Question

HIM Review Tst your undertanding of the material covered in this chapter by completing d provided Check Your Understanding ns Fir ach ustion seet the bmerm he choicl is a method of arranging related disease entities in groups for statistical data, and it usually includes all potential terms. a. A nomenclature b. Terminology c. A coding system d. A classification system 2. Submitting claims for more reimbursement than is justified by the document tion in the patient record is a. allowable if the coder believes it is the appropriate code. b. upcoding c. downcoding. d. claim denial. 3. SNOMED CT is a. used for reimbursement purposes. b. a nomenclature of clinical terms and multilingual health terminology c. a classification system. d. no longer used. 4. A disease index is used to find the names and the definitions of diseases. b. part of the reference software available to coders. c. used to identify patients with a certain condition. d. None of the choices are correct. 5. ICD-O-3 is used to code a. cancer. b. orthopedics. c. ophthalmology d. operations/procedures. Chapter 9 Classification Systems and

Answer 1

According to AHIMA , Health information management (HIM) is the practice of acquiring, analyzing, and protecting digital and traditional medical information vital to providing quality patient care.

1.a. A nomenclature is a standardized system for listing medical terminologies which are preferred

b. Terminology is the body of terms used with a particular technical application in a subject of study/profession.

c.Coding system is used for transmitting messages in a consiced and concealed manner and in medical field it is used for translating descriptions of diseases, injuries, procedures and supplies into numerical or alphanumeric designations.

d. Classification system serves by arranging related disease entities into groups for data retrieval, statistical analysis and reimbursement.It also groups diseases and procedures which are similar.(answer)

2. a.Reimbursement is based on claims and documentation filed by providers using medical diagnosis and procedure codes.

b. Upcoding is found to be illegal. Upcoding is a practice in which a provider bills a health insurance payer private, Medicaid or Medicare using a CPT code for a more expensive service than performed.( Answer).

c.Downcoding is insufficient evidence on a claim to prove that a provider performed the coded medicalservices.

d.Denial of claim is the refusal of an insurance company or carrier to honor a request by an individual

3. SNOMED CT is Systematized Nomenclature of Medicine -- Clinical Terms.It was initially developed by the College of American Pathologists and England’s National Health Service. It is a controlled reference terminology.SNOMED CT is the most comprehensive and precise, multilingual health terminology in the world.

a . SNOMED CT provides a summary record for each transition of care and doesn't serve reimbursement purposes

b. SNOMED CT is enables multilingual usage, and supports the exchange of clinically validated health data between different health care providers, setting, researchers and others.It is a nomenclature of clinical terms and multilingual health terminology.( Answer)

c.SNOMED CT is an international clinical reference terminology designed for use in electronic health records and other electronic health recording and not a classification system. SNOMED CT is large and comprehensive .

d. SNOMED CT is widely used.

4. ICD-O-3 is a system for classifying incidences of malignant diseases and used to develop cancer registries in hospital.

Answer is a . Cancer ( study of cancer is oncology).

5. A disease index  includes the patient's health record number as well as the diagnosis codes so that records can be retrieved by diagnosis and also each patient's diagnoses code is converted from a verbal description to a numerical code which can be used to identify patients with a certain condition.

Answer is c.