HLashleyWeek5HomeworkBilling

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Charter College, Anchorage *

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SS1001

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Mechanical Engineering

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Feb 20, 2024

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docx

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Haley Lashley Week 5 Homework In your opinion, is each of the following procedures likely to be considered medically necessary by a payer’s health care claims examiner? Why? This is a two-part question. Be sure to explain why it is or is not medical a medically necessary test/procedure. 1. Diagnosis : deviated septum; Procedure: nasal surgery. Medically necessary because this would be recommended by a doctor. 2. Diagnosis : mole on a female patient’s cheek, questionable nature; Procedure: surgical removal and biopsy. Medically necessary due to the probability of it being cancerous. 3. Diagnosis : male syndrome hair loss; Procedure: implant hair plugs on the scalp. Not medically necessary because it is more cosmetic and insurance will not likely cover the costs. 4. Diagnosis : probable broken wrist; Procedure: comprehensive full-body examination, with a complete set of lab tests, chest X-ray, and ECG. Not medically necessary for a broken wrist: Labs Medically necessary for a broken wrist: chest x-rays and ECG to rule out a broken rib Indicate whether each statement below is true or false . 1. True 2. False 3. True
4. False 5. False 6. False 7. True 8. True Billing and coding summary : In 2 paragraphs, summarize what you have learned during the last five weeks. Additionally, please discuss how you will utilize what you have learned in the field. Within the billing and coding module I have learned about ICD 10 codes, as well as how to apply them and use them for diagnoses. I have learned that CPT are used as procedure codes, and HCPS are used for equipment codes. I have learned how to also input CPT and HCPS codes withing a superbill and how important it is to use correct coding. I have also learned how to document these codes within Dr. Chronos and simulate real life coding. We practiced different scenarios within Dr. Chronos as well as how to navigate and use Dr. Chronos efficiently.
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