PAR Medical Terminology and Clinical Documentation Flashcards

What does the abbreviation 'CPT' stand for in medical billing?

Answer: Current Procedural Terminology

CPT stands for Current Procedural Terminology, a standardized code set maintained by the AMA used to report medical procedures and services.

What is the primary purpose of an ICD-10-CM code in patient access?

Answer: To identify the patient's diagnosis or reason for the encounter

ICD-10-CM codes identify the patient's diagnosis or reason for the encounter and are required on claims to establish medical necessity.

What does 'NPI' stand for in healthcare?

Answer: National Provider Identifier

NPI stands for National Provider Identifier, a unique 10-digit identification number assigned to health care providers by CMS.

What is the purpose of an Advance Beneficiary Notice (ABN)?

Answer: To inform Medicare patients that a service may not be covered and they may be responsible for payment

An ABN notifies Medicare patients in advance that a specific service may not be covered, allowing them to decide whether to proceed and accept financial responsibility.

What does the term 'superbill' refer to in a healthcare setting?

Answer: An itemized statement listing all services rendered along with corresponding diagnosis and procedure codes

A superbill is an itemized receipt containing all the information needed to submit a claim, including diagnosis codes, procedure codes, provider details, and service dates.

What is a 'covered entity' as defined under HIPAA?

Answer: A health plan, healthcare clearinghouse, or healthcare provider that transmits health information electronically

Under HIPAA, a covered entity is a health plan, healthcare clearinghouse, or healthcare provider that electronically transmits health information in connection with certain transactions.