Medical Billing And Coding Test: Quiz!

Explanation
The responsible personnel for selecting a diagnosis is the physician. Physicians are trained medical professionals who diagnose and treat illnesses and diseases. They have the knowledge and expertise to evaluate patients, order tests, and interpret the results to determine the correct diagnosis. Nurses, coders, and physiotherapists may assist in the diagnostic process, but ultimately it is the physician who is responsible for making the final diagnosis.

Explanation
Coders assign codes based on documentation because they rely on the information provided in medical records, such as diagnoses, procedures, and treatments, to accurately assign the appropriate codes. The documentation serves as a reference for coders to determine the correct codes that reflect the patient's medical condition and the services provided.

Explanation
Documentation gaps in Tulip HCC claims can result in the rejection of claims. When there are gaps or missing information in the documentation, it becomes difficult for the insurance company to accurately assess the accuracy of coding and billing. This lack of clarity can lead to the rejection of claims as the insurance company may not have enough information to determine the validity of the claim. Therefore, all of the options mentioned, including accuracy of coding and billing, can be a result of documentation gaps, ultimately resulting in claim rejection.

Explanation
The Per Diem code represents the level of care provided. Per Diem is a Latin term meaning "per day," and in healthcare, it is used to describe a payment system where providers are reimbursed a fixed amount per day for services rendered. The Per Diem code helps determine the level of care required for a patient and is used to calculate reimbursement rates. It is not related to eligibility, type of facility, or reason for visit.

Explanation
The suffix "megaly" is commonly used in medical terminology to indicate enlargement. Therefore, the correct answer is "Enlargement."

Explanation
The correct answer is 2 months. This means that Daman, a healthcare provider, requires homecare patients to provide updated medical reports every 2 months. This frequency allows for regular monitoring of the patients' health conditions and ensures that appropriate care is provided.

Explanation
ICD stands for International Classification of Diseases. It is a globally recognized system used for classifying and coding various diseases, disorders, injuries, and other health conditions. The ICD provides a standardized way for healthcare professionals to communicate and share information about diseases and their corresponding codes. It is widely used for statistical purposes, epidemiological studies, healthcare management, and reimbursement systems.

Explanation
The statement is describing the responsibilities of a Coder, who is responsible for confirming diagnoses and procedures codes by an in-house physician, having a final review by Medical Advisory, and submitting documents for pre-authorization. The answer is true because it accurately reflects the given responsibilities of a Coder.

Explanation
The statement is true because CPT does stand for Current Procedure Terminology and it is a standardized code set used to describe medical services and procedures provided by healthcare providers.

Explanation
Medical coding refers to the process of converting healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. These codes are used for various purposes, such as billing, insurance claims, and statistical analysis. By using standardized codes, medical coding ensures accuracy, consistency, and efficiency in healthcare documentation and communication.