Questions and Answers
Which type of information is NOT maintained in a medical record?
Professionals who specialize in coding are called?
Coding Specialists
When coding an operative report, what action would NOT be recommended?
Coding from the header without reading the body of the report
Which coding manuals do outpatient coders focus on learning?
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The ___________ describes whether specific medical items, services, treatment procedures, or technologies are considered medically necessary under Medicare.
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What is the purpose of National Coverage Determinations?
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Local Coverage Determinations are administered by whom?
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LCDs only have jurisdiction in their ___________.
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ABN stands for _______________.
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When are providers responsible for obtaining an ABN for a service NOT considered medically necessary?
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In what year did HIPAA become law?
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Who is responsible for enforcing the HIPAA security rule?
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Healthcare providers are responsible for developing ____________ and policies and procedures regarding privacy in their practices.
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HITECH provides a ___________ day window during which any violation not due to willful neglect may be corrected without penalty.
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What is NOT a benefit of an active compliance plan?
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How many components are in a compliance plan?
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According to AAPC's Code of Ethics, an AAPC member shall use only ____________ and __________ means in all professional dealings.
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What type of insurance is Medicare Part D?
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What is PHI?
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What form is used to submit a provider's charge to the insurance carrier?
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What is a BENEFIT of electronic transactions?
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Which provider is NOT a mid-level provider? (Options: a) Physician Assistant, b) Nurse Practitioner, c) Anesthesiologist, d) All choices are mid-level providers)
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In what year was AAPC founded?
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AAPC credentialed coders have proven mastery of what information?
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The AAPC offers over 500 local chapters across the country for the purpose of?
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Study Notes
Financial Records
- Medical records do not maintain certain types of information.
Coding Specialists
- Professionals specializing in coding are known as coding specialists.
Coding Practices
- It is discouraged to code operative reports solely from the header without reviewing the report body.
Key Coding Manuals
- Outpatient coders primarily focus on learning CPT, HCPCS Level II, and ICD-10-CM coding manuals.
National Coverage Determinations
- This manual outlines which medical items and treatments are deemed medically necessary for Medicare coverage.
Purpose of National Coverage Determinations
- These determinations clarify when Medicare will reimburse for specific items or services.
Local Coverage Determinations Administration
- Each regional Medicare Administrative Contractor (MAC) manages Local Coverage Determinations (LCDs).
LCD Jurisdiction
- LCDs are applicable only within their specific regional jurisdiction.
Advance Beneficiary Notice (ABN)
- ABN stands for Advance Beneficiary Notice.
ABN Responsibility
- Providers must secure an ABN before delivering services deemed not medically necessary.
HIPAA Enactment Year
- HIPAA was enacted in 1996.
HIPAA Security Rule Enforcement
- The Office of Civil Rights (OCR) is responsible for enforcing HIPAA security regulations.
Notices of Privacy Practices
- Healthcare providers must establish policies and procedures regarding privacy, including Notices of Privacy Practices.
HITECH Correction Window
- HITECH allows a 30-day window to rectify non-willful neglect violations without incurring penalties.
Compliance Plan Benefits
- An active compliance plan reduces audit risks, though it does not eliminate them entirely.
Components of a Compliance Plan
- A compliance plan consists of seven essential components.
AAPC Code of Ethics
- AAPC members must operate using legal and ethical means in all professional interactions.
Medicare Part D
- Medicare Part D offers prescription drug coverage to all eligible beneficiaries.
Protected Health Information (PHI)
- PHI refers to any health information that can be linked to an individual.
CMS-1500 Form
- The CMS-1500 form is used to submit provider charges to insurance carriers.
Electronic Transactions Benefits
- One advantage of electronic transactions is the timely submission of claims.
Provider Classification
- An anesthesiologist is considered a physician and is not classified as a mid-level provider.
AAPC Foundation Year
- AAPC was founded in 1988.
AAPC Coder Mastery Areas
- Credentialed AAPC coders demonstrate mastery in code sets, evaluation & management principles, and documentation guidelines.
AAPC Local Chapters
- AAPC has over 500 local chapters to promote continuing education and networking among members.
Studying That Suits You
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Description
Test your knowledge of medical coding with these flashcards covering key terms and concepts from AAPC Chapter 1. Whether it's understanding financial records or coding specialists, this quiz will help reinforce your understanding of essential coding practices.
