CAMC Part 1 Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Prefix brady-

A prefix meaning slow, as in bradycardia (slow heart rate) or bradypnea (slow breathing).

Suffix -ectomy

A suffix meaning surgical removal or excision, as in appendectomy (removal of the appendix) or cholecystectomy (removal of the gallbladder).

Hypoxia

A condition in which cells are deprived of adequate oxygen; it is the most common cause of cell injury and leads to ATP depletion and cell swelling.

Excludes1 note

An ICD-10-CM instructional note indicating that two codes cannot be reported together because the conditions are mutually exclusive.

Excludes2 note

An ICD-10-CM instructional note indicating that the condition is not included in the code but may be reported together if both conditions are present.

Code first note

An ICD-10-CM instruction indicating that the underlying etiology should be sequenced before the manifestation code.

7th character A

In ICD-10-CM injury codes, the 7th character A indicates the initial encounter for the injury.

ICD-10-PCS root operation

The third character of an ICD-10-PCS code that defines the intent of the procedure, such as excision, resection, or bypass.

CPT modifier -25

A modifier indicating a significant, separately identifiable evaluation and management service by the same physician on the same day as a procedure.

CPT modifier -59

A modifier indicating that a procedure or service is distinct and independent from other services performed on the same day.

Global surgical package

The surgical service includes the operation, local anesthesia, and typical pre- and post-operative care; E/M services on the same day are generally not separately billable.

MDM

Medical decision making; one of the two methods for selecting office/outpatient E/M codes, based on problems, data, and risk.

Total time for E/M

The time spent on the date of the encounter, including pre-visit review, the visit, and post-visit documentation, used to select E/M codes.

Critical care 99291

The CPT code for the first 30-74 minutes of direct critical care delivery to a critically ill or injured patient.

Medicare Part A

The Medicare component that covers inpatient hospital, skilled nursing facility, hospice, and some home health services.

CMS-1500 form

The standard paper claim form used for physician and outpatient services in the United States.

NCCI edit

A national correct coding initiative edit that bundles Column 2 codes into Column 1 codes; modifier -59 may bypass if services are distinct.

False Claims Act

A federal law that prohibits knowingly submitting false or fraudulent claims to government payers, with penalties including treble damages and per-claim fines.

Anti-Kickback Statute

A federal law prohibiting offering or receiving remuneration to induce referrals for items or services covered by federal healthcare programs.

Stark Law

A federal law prohibiting physicians from referring Medicare patients to entities with which they have a financial relationship, unless an exception applies.

HIPAA Privacy Rule

A federal regulation protecting individually identifiable health information and setting rules for its use and disclosure.

Minimum necessary standard

A HIPAA requirement to limit the use or disclosure of protected health information to the minimum needed for the purpose.

Record retention

The period for which medical records must be kept; Medicare requires at least 7 years, but state laws may require longer.

Principal diagnosis

The condition established after study to be chiefly responsible for the inpatient admission; it is sequenced first.

First-listed diagnosis

The diagnosis sequenced first on an outpatient claim, representing the reason for the visit.

Provider query

A communication to the provider to clarify ambiguous, inconsistent, or incomplete documentation before assigning a code.

Laterality

The side of the body (right or left) that must be specified in ICD-10-CM codes when the documentation supports it.

CPT Category II codes

Four-digit codes with an F suffix used for performance measurement and tracking, not for billing.

CPT Category III codes

Four-digit codes with a T suffix used for emerging technology and services, not yet assigned a Category I code.

EOB

Explanation of Benefits; a statement from the payer explaining which services were paid, denied, or adjusted.

Compliance program

A set of internal policies and procedures designed to prevent and detect violations of law and payer requirements.

Legal health record

The record that would be released in response to a legal request, including documents created at or near the time of care by authorized personnel.