Podcast
Questions and Answers
What does EOB stand for?
What does EOB stand for?
Explanation of benefits.
What is it called when the level of service code is deliberately increased to receive higher reimbursements?
What is it called when the level of service code is deliberately increased to receive higher reimbursements?
Upcoding.
A CPT code stating 'separate procedure' is part of a bundled code.
A CPT code stating 'separate procedure' is part of a bundled code.
False
What does the surgical package include except for post-operative physical therapy?
What does the surgical package include except for post-operative physical therapy?
Signup and view all the answers
What is the appropriate CPT code for an expanded focus office visit with an established patient?
What is the appropriate CPT code for an expanded focus office visit with an established patient?
Signup and view all the answers
What is the appropriate CPT code for blood glucose, monitoring device?
What is the appropriate CPT code for blood glucose, monitoring device?
Signup and view all the answers
The statute of limitations is the same for every state.
The statute of limitations is the same for every state.
Signup and view all the answers
The correct ICD-10 code for diabetes mellitus type 2 without complications is ________.
The correct ICD-10 code for diabetes mellitus type 2 without complications is ________.
Signup and view all the answers
What is one of the more important types of information in the patient's billing record?
What is one of the more important types of information in the patient's billing record?
Signup and view all the answers
What term describes the act of a physician deliberately asking the Billing Department to increase all the Medicare claims by 5%?
What term describes the act of a physician deliberately asking the Billing Department to increase all the Medicare claims by 5%?
Signup and view all the answers
Study Notes
Medical Billing Terminology
- EOB stands for "explanation of benefits," which outlines the services provided and payment details.
- Upcoding refers to the practice of unnecessarily increasing service codes to obtain higher reimbursements from insurance.
CPT Codes and Procedures
- A CPT code labeled as "separate procedure" indicates that it is not bundled with other services.
- Surgical packages do not include post-operative physical therapy, focusing instead on the procedure itself and immediate post-operative care.
Office Visits and Coding
- An expanded focus office visit for an established patient is coded as 99213, which pertains to specific requirements set by CPT guidelines.
- The appropriate CPT code for a blood glucose monitoring device is 82962, highlighting its significance in diabetes management.
Legal and Regulatory Considerations
- The statute of limitations varies by state, indicating differing time frames for legal actions.
- The ICD-10 code for diabetes mellitus type 2 without complications is noted as E11.9, essential for accurate medical coding.
Billing Record and Fraud Awareness
- An important aspect of a patient's billing record is keeping updated insurance information to ensure accurate billing and claims.
- Deliberately inflating Medicare claims by 5% before submission is considered fraud and can have legal repercussions.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge on medical coding terminology and concepts with this quiz. From understanding EOB to the intricacies of surgical packages, challenge yourself with various questions designed to enhance your coding expertise.
