A clinical medical assistant is preparing to bill a patient's insurance for a recent visit. Which of the following actions should the assistant take?
A Choose procedure codes based on the encounter form.
Upcode for greater reimbursement.
Refer to ICD-9 for diagnostic codes.
Enter all data using lowercase letters.
The Correct Answer is A
A. Choose procedure codes based on the encounter form. The encounter form, also known as a superbill, lists the procedures and services provided during the visit. The correct procedure codes (CPT codes) should be selected from this form to ensure accurate billing.
B. Upcode for greater reimbursement. Upcoding, or selecting a higher-level code than justified, is illegal and unethical as it constitutes fraud. This should never be done.
C. Refer to ICD-9 for diagnostic codes. ICD-9 codes have been replaced by ICD-10 codes, which are now the standard for diagnostic coding in the United States. Referring to ICD-9 codes would result in incorrect or outdated billing.
D. Enter all data using lowercase letters. Data entry in all lowercase letters is not a standard practice in medical billing and would not affect the accuracy of the codes. Proper case usage is typically recommended for clarity.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Temperature: Temperature is a vital sign, not an anthropometric measurement.
B. Pulse: Pulse is a vital sign, not an anthropometric measurement.
C. Blood pressure: Blood pressure is a vital sign, not an anthropometric measurement.
D. Weight: Anthropometric measurements include weight, height, and other body measurements used to assess physical development and health.
Correct Answer is A
Explanation
A. Allergies: Allergy information is crucial for preventing adverse reactions to medications and treatments, so it often appears as a pop-up alert in electronic health records (EHRs) to ensure that healthcare providers are aware of any potential risks.
B. Illnesses: Illnesses are typically documented in the patient's history, but they do not usually trigger a pop-up alert unless they are related to specific critical conditions or current treatment concerns.
C. Hospitalizations: Hospitalization history is important but is typically found in the patient's medical history section rather than as an immediate alert in the EHR.
D. Surgeries: Surgical history is generally noted in the patient’s medical history, and while important, it does not usually appear as a pop-up alert unless it directly impacts current treatment.
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