1.
ICD-9-CM codes are how many digits long?
Correct Answer
A. 3-5
Explanation
ICD-9-CM codes are alphanumeric codes used to classify and report medical diagnoses and procedures. The correct answer, 3-5, indicates that these codes can have a minimum of 3 digits and a maximum of 5 digits. This means that an ICD-9-CM code can range from a shorter code like "001" to a longer code like "99999". The range of digits allows for a comprehensive classification system that covers a wide range of medical conditions and procedures.
2.
Which of the following agencies is NOT part of the review of the official guidelines for coding and reporting?
Correct Answer
A. Food and Drug Administration [FDA]
Explanation
The Food and Drug Administration [FDA] is not part of the review of the official guidelines for coding and reporting. The other three agencies mentioned, the National Center for Health Statistics, the American Hospital Association [AMA], and the American Health Information Management Association, are all involved in the review process.
3.
When coding, one must analyze the information located
Correct Answer
B. In the medical record
Explanation
When coding, it is essential to analyze the information located in the medical record. The medical record contains all the relevant details about the patient's condition, treatment, and any procedures performed. It provides the necessary documentation to accurately assign the appropriate codes for billing and reimbursement purposes. The coding manual, healthcare claim form, and encounter form may also contain relevant information, but the medical record is the primary source of data for coding purposes.
4.
When coding, it is important to limit?
Correct Answer
D. Distractions
Explanation
When coding, it is important to limit distractions. Distractions can hinder concentration and productivity, leading to errors or delays in coding tasks. By minimizing distractions such as noise, interruptions, or non-work-related activities, coders can maintain focus and work more efficiently. This allows them to better understand and solve problems, write cleaner code, and meet deadlines effectively.
5.
Which of the ICD-9-CM codes explain why the patient had a service?
Correct Answer
A. V codes
Explanation
V codes in the ICD-9-CM coding system are used to classify reasons for encounters that are not due to a disease or injury. These codes are used to provide additional information about the patient's condition or to describe the reason for the service provided. Therefore, V codes would explain why the patient had a service.
6.
When there is a box with 4th and 5th next to a diagnosis code, it means that
Correct Answer
C. The information is not specific enought to assign as a code
Explanation
When there is a box with 4th and 5th next to a diagnosis code, it means that the information is not specific enough to assign as a code. This suggests that the code alone does not provide enough details to accurately identify the diagnosis or condition. Additional information is needed in order to assign a more specific code.
7.
It is not necessary to read the category and subcategory in addition to the sub-classification to understand what information a code represents.
Correct Answer
B. False
Explanation
The statement is false because in order to fully understand what information a code represents, it is necessary to read not only the sub-classification but also the category and subcategory. The category provides a broad classification, the subcategory provides a more specific classification, and the sub-classification provides even more detailed information about the code. Therefore, all three components are necessary to fully comprehend the information represented by a code.
8.
Coding to the highest level of specificity is mandatory, not optional.
Correct Answer
A. True
Explanation
Coding to the highest level of specificity means providing detailed and precise instructions in the code. This ensures that the code is accurate, efficient, and easy to understand and maintain. It helps to avoid ambiguity and reduces the chances of errors or bugs in the code. Therefore, coding to the highest level of specificity is mandatory to ensure the quality and reliability of the code.
9.
Unspecified means that the physician did not specifiy the type of disorder in the documentation.
Correct Answer
A. True
Explanation
The statement is explaining that when a physician uses the term "unspecified" in their documentation, it means that they did not provide specific details about the type of disorder. This implies that the physician's documentation lacks specific information or details regarding the disorder, leaving it unspecified. Therefore, the answer "True" is correct as it accurately reflects the explanation provided.
10.
Do coders have to follow the rules of which agency to get paid for Medicare billings?
Correct Answer
A. CMS
Explanation
Coders have to follow the rules of CMS (Centers for Medicare and Medicaid Services) in order to get paid for Medicare billings. CMS is the federal agency responsible for administering the Medicare program and ensuring compliance with its regulations. They establish guidelines and policies for billing and coding procedures that healthcare providers must adhere to in order to receive reimbursement for services provided to Medicare beneficiaries.
11.
Which definition best fits the term coordination of care?
Correct Answer
A. Providers sharing information to best treat the patient
Explanation
The term "coordination of care" refers to the process of healthcare providers working together and sharing information in order to provide the best possible treatment for a patient. This involves effective communication and collaboration among different healthcare professionals involved in the patient's care, such as doctors, nurses, and specialists. By sharing information, they can ensure that all aspects of the patient's care are well-coordinated and that they are working towards a common goal of improving the patient's health outcomes. This definition aligns with the concept of coordination of care.
12.
One of the biggest disadvantages of manual medical records is that
Correct Answer
B. Only one person can access the record at a time
Explanation
Manual medical records can only be accessed by one person at a time, which can be a major disadvantage in a healthcare setting where multiple healthcare providers need access to patient information simultaneously. This limitation can lead to delays in providing timely care, coordination issues, and inefficiencies in the overall healthcare system.
13.
A goal of HIPAA related to health information is
Correct Answer
C. Safely transferring information necessary to treat the patient
Explanation
HIPAA, the Health Insurance Portability and Accountability Act, aims to ensure the privacy and security of individuals' health information. One of its goals is to facilitate the safe transfer of necessary information for patient treatment. This means that healthcare providers can securely share relevant medical data with other authorized entities involved in a patient's care, such as hospitals, specialists, or laboratories. By enabling this transfer, HIPAA promotes effective and coordinated healthcare delivery while maintaining patient confidentiality and protecting their sensitive health information.
14.
Why are some diagnosis and or procedure codes mandatory reported to various agencies?
Correct Answer
D. To track patterns in diseases
Explanation
Some diagnosis and procedure codes are mandatory reported to various agencies in order to track patterns in diseases. By collecting data on the types and frequencies of diseases, agencies can identify trends and patterns that may help in understanding the spread and impact of diseases. This information can then be used to develop strategies for prevention, control, and treatment of diseases.
15.
What agency created the ICD coding system?
Correct Answer
B. World Health Organiziation [WHO]
Explanation
The World Health Organization (WHO) created the ICD coding system. The ICD, or International Classification of Diseases, is a standardized system used worldwide for classifying and coding diseases, symptoms, and other health-related conditions. WHO, as a global health agency, has the responsibility of developing and maintaining the ICD system to ensure consistency and accuracy in healthcare data collection and reporting.
16.
CPT codes are the codes for diagnostic coding.
Correct Answer
B. False
Explanation
CPT codes are not specifically for diagnostic coding, but rather for procedural coding. These codes are used to identify and categorize medical procedures and services provided to patients. Diagnostic coding, on the other hand, is typically done using ICD codes, which are used to classify diseases, injuries, and symptoms. Therefore, the statement that CPT codes are for diagnostic coding is false.
17.
A participating provider is also called a par provider.
Correct Answer
A. True
Explanation
A participating provider is indeed referred to as a par provider. This means that the provider has agreed to accept the terms and conditions of a specific insurance plan and has entered into a contractual agreement with the insurance company. By doing so, the provider agrees to provide services to the plan's members at negotiated rates and to abide by the plan's rules and guidelines. This term is commonly used in the healthcare industry to distinguish providers who have a contract with an insurance company from those who do not.
18.
The privacy officer's job duties pertain to overseeing privacy processes protecting patient health information.
Correct Answer
A. True
Explanation
The privacy officer's job duties involve monitoring and supervising the procedures and protocols in place to safeguard patient health information. This includes ensuring that privacy processes are implemented effectively and that all necessary measures are taken to protect the confidentiality and security of patient data. Therefore, the statement is true.