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CPC 2022 Exam Study Guide
1.Documentation (content): Proper code assignment is determined both
by in the medical record and by the unique rules that govern each code set in that instance
2.An auditor: The role a coder may take on to verify that the
documentation supports the codes the physician has selected
3.Query the physician: If the medical record is inaccurate or
incomplete, it will not translate properly to the language of codes.What can a coder do in order for the medical record to be complete and accurate so they can bill properly?
4.Quarterly (usually): How often are codes and insurance payment
policies updated?
5.NPP: Non-Physician Provider (also known as mid-level providers or
physician extenders)
6.PA: Physician assistant
7.NP: Nurse practitioner
8.Commercial and Government: The two types of primary insurances
9.Commercial Carriers: Private payers that may offer both group and
individual plans 1 / 2
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10.Medicare: The most significant government insurer; a federal health
insurance program 11.People over 65, blind or disabled individuals, and people with
permanent kidney failure or end-stage renal disease: Medicare provides
coverage for what kind of people?
12.ESRD: end-stage renal disease
13.Medicare Part A: Helps cover inpatient hospital care, as well as care
provided in skilled nursing facilities, hospice care, and home healthcare,
14.Medicare Part B: Covers medically necessary physicians' services,
outpatient care, and other medical services (including some preventive services) not covered under Medicare Part A. It can be an optional benefit.
15.Medicare Part C: Also called Medicare Advantage, combines the
benefits of Medicare Part A, Part B, and-sometimes- Part D. The plans are managed by private insurers approved by Medicare.
16.Medicare Part D: A prescription drug program available to all
Medicare bene- ficiaries.
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