The following diagnosis and procedure codes were rejected for payment. What is the probable reason for...
The following diagnosis and procedure codes were rejected for payment. What is the probable reason for the payer's decision in each case?
A. O35.0XXO
B. Z41.3, 69090
C. B00.89, 69145
D. Z00.00, 80050, 80053
Homework Answers
A.) O35. 0XX0 is a billable ICD code used to specify a diagnosis of maternal care for (suspected) central nervous system malformation in fetus, not applicable or unspecified. A 'billable code' is detailed enough to be used to specify a medical diagnosis. Hence, was rejected for payment
B.) The code Z41. 3 describes a circumstance which influences the patient's health status but not a current illness or injury. The code is unacceptable as a principal diagnosis. Hence, the payer rejected payment. 69090 deals with Incision procedures on external ear that is not necessary for an unacceptable diagnosis. Hence payment was rejected.
C.) B00. 89 is a billable ICD code used to specify a diagnosis of other herpesviral infection. While 69145 deals with Excision procedures on external ear. The diagnosis and procedures are not related. Hence, payment was rejected.
D) Z00. 00 is a billable ICD code used to specify a diagnosis of encounter for general adult medical examination without abnormal findings.
80050 - General health panel
80053 - Comprehensive metabolic panel
For diagnosis of general adult medical examination, metabolic panels are unnecessary. Hence treatment was rejected.
Add Answer to:
The following diagnosis and procedure codes were
rejected for payment. What is the probable reason for...
medical coding question: How are procedure codes different from diagnosis codes? What items do we need...
medical coding question: How are procedure codes different from diagnosis codes? What items do we need to look for in the medical record to find the correct procedure codes? What does the chapter tell us about HCPCS level 2 codes?
Questions: List the words that indicate a qualified diagnosis . How can you verify the codes...
Questions: List the words that indicate a qualified diagnosis . How can you verify the codes you find in the Index? List the terms used for the owner of a health insurance policy . What is the usual deadline for accepting a claim by most insurance carriers? Name patients' out of pocket expenses. How many characters are there in an ICD-10-CM. . What are Disability income (DI) insurance benefits based on? What is national provider identifier (NPI)? . How often...
Which of the following would be the most probable reason for a firm to diversify________? A....
Which of the following would be the most probable reason for a firm to diversify________? A. To increase social benefits. B. To promote the production of goods that are complementary to the goods that it produces. C. To internalize negative externalities. D. To promote the production of goods that are similar to the goods that it already produces.
What are the diagnosis codes? For pic below Intraoperall Complications of tH Category D78, Intraoperative and...
What are the diagnosis codes? For pic below
Intraoperall Complications of tH Category D78, Intraoperative and postproce for intraopera of the spleen, and postprocedural h tion codes identity the specific complicat complications of the ne splen. ma of the spleen. The of the spleen, ind and Posttoma of the spleen, accidental, the r the complication hemorrhage and hematoma of codes, D78.81 and D78.89, are available to iden the spleen beyond the codes in the further identify what the complication was....
A. What is the probable diagnosis of this patient? Describe the phase of the disease B....
A. What is the probable diagnosis of this patient? Describe the phase of the disease B. what is the likely microorganism involved? C. How did he acquire the disease? D. Stan's partner, Tracy is in her second trimester of pregnancy. Should we be concerned about the health of the fetus? Why? E. Who should be screened for STDs based on the epidemiology of the case? A 58-year old lawyer presents in the emergency room with a headache, irritability. generalized muscle...
Coding Hint: This chart has 1 principal diagnosis, 13 secondary diagnosis codes, and 5 Z codes....
Coding Hint: This chart has 1 principal diagnosis, 13 secondary diagnosis codes, and 5 Z codes. In this case, the Z codes include two status heart procedure codes and three long-term drug use codes. Admission Diagnosis: Renal Failure Discharge Diagnosis: (all present on admission) ARF on stage 3 CKD C. Difficile colitis UTI Gout Secondary Diagnoses: Patient Active Problem List Diagnosis Heart replaced by transplant Sinus node dysfunction HTN (hypertension) Hyperlipidemia DM type 2 (diabetes mellitus, type 2) Hypomagnesemia Systolic...
coding resources Part A Complete the tables below. Determine a diagnosis code for the following case...
coding resources Part A Complete the tables below. Determine a diagnosis code for the following case studies and include your reference. Case Study Diagnosis Code or Resourc 1. Patient presents to ER with severe abdominal pain. Patient had coffee ground emesis. The diagnosis was determined to be gastritis with bleedina. 2. During the initial visit to the ER, a 14 year old presents with anaphylaxis after eating a peanut butter cookie. The diagnosis is anaphylactic shock from peanuts. 3. 10...
1.What type of procedure is performed for revascularization? a. PCI b.ECG c.TCD d.EPS 2.0Read the mini-medical-record...
1.What type of procedure is performed for revascularization? a. PCI b.ECG c.TCD d.EPS 2.0Read the mini-medical-record of the patient’s encounter, then abstract, assign, and sequence ICD-10-CM diagnosis codes and CPT procedure codes using the Index and Tabular List. What are the correct code(s)? a.N17.8, 99291, 99292 b.N17.9, 99291 c.N17.9, 99291, 99292 d. N17.8, 99291 3.Read the mini-medical-record of the patient’s encounter, then abstract, assign, and sequence ICD-10-CM diagnosis codes and CPT procedure codes using the Index and Tabular List. Group...
Please assign the correct ICD-10-PCS codes to the following operative report: PREOPERATIVE DIAGNOSIS: POSTOPERATIVE DIAGNOSIS: PROCEDURES:...
Please assign the correct ICD-10-PCS codes to the following operative report: PREOPERATIVE DIAGNOSIS: POSTOPERATIVE DIAGNOSIS: PROCEDURES: Status post transurethral resection of bladder tumor with clot retention Status post transurethral resection of bladder tumor with clot retention 1. Cystoscopy 2. Clot evacuation 3. Fulguration of bleeders DESCRIPTION OF OPERATION: Following induction of an adequate level of general anesthesia, the patient was placed in the lithotomy position. His penis and surrounding areas were prepared with Betadine and he was draped in a...
PREPARING FOR THE CERTIFICATION EXA 1. What convention identifies two codes that are mutually exclusive and...
PREPARING FOR THE CERTIFICATION EXA 1. What convention identifies two codes that are mutually exclusive and cannot be used together? a. Code also b. Excludes1 c. NEC d. See also e. Excludes2 2. Which of the following is NOT an expected benefit of ICD-10-CM? a. Detailed diagnosis codes reduce the need for attachments to claims. b. Provides more consistent and more detailed data for physician use c. Allows anyone in the office to perform diagnosis coding. d. Reflects advancements in...
Questions: List the words that indicate a qualified diagnosis . How can you verify the codes you find in the Index? List the terms used for the owner of a health insurance policy . What is the usual deadline for accepting a claim by most insurance carriers? Name patients' out of pocket expenses. How many characters are there in an ICD-10-CM. . What are Disability income (DI) insurance benefits based on? What is national provider identifier (NPI)? . How often...
What are the diagnosis codes? For pic below
Intraoperall Complications of tH Category D78, Intraoperative and postproce for intraopera of the spleen, and postprocedural h tion codes identity the specific complicat complications of the ne splen. ma of the spleen. The of the spleen, ind and Posttoma of the spleen, accidental, the r the complication hemorrhage and hematoma of codes, D78.81 and D78.89, are available to iden the spleen beyond the codes in the further identify what the complication was....
A. What is the probable diagnosis of this patient? Describe the phase of the disease B. what is the likely microorganism involved? C. How did he acquire the disease? D. Stan's partner, Tracy is in her second trimester of pregnancy. Should we be concerned about the health of the fetus? Why? E. Who should be screened for STDs based on the epidemiology of the case? A 58-year old lawyer presents in the emergency room with a headache, irritability. generalized muscle...
coding resources Part A Complete the tables below. Determine a diagnosis code for the following case studies and include your reference. Case Study Diagnosis Code or Resourc 1. Patient presents to ER with severe abdominal pain. Patient had coffee ground emesis. The diagnosis was determined to be gastritis with bleedina. 2. During the initial visit to the ER, a 14 year old presents with anaphylaxis after eating a peanut butter cookie. The diagnosis is anaphylactic shock from peanuts. 3. 10...
Please assign the correct ICD-10-PCS codes to the following operative report: PREOPERATIVE DIAGNOSIS: POSTOPERATIVE DIAGNOSIS: PROCEDURES: Status post transurethral resection of bladder tumor with clot retention Status post transurethral resection of bladder tumor with clot retention 1. Cystoscopy 2. Clot evacuation 3. Fulguration of bleeders DESCRIPTION OF OPERATION: Following induction of an adequate level of general anesthesia, the patient was placed in the lithotomy position. His penis and surrounding areas were prepared with Betadine and he was draped in a...
PREPARING FOR THE CERTIFICATION EXA 1. What convention identifies two codes that are mutually exclusive and cannot be used together? a. Code also b. Excludes1 c. NEC d. See also e. Excludes2 2. Which of the following is NOT an expected benefit of ICD-10-CM? a. Detailed diagnosis codes reduce the need for attachments to claims. b. Provides more consistent and more detailed data for physician use c. Allows anyone in the office to perform diagnosis coding. d. Reflects advancements in...
Most questions answered within 3 hours.
-
Calculate the equillibrium constent K for a redox reaction that
has E°cell = -.98 V at...
asked 6 minutes ago -
A concave spherical mirror has a radius of curvature of
magnitude 19.6 cm.
(a) Find the...
asked 8 minutes ago -
3. draw a diagram of the magnetic field:
a. around a long straight wire with a...
asked 7 minutes ago -
If you titrated 30.0 mL of 0.1 M HCl with 0.1 M NaOH, indicate
the approximate...
asked 15 minutes ago -
NADH passes electrons into the electron transport chain. List
the carriers that would receive the electrons,...
asked 23 minutes ago -
A cylindrical cable with a resistivity of 1.6x10-8 Ω·m and cross
sectional area of 3x10-5 m^2...
asked 23 minutes ago -
True or False.
A consumer with convex preferences who is indifferent between
the bundles (5,2) and...
asked 27 minutes ago -
A diamond's index of refraction for red light, 656 nm, is 2.410,
while that for blue...
asked 40 minutes ago -
Compare HPLC, SPE, and GC. Identify the differences, the
advantages, and the weaknesses of each method.
asked 41 minutes ago -
Characteristic x-rays emitted by potassium have a wavelength of
0.374 nm. What is the energy of...
asked 44 minutes ago -
there is a function to create two random numbers between 1 and
25 and a function...
asked 1 hour ago -
At a certain temperature, the ?pKp for the decomposition of
H2SH2S is 0.832.0.832.
H2S(g)↽−−⇀H2(g)+S(g)H2S(g)↽−−⇀H2(g)+S(g)
Initially, only...
asked 55 minutes ago