Download CBCS TEST PREP COURSEWORK SCRIPT STUDY SHEET 2026 GRADED A+. and more Exams Advanced Accounting in PDF only on Docsity!
CBCS TEST PREP COURSEWORK SCRIPT
STUDY SHEET 2026 GRADED A+.
⫸ What are Medical Ethics? Answer: Standards of conduct based on moral principle. They are generally accepted as a guide for behavior towards pt's, dr's, co-workers, the gov, and ins co's. ⫸ What does acting within ethical behavior boundaries mean? Answer: carrying out one's responsibilities w/ integrity, dignity, respect, honesty, competence, fairness, & trust. ⫸ Legal Aspects of of Medical Billing & Coding: Answer: ... ⫸ Compliance regulations: Answer: Most billing-related cases are based on HIPPA and False Claims Act ⫸ Health Insurance Portability & Accountability Act (HIPPA) Answer: Enacted in 1996, created by the Health Care Fraud & Abuse Control Program-enacted to check for fraud and abuse in the Medicare/Medicaid Programs and private payers ⫸ What are the 2 provisions of HIPPA? Answer: Title I: Insurance Reform Title II: Administrative Simplification
⫸ What is Title I of HIPPA? Answer: Insurance Reform-primary purpose is to provide continuous ins coverage for worker & their dependents when they change or lose jobs. Also *Limits the use of preexisting conditions exclusions *Prohibits discrimination from past or present poor health *Guarantees certain employees/indv the right to purchase new health ins coverage after losing job *Allows renewal of health ins cov regardless of an indv's health cond. that is covered under the particular policy. ⫸ What is Title II of HIPPA? Answer: Administrative Simplification- goal is to focus on the health care practice setting to reduce administrative cost & burdens. Has 2 parts- 1) development and implementation of standardized health-related financial & administrative activities electronically 2) Implementation of privacy & security procedures to prevent the misuse of health info by ensuring confidentiality ⫸ What is the False Claims Act (FCA)? Answer: Federal law that prohibits submitting a fraudulent claim or making a false statement or representation in connection w/ a claim. Also protects & rewards whistle-blowers. ⫸ What is the National Correct Coding Initiative (NCCI)? Answer: Developed by CMS to promote the national correct coding methodologies & to control improper coding that lead to inappropriate payment of Part B health ins claims. ⫸ How many edits does NCCI include? Answer: 2: 1)Column 1/Column 2 (prev called Comprehensive/Component) Edits
⫸ What are common forms of fraud? Answer: billing for services not furnished, unbundling, & misrepresenting diagnosis to justify payment ⫸ Abuse Answer: incidences or practices, not usually considered fraudulent, that are inconsistent w/ the accepted medical business or fiscal practices in the industry. ⫸ What are examples of Abuse? Answer: submitting a claim for services/procedures performed that is not medically necessary, and excessive charges for services, equipment or supplies. ⫸ What is a method use to minimize danger, hazards, & liabilities associated w/ abuse? Answer: Risk Management ⫸ Patient Confidentiality Answer: All pt's have right to privacy & all info should remain privileged. Only discuss pt info when necessary to do job. Obtain a signed consent form to release medical info to ins co or other individual. ⫸ When may providers use PHI (Protected Health Information) w/o specific authorization under the HIPPA Privacy Rule? Answer: When using for TPO, Treatment (primarily for the purpose of discussion of pt's case w/ other dr's) Payment (providers submit claims on behalf of pt's) & Operations (for purposes such as training staff & quality improvement)
⫸ What is Employer Liability? Answer: Means physicians are legally responsible for their own conduct and any actions of their employees (designee) performed w/in the context of their employment. Referred to as "vicarious liability. A.K.A "respondent superior"-"let the master answer". Means employee can be sued & brought to trial ⫸ What is Employee Liability? Answer: "Errors & Omissions Insurance"-protection against loss of monies caused by failure through error or unintentional omission on the part of the indv or service submitting the claim. ****Some dr's contract w/ a billing service (clearinghouse) to handle claims submission, & some agreements contain a clause stating that the dr will hold the co harmless from "liability resulting from claims submitted by the service for any account", means dr is responsible for mistakes made by billing service, errors & omissions is not needed in the instance. ******However, if dr ever asks the ins biller to do the least bit questionable, such as write of pt's balances for certain pt's automatically, make sure you have a legal document or signed waiver of liability relieving you of responsibility for such actions. ⫸ What is a Medical Record & what is it comprised of? Answer: documentation of the pt's social & medical history, family history, physical exam findings, progress notes, radiology & lab results, consultation reports and correspondence to pt- Is the foremost tool of clinical care and communication. ⫸ What is a medical report? Answer: part of the medical record & is a permanent legal document that formally states the consequences of the pt's exam or treatment in letter or report form. IT IS THIS
⫸ - itis Answer: inflammation ⫸ - megaly Answer: enlargement ⫸ - meter Answer: measure ⫸ - oma Answer: tumor, mass ⫸ - osis Answer: abnormal condition ⫸ - pathy Answer: disease condition ⫸ - rrhagia Answer: bursting forth of blood ⫸ - rrhea Answer: discharge, flow ⫸ - sclerosis Answer: hardening ⫸ - scopy Answer: to view ⫸ Procedural Suffixes: Answer: ... ⫸ - centesis Answer: surgical puncture
⫸ - ectomy Answer: removal, resection, excision ⫸ - gram Answer: record ⫸ - graphy Answer: process of recording ⫸ - lysis Answer: separation, breakdown, destruction ⫸ - pexy Answer: surgical fixation ⫸ - plasty Answer: surgical repair ⫸ - rrhapy Answer: suture ⫸ - scopy Answer: visual examination ⫸ - stomy Answer: opening ⫸ - therapy Answer: treatment ⫸ - tomy Answer: incision, to cut into ⫸ Common Prefixes: Answer: ...
⫸ neo Answer: new ⫸ oligo Answer: scanty, little ⫸ pan Answer: all ⫸ para Answer: beside ⫸ per Answer: through ⫸ poly Answer: many ⫸ pre Answer: before, in front of ⫸ pseudo Answer: false ⫸ sub Answer: under ⫸ supra Answer: above, beyond ⫸ tetra Answer: four ⫸ Common Root Words Answer: ...
⫸ arth Answer: cartilage ⫸ cephal Answer: head ⫸ cardi Answer: heart ⫸ cholecyst Answer: gall bladder ⫸ chondro Answer: cartilage ⫸ colp Answer: vagina ⫸ derm Answer: skim ⫸ enter Answer: intestine ⫸ episi Answer: vulva ⫸ gastro Answer: stomach ⫸ gloss Answer: tongue ⫸ hepato Answer: liver
⫸ stomat Answer: mouth ⫸ Directional Terms: Answer: ... ⫸ Anterior, Ventral Answer: front surface of the body ⫸ Posterior, Dorsal Answer: back side of the body ⫸ Superior Answer: above another structure ⫸ Inferior Answer: below another structure ⫸ Proximal Answer: near the point of attachment to the trunk ⫸ Distal Answer: far from the point of attachment to the trunk ⫸ Medial Answer: pertaining to the middle of the body ⫸ Lateral Answer: pertaining to the side ⫸ Frontal, Coronal Answer: Vertical plane dividing the body into anterior & posterior portions
⫸ Sagittal Answer: vertical plane dividing the body into right & left sides ⫸ Transverse, Cross-sectional Answer: Horizontal plane dividing the body into upper & lower portions ⫸ Anatomy & Physiology Answer: A professional medical coder must have knowledge of anatomy & physiology so that coding assignment is quick & accurate. ⫸ What is the 1st body system for which medical procedures are described in the CPT manual? Answer: The Integumentary System (the skin and it's accessory organs) Integument means covering. It is a complex system of specialized tissues containing glands, nerves and blood vessels. ⫸ How much area does the skin cover? Answer: an area of 22 sq ft (an average adult). It is the largest organ of the body ⫸ What is the main function of the skin? Answer: To protect the deeper tissues from excessive loss of minerals, heat & water. It also provides protection form diseases by providing a barrier. It accomplishes its diverse functions w/ assistance from the hair, nails and glands. ⫸ SEBACEOUS (OIL) GLANDS & SUDDORIFERIOUS (SWEAT GLANDS) Answer: produce secretions that allow the body to be moisturized or cooled.
⫸ SEBACEOUS GLANDS Answer: located in the dermal layer of the skin over the entire body, expect for palm of hands and soles of feet. Secrete oily substance called SEBUM. SEBUM CONTAINS LIPIDS THAT HELP LUBRICATE THE SKIN & MINIMIZE WATER LOSS. It is the overproduction of sebum during puberty that contributes to acne in some people ⫸ SUDDORIFEROUS GLANDS Answer: sweat glands that are tiny, coiled gland found on almost all body surfaces. They are most numerous in the palms and soles of feet. Coiled sweat glands originate in the dermis and straighten out to extend up through the epidermis. Tiny opening at surface is called a PORE. ⫸ How many types of sweat glands? Answer: 2;
- eccrine sweat glands (most common)
- apocrine sweat glands (secrete orderless sweat) ⫸ What organ secretes hormones? Answer: the adrenal glands, they secrete epinephrine & steriods ⫸ Integumentery Vocabulary Answer: ... ⫸ Albino Answer: deficient in pigment (melanin) ⫸ Collagen Answer: structural protein found in the skin & connective tissue
⫸ Melanin Answer: major skin pigment ⫸ Lipocyte Answer: a fat cell ⫸ Macule Answer: discolored, flat lesion (freckles,, tattoo marks) ⫸ Polyp Answer: benign growth extending from the surface of the mucous membrane ⫸ Fissure- Answer: groove or crack like sore ⫸ Nodule Answer: solid, round or oval elevated lesion more than 1 cm in diameter ⫸ Ulcer Answer: open sore on the skin or mucous membrane ⫸ Vesicle Answer: small collection of clear fluid; blister ⫸ Wheal Answer: Smooth, slightly elevated, edematous (swollen) area that is redder or paler than the surrounding skin ⫸ Alopecia Answer: absence of hair form areas where it normally grows
⫸ How are bones categorized? Answer: as belonging to either the AXIAL SKELETON or the APPENDICULAR SKELETON. ⫸ Axial Skeleton Answer: consist of the skull, rib cage & spine ⫸ Appendicular Skeleton Answer: made up of the shoulder, collar, pelvic, arm & legs ⫸ Long Bones Answer: typically very strong, are broad at the ends and have large surfaces for muscle attachment. IE: HUMERUS & FEMUR. ⫸ Short Bones Answer: are small w/ irregular shapes, they are found in wrist and ankle ⫸ Flat Bones Answer: are found covering the soft body parts, IE; SHOULDER BLADES, RIBS AND PELVIC BONES ⫸ Sesamoid Bones Answer: small, rounded bones that resemble a sesame seed. they are found near joints and increase the efficiency of muscles near a joint. IE, KNEE CAP ⫸ The Axial Skeleton-Skull, Rib Cage, Spine Answer: ... ⫸ Skull Answer: made up of 2 parts, the cranium and the facial bone
⫸ Cranium Answer: includes following bones *Frontal Bone- forms the anterior part of the skull & forehead *Parietal Bone- Forms the sides of the cranium *Occipital Bone- forms the back of the skull, there is a large hole at the ventral surface in this bone, called the foramen magnum, which allows the brain communication w/ the spinal cord *Temporal Bone- forms the 2 lower sides of the cranium *Ethmoid Bone- forms the roof of the nasal cavity *Sphenoid Bones- anterior to the temporal bones ⫸ Facial Bones Answer: ... ⫸ Zygoma Answer: cheekbone ⫸ Lacrimal Bones Answer: paired bones at the corner of each eye that cradle the tear ducts ⫸ Maxilla Answer: upper jaw bone ⫸ Mandible Answer: lower jaw bone ⫸ Vomer Answer: bone that forms posterior/inferior part of the nasal septal wall between the nostrils
