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NHA NEW CBCS PRACTICE TESTS- study questions and answers rated A+ 2024/2025
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NHA NEW CBCS PRACTICE TESTS-study
Medical Ethics - ANSStandards of behavior primarily based on ethical ideas. Generally
frequent as a manual for behavior closer to patients, physicians, co-workers, the
government, and insurance compaines.
Compliance Regulations - ANSbilling-associated cases are based totally on HIPAA and
False Claims Act.
Health Insurance Portability and Accountability Act of 1996 (HIPPA) - ANSCreated the
Health Care Frad and Abuse Control Prpgram enacted nt test for fraud and abuse in the
Medicare and Medicaid packages, and private payers.
Two provisions of HIPPA - ANSTitile I: Insurance Reform
Title II: Administrative Simplification
Insurance Reform. -Primary motive to offer non-stop coverage coverage for workers and
their dependents when they exchange or lose their jobs. - ANS-Limits the usage of
preexisting conditions exclusions
-Prohibits discrimination for component or gift negative fitness
-Guarantees cetraom personnel and individuals the right to buy health insurance coverage
after losing a task
- Allows renewal of health insurance coverage no matter an man or woman's fitness
circumstance that is protected under the unique policy
Administrative Simplification-The purpose is to cognizance at the health care exercise
putting to lessen administrative fee and burdens. - ANSTwo parts:
1. Development and implementation of standardized fitness-related economic and
administrative sports electronically.
2. Implementation of privateness and protection procedures to prevent the misuse of health
facts by way of making sure confidentiality.
False Claim Act (FCA) - ANSFederal regulation that prohibits submittimg a fraudulent claim
or making declaration or representation in reference to a declare.
National Correct Coding Initiative (NCCI) - ANSDeveloped by way of the CMS to promote
country wide correct coding methodologies and to control incorrect coding that leads to
inappropriate payment of element B medical insurance claims.
Two sort of NCCA edits - 1. Column 1 /Column 2 or Comprehensive Component Edits:
identifies code pairs that have to no longer be billed collectively because one code. Column
1 consists of all the offerings described via any other code in Column 2. - ANS2. Mutually
,Exclusive Edits: identifies code pairs that, for clinical reason, are not going to be carried out
on the identical affected person on the same day.
Office of Inspector General (OIG) - ANSInvestigates and prosecute health care fraud and
abuse.
Fraud - ANSKnowingly and intentionally deceiving or misrepresenting statistics which can
result in unauthorized benefits.
Abuse - ANSDefined as incidents or practices, now not commonly considered fradulaent that
are inconsistant with the universal medical enterprise or economic practices inside the
enterprise.
Patient Confidentiality- All sufferers have the right to privacy, and all records ought to stay
privileged. - ANSDiscuss affected person information with simplest the affected person's
medical doctor or office personnel that want cetain information to do their task. Obtained a
signed consent form to release clinical infomation to the coverage organization or different
character.
Under HIPPA Privacy Rule, companies may additionally use patient's Protected Health
Information (PHI) without unique authorization for - ANSTreatment: typically for the purpose
of debate fo the affected person's case with different providers.
Payment: carriers put up claims on behalf of sufferers.
Operations: for purposes along with stafff training and first-class improvment.
Employern Liability - ANSPhysicians are legally chargeable for their personal conduct and
any movement of their personnel (their designee) perform in the context of their
employment. Refered to as "vacarious legal responsibility"additionally known as "respondent
superior" which means "allow the master answer".
Employee Liabiltiy - ANS"Errors and omissions insurance" is safety towards lack of monies
by means of failure through mistakes or unintended omission at the part of the individual or
service submitting the insurance claim.
Medical Records - ANSDocumentaiton of the patient's social and scientific records, family
history, bodily examination findings, development notes, radiology, and lab consequences,
session reports, and correspondence to affected person.
Information wished whilst billing the coverage organization - ANSDate of service (DOS),
vicinity of provider (POS), kind of provider (TOS), analysis (dx or DX), and procedures.
Retention of Medical Records - ANSGoverned via kingdom and local laws and may bary
from nation-to-country. Most physicians are required to keep statistics indefinitley; deceased
patient facts should be kept for at the least (5) years.
New patient - ANSone who has not received any scientific services within the remaining
three years
, Established affected person - ANSsomeone who has received clinical services inside the
last 3 years from the physician or some other medical doctor of the equal distinctiveness
who belong to the equal institution practice.
Cheif complaint - ANSbrief announcement describing they symptom, problem, diagnosis, or
circumstance this is the reason a patient seeks hospital therapy.
Three volumns of ICD-nine manal - ANSVolumn 1-Diseases: Tabular List
Volumn 2-Diseases: Alphabetic Index
Volumn 1 and a couple of are used in the inpatient and outpatient placing
Volumn 3- Procedures:Tabular List and Alphabetic Index
Volumn 1 - Diseases: Tabular List - ANS-consists of the diease and condition code and the
descriptions
- also includes the V codes and E codes
Volumn 2 - Diseases: Alphabetic Index - ANSalphabetic index of volumn 1
Volumn 3 - Tabular List and Alphabetic Index - ANScontains codes for surgical, therapeutic,
and diagnostic tactics; used usually with the aid of hospitals
Hypertension classifications: - ANSMaligant- an expanded, severe shape of hypertension
with vascular harm and a diastolic strain of 130mmHg or greater.
Benign- Mild or controlled hypertension and no damage to the vascular device or organs.
Unspecified- now not certain as bengin or malignant inside the diagnosis or medical record.
Malignant neoplasm - ANSfurther categorised as to number one , secondary, or cacinoma in
situ
primary malignancy - ANSoriginal cancer website. Malignant tumors are considered number
one except documented as secondary or metastatic
carcinoma in situ - ANScancer this is localized and has no longer unfold to adjoining tissue
or distant elements of the body
secondary malignacy - ANScancer that has metasized (unfold) to a secondary site both
adjoining or faraway location of the frame
three sections of Alphabetic index - ANSSection 1: Index to Diseases: each time period is
observed with the aid of the code or codes that follow to that time period
Section 2: Table of Drugs and Chemiclas: contains list of medicine and chemicals with
corresponding poisoning codes and E codes.
Current Procedural Terminology (CPT) - ANSCodes used to file services and strategies
through physicians.
Published and updated anually by means of the American Medical Association (AMA) with a
new one coming out each November and turning into effective on January 1st of the
subsequent calendar year.
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