECT ANSWERS-Health Insurance Portability and
Accountability Act of 1996.
Life Cycle of a Claim - CORRECT ANSWERS-Submission, Processing, Adjudication,
Non-covered, Unauthorized, Medical Necessity Checks, Payment / RA / ERA
Level 1 codes - CORRECT ANSWERS-Codes found in the CPT manual
Deductible - CORRECT ANSWERS-The out-of-pocket payment amount that a
policyholder must meet before insurance covers the service(s) is called?
Coinsurance - CORRECT ANSWERS-A fixed percentage of covered charges applied to
the patients bill after the deductible has been met.
Liability Insurance - CORRECT ANSWERS-Covers injuries caused by insured that
occurred on the insured's property.
Unspecified - CORRECT ANSWERS-"No notation of benign or malignant status is
found in the diagnosis or in the patient's chart."