CodingCâu 15 / 100
In coding, 'medical necessity' generally means that a service is:
a.Reasonable and necessary for the diagnosis or treatment of the patient's condition
b.The most expensive option available to the provider
c.Requested by the patient regardless of clinical indication
d.Always covered by every insurance plan
Giải thích
Medical necessity is the standard that a service must be appropriate and needed to evaluate or treat the patient's documented condition to qualify for payment. The diagnosis code must support the procedure code billed. Services deemed not medically necessary are commonly denied even when correctly coded.
Luyện miễn phí toàn bộ 100 câu hỏi — không cần đăng ký.
Câu hỏi liên quan cùng chủ đề
- Modifier 25 is most appropriately used to report:
- Three key components historically used to determine the level of an evaluation and management (E/M) service are:
- When selecting an office E/M visit level by time under current guidelines, the coder should count:
- The primary or first-listed diagnosis on an outpatient claim should represent:
- When a definitive diagnosis has not been established at the end of an outpatient encounter, ICD-10-CM guidelines direct the coder to report:
- The instructional note 'use additional code' in ICD-10-CM tells the coder to:
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