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 ICD-9 codes have been replaced by ICD-10 codes, which are now the standard for diagnostic coding in the United States. Referring to ICD-9 codes would result in incorrect or outdated billing.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. The number of no-shows on the patient's record: While the number of no-shows can be relevant for overall management, it is not the primary consideration when scheduling a specific appointment.
B. The referring provider's recommendation: Referring provider recommendations are important but typically influence the initial appointment or consultation rather than ongoing scheduling.
C. The amount of deductible the patient owes for their insurance: Insurance deductible information is important for billing but does not directly affect the scheduling of appointments.
D. The amount of time required based on the reason for visit: It is essential to consider the time needed for the appointment based on the patient's reason for the visit to ensure that the appointment is appropriately scheduled and sufficient time is allocated.
Correct Answer is B
Explanation
A. Assist the patient into the prone position: The prone position (lying face down) is not suitable for eye irrigation and may make the procedure more difficult.
B. Position the patient with their head turned toward the affected side: Turning the patient’s head toward the affected side helps to ensure that the irrigation fluid drains away from the unaffected eye and is more effective in flushing out debris or irritants.
C. Flush the patient's eye from the outer to the inner canthus: Flushing from the inner to the outer canthus is preferred to prevent contaminating the unaffected eye and to ensure effective irrigation.
D. Instruct the patient to hold their affected eye open: The patient should be instructed to keep their eye open, but it is more important to ensure proper positioning and technique during the irrigation.
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