Procedure Coding Ch 16 Review p 1

The medical assistant’s role in procedure coding includes which of the following?

• Assigning appropriate codes based on documentation

• Performing surgical procedures

• Prescribing medications

• Diagnosing patient conditions

The history of procedure coding can be described as:

• A chronological account of the development and changes in procedure coding systems.

• A list of current procedure codes only.

• A summary of medical billing errors.

• A description of patient care techniques.

Medical necessity as it applies to coding refers to:

• The requirement that services or procedures are reasonable and necessary for the diagnosis or treatment of a medical condition.

• The process of assigning codes to all procedures regardless of their relevance.

• The use of the most expensive procedures for all patients.

• The documentation of every patient visit, regardless of the service provided.

The difference between fraud and abuse is:

• Fraud is intentional deception for gain, while abuse is improper practices not necessarily intended to deceive.

• Fraud and abuse are both intentional acts of deception for personal gain.

• Fraud is a minor offense, while abuse is a serious crime.

• Fraud involves only financial loss, while abuse involves only physical harm.

Upcoding and downcoding have different effects in medical billing. Which statement best compares and contrasts their effects?

• Upcoding increases reimbursement and risk of fraud, while downcoding decreases reimbursement and may result in underpayment.

• Upcoding and downcoding both increase reimbursement for providers.

• Upcoding decreases reimbursement, while downcoding increases it.

• Upcoding and downcoding have no impact on reimbursement or compliance.

The organization of the CPT coding manual is best described as:

• Divided into sections based on medical specialties and procedures

• Arranged alphabetically by procedure name

• Organized by patient age groups

• Sorted by insurance provider requirements

Using the CPT coding system to assign a procedure code involves:

• Selecting the code that best describes the procedure performed from the CPT manual.

• Assigning a code based on the patient's insurance provider.

• Choosing a code at random from the CPT manual.

• Using only the first code listed in the CPT manual.

Procedure coding is the act of assigning _______ characters to the procedures and services that physicians provide to patients.

• alphanumeric

• numeric

• alphabetic

• symbolic

Which of the following must be reported in conjunction with a procedure code?

• A patient's age

• A diagnosis code that identifies the reason the procedure was performed

• The physician's name

• The date of the procedure

What does Current Procedural Terminology (CPT) refer to?

• A) A list of medications

• B) A listing of five-character alphanumeric codes and descriptions used to report outpatient medical services and procedures

• C) A type of insurance policy

• D) A hospital department