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 ICD-9 codes have been replaced by ICD-10 codes, which are now the standard for diagnostic coding in the United States. Referring to ICD-9 codes would result in incorrect or outdated billing.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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Related Questions
Correct Answer is D
Explanation
A. Women, Infants, and Children Program (WIC): WIC provides assistance for food, nutrition education, and healthcare referrals but does not cover general medical treatment for children.
B. Medicare: Medicare is primarily for individuals aged 65 and older or those with certain disabilities, not for pediatric patients.
C. TRICARE: TRICARE is a healthcare program for military personnel and their families, not a general public assistance program for children.
D. Children's Health Insurance Program (CHIP): CHIP is designed to provide low-cost health coverage to children in families who earn too much money to qualify for Medicaid but cannot afford private insurance. This is the appropriate resource for the situation.
Correct Answer is C
Explanation
A. Convulsions: Convulsions are not a common complication of phlebotomy; they are unrelated to the procedure.
B. Petechiae: Petechiae are small red spots that can occur but are less common than hematomas in phlebotomy.
C. Hematoma: A hematoma, or bruise, is the most common complication resulting from the accumulation of blood outside the vein after a blood draw.
D. Hypovolemia: Hypovolemia, or low blood volume, is not a common complication from routine phlebotomy.
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