Match the following:

Question

A) downcoded
B) retrospective
C) internal
D) prospective
E) complete review of systems
F) upcoded
G) external
H) code edits
I) extended review of systems
J) problem-pertinent review of systems

1) The type of ROS that inquires about the system directly related to the problem identified in the HPI.

2) Software function used by payers to screen for incorrect or improperly reported procedure codes.

3) The term used when a code reports a procedure that is more involved than that documented in the patient chart.

4) The type of audit conducted within a practice to make sure the office is compliant.

5) The type of audit conducted by an insurance carrier to make sure a practice is compliant.

6) The term used when a code reports a procedure that is less involved than that documented in the patient chart.

7) The type of ROS that inquires about the system directly related to the problem identified in the HPI plus all additional body systems.

8) The type of audit done before a claim is submitted to the insurance carrier for payment.

9) The type of ROS that inquires about the system directly related to the problem identified in the HPI and two to nine additional systems.
10) The type of audit performed after payment is received from an insurance carrier.

Answer 1

1) J) problem-pertinent review of systems
2) H) code edits
3) F) upcoded
4) C) internal
5) G) external
6) A) downcoded
7) E) complete review of systems
8) D) prospective
9) I) extended review of systems
10) B) retrospective