Outpatient Insurance Coding - Applying Concepts Ch 4 #1
1. Patient was seen in office and given blood tests. Doctor's diagnosis is group D hyperlipidemia.
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Outpatient Insurance Coding - Applying Concepts Ch 4
ASSIGN ICD-10-CM CODES1. Patient was seen in office and given blood tests. Doctor's diagnosis is group D hyperlipidemia.2. An astronaut returns to Earth and is diagnosed with dizziness due to the effects of weightlessness during the space mission.3. A sixteen-year-old patient was seen in the office for a routine medical examination for a driver's license.4. The patient suffered a first-degree sunburn of his upper body for the first time after spending the day at the beach.5. A patient tested positive...
ASSIGN ICD-10-CM CODES Ch 4 #1
1. Patient was seen in office and given blood tests. Doctor's diagnosis is group D hyperlipidemia.
Outpatient Insurance Coding - Applying Concepts Ch 5
ASSIGN CPT CODES1. lan Schmidt, a sixteen-year-old patient, was seen in the office for a very brief nurse visit.2. The patient was already under the effects of anesthesia when the blepharoplasty was canceled.3. A patient has a esophagotomy via cervical approach with removal of a foreign body.4. Nancy Noonan, a seventy-two-year-old established patient, had her annual physical.5. Due to an occupational injury, the patient had evisceration of ocular contents with implant. Two surgeons participated in the surgery.& A new patient...
Outpatient Insurance Coding - Applying Concepts Ch 1
1. The patient's health insurance plan has a $750 deductible for hospital visits, and then it covers 100 percent of hospital visit charges. The patient's first hospital visit this year had charges of $612. The patient was subsequently admitted to the hospital a second time this year, and the charges totaled $358. How much will the patient be billed for each visit? How much will the health insurance plan reimburse for each visit?2 A patient insured under an indemnity plan...
Outpatient Insurance Coding - Applying Concepts Ch 3
1. The patient is insured by a PPO with 100 percent coverage after a copay of $15. The patient was seen in the office for a checkup, and the total charges were $115. What amount must the patient pay? When? What amount must the insurance plan pay? When?2 Afaf Darcy is insured by an HMO with a $10 copay and out-of-network coinsurance on charge balances of 90-10. She needed ysical therapy after her knee replacement. Her HMO pays for eighteen...
Outpatient Insurance Coding - Applying Concepts Ch 2
1. An employee of Riverside Family Practice is having difficulty getting all the faxed lab reports placed into patient files each week. She decides to take the charts and faxed lab reports home over the weekend to get caught up on the filing. What are the legal implications for the employee and the practice due to this action? What are the ethical implications?2 You receive a telephone call from a person who says she is one of your practice's patients,...
OIC - Applying Concepts Ch 3 #4
4. Lisa Perez was seen in your office twice last fall. Her deductible has been met and her coinsurance is 85-15. In October, she was seen for influenza vaccination, and her insurance company was billed $13.00 for the vaccine and $9.00 for the administration of the vaccine. Lisa's schedule of benefits for her indemnity insurance plan lists the influenza administration as being a covered service, but it does not include the actual vaccine. In December, Lisa had an office visit...
OIC - Applying Concepts Ch 3 #5
5. Harold and Helen Rubright's coverage is with a consumer-driven PPO with a high deductible of $1,000. The patient must pay a $25 copay for office visits. Previously, Mr. Rubright was seen in the office for a minor surgical procedure with charges totaling $1,000. The PPO was billed to maintain a record of the deductible; Mr. Rubright paid $1,000 on 5/3. These entries are shown on the ledger card/patient statement.On 6/21 Mrs. Rubright was seen for an office visit. Charges...
OIC - Applying Concepts Ch 2 #3
3. A patient in a POS plan has a $10 copayment and a 70-30 coinsurance rate on the balance of the charge. The patient is seen for an office visit; the total charge for the office visit is $85. What amount is owed by the patient?
Outpatient Insurance Coding - Applying Concepts 6.7
The director of coding and billing forwarded this memo to you, the medical insurance specialist, to help you plan for an internal audit.Good Afternoon to All,OIG today posts this report. As always, selecting the link immediately following the titles will take you directly to the full documentsUse of Modifier 25 (OEI-07-03-00470) www.oig.hhs.gov/oei/reports/oei-07-03-00470.pdfOIG conducted this study to assess the extent to which use of modifier 25 meets program requirements. Modifier 25 is used to allow additional payment for evaluation and management...
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