MOA115_wk2_assn_cravello_02282024

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MOA115 Medical Records and Insurance Week 2 Assignment Section A: Coding Accuracy Section B: ICD Coding Concepts Section A: Coding Accuracy  Using reliable internet resources, research the questions. Type your answers below the questions.  Your answers should be at least 5 sentences. 1. Describe the importance of coding medical charges accurately. Medical billing and coding are an important part of the healthcare system because it enables care providers to accurately bill insurance providers as well as gather useful data about the treatments, procedures, and patient experience. Decision makers at a care facility can also use this data to help them choose where to allocate resources, ultimately working toward improving the quality of patient care. As a medical biller and coder, you need to have a good understanding of medical terminology to quickly identify and assign codes for a variety of procedures, conditions, and equipment. Having a good grasp of this terminology can help you locate and assign the right codes to make sure the patient’s records are accurate and reflect all the necessary data for medical staff and insurance providers. 2. Describe two of the most common ways medical charges can be coded inaccurately. One way could be failing to provide information to payers to support claims results in denials or delays causing less data. For instance, problems can occur if billing department employees don’t link a diagnosis code to the Current Procedural Terminology or Healthcare Common Procedure Coding System code or don’t add a fourth or fifth digit to the diagnosis code. Incorrect use of modifiers for telehealth services results in payment delays. For example, the GT Modifier applies to real-time telehealth services provided by audio or video systems, while the GQ modifier covers services provided through asynchronous telecommunications systems, suchas an emailed X-ray. 3. Describe the impact of inaccurate coding on the healthcare facility. Codes have slight variances between the specificity of a diagnosis. Inaccurate coding of the specifics during diagnosis could result in improper patient care at another practice, or for a particular service. A missing 2-digit modifier for a knee injury could result in having an MRI study conducted on the wrong knee. This would be an extreme case, but altogether terrifying and harmful for the patient.

4. Describe the impact of inaccurate coding on the patient. There are slight variances in codes that denote specificity for each medical diagnosis. Using inaccurate codes during diagnosis, the testing, treatment, and care rendered at a referral source or other healthcare facility may be inappropriate or not extensive enough for the issue being treated. Aside from impacting the reimbursement, and potentially the patient’s portion due, inaccurate coding can also directly harm the patient’s treatment. 5. Describe an encoder for medical coding. These codes are used for a variety of purposes, including billing, research, and tracking disease prevalence. An encoder is a specialized software tool that assists in the process of medical coding. It helps healthcare professionals to select the correct codes and ensure that the coding is done accurately and efficiently. There are three encoders which include automated encoders that use artificial intelligence to automatically assign codes based on the input data, interactive encoders which require the coder to input information and then suggest possible codes, and grouping encoders that are used to group codes together for billing purposes. 6. Discuss accuracy in coding when using an encoder. The accuracy of an encoder is a combination of the scale accuracy and the errors caused by the readhead. For rotary encoders it is usually expressed in arcseconds or degrees. The most common unit for indicating the accuracy of linear encoders is µm per unit of length of the scale (µm/m). MOA115 Medical Records and Insurance Week 2 Assignment Section A: Coding Accuracy Section B: ICD Coding Concepts Section B: ICD Coding Concepts . Getting to Know the ICD-10-CM (Answer #1-5) 1. Fill in the blanks in the following statements with terms from the word bank to describe how to use the most current diagnostic coding classification system. Word Bank:

Code Convention Essential modifier Main term Coding guidelines Diagnostic Exclusion Tabular List Character Diagnostic statements ICD-10-CM 1. Abstract the correct diagnosis from the __diagnostic statements____ found in the patient health record. 2. Use the __main term____ to look up the diagnosis in the Alphabetic Index. 3. Review the __essential modifier___ under the main term. 4. Choose the correct code based on the __diagnostic____ statement. 5. Look up the code from the Alphabetic Index in the __Tabular list__. 6. Check for any __coding guidelines___, ___convention___, inclusion notes, __exclusion___ notes, or additional _character_ symbol. 7. Assign the final __ICD-10-CM____ diagnosis code. 2. ICD-10-CM codes can have up to __7__ characters. A(n) __placeholder___ “x” is used to fill in for positions that don’t have characters. 3. What are the seventh characters used for encounter types and what do they indicate? A- Initial encounter ( active phase of treatment) D- Subsequent encounter( care performed after active phase of treatment) S- Sequela ( possible combination that may arise after treatment)__ 4. Four basic forms of punctuation are used in the Tabular Index. List them and what they are used for. Brackets- enclose synonyms Parentheses- enclose supplementary words Braces- enclose a series of terms Colon- used after a complete term 5. Match the following terms. __B_ Main terms __D_ Subterms __C__ Nonessential modifiers __A_ Essential modifiers

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