Interview Question for Fresher
The interviewer know that the candidate is beginner in the medical coding and they had just got certification. So they will ask basic question that is included in medical coding certification exam. They can also ask questions from life science.
What is medical coding ?
Medical coding is the assigning a code for healthcare diagnosis, procedures, medical services and equipment into well defined designated code such as ICD 10 code for diagnosis, CPT code for procedures and HCPCS Code for medical supplies like drugs or medical equipment
What is revenue cycle management (RCM) ?
Revenue cycle management (RCM) is the process healthcare organizations use to manage financial operations related to billing and collecting revenue for medical services
Steps for an Effective Revenue Cycle Include:
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Appointment scheduling: Determining the need for services, along with collecting patient name, contact information, and insurance coverage details
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Registration: Completing patient intake, including insurance verification, front-desk collections, and collecting patient demographics
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Charge capture for services: Assigning medical procedure and diagnosis codes for the encounter
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Billing: Creating clean claims to receive reimbursement from insurers and provide bills for patients
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Denial management: Regularly reviewing denial reason codes to determine why a claim was denied and making corrections to prevent denials in the future
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Accounts receivable (A/R) follow-up: Identifying and following up on unpaid charges
Important topic must be covered for fresher to get selected in interview for medical coder
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B.Disease/Procedure
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C.ICD 10 Guideline
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D.Medical Abbreviation/Suffix/ Prefix
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E.Modifier
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F.Compliance
A.Anatomy / Biology Life science
Explain any Human organ System ?
Must prepare 12 organ system anatomy and physiology
Name the human verterbrae bone ?
Vertebrae are the 33 individual bones that join with each other to form the spinal column. The vertebrae are divided into regions:
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Cervical (7 Vertebrae C1 to C5)
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Thoracic (12 Vertebrae T1 to T12)
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lumbar (5 Vertebrae L1 to L5)
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Sacrum (5 Vertebrae fused, S1 to S5)
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Coccyx (4 Vertebrae fused)
Which is the largest seasmoid bone ?
Patella
Difference between systolic and diastolic pressure of heart ?
Systolic blood pressure is the highest blood pressure during ventricular contraction. Diastolic blood pressure is the lowest blood pressure recorded just before the end of contraction. Blood pressure is defined as systolic based on diastolic pressure (eg 120/80 mmHg).
How many valves are present in the human heart ?
There are four valves in the heart
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Aortic valve
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Mitral valve
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Tricupsid valve
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Pulmonary valve
How many layers are present in the human heart ?
There are three layers are present in the heart
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Epicardium
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Myocardium
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Endocardium
How many part in which small intestine and Large instestine is divided ?
Small intestine is divided into
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Duodenum
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Jejujum
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Ilelum
Large Instestine is divided into
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Cecum
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Ascending colon
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Transverse colon
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Descending colon
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Sigmoid colon
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Rectum
Name the largest and the smallest bone in human body ?
Femur is the largest bone and stapes is the smallest bone.
Name the largest and smallest endocrine gland ?
Thyroid gland is the largest gland and pineal gland is the smallest gland.
Name the largest and smallest exocrine gland ?
Liver is the largest gland
Difference between arteries and vein ?
Arteries carries oxygenated blood from heart to different body part whereas vein carries deoxygenated blood from different body part to heart.
Difference between exocrine and endocrine gland ?
Exocrine glands secrete their substances/hormone through ducts onto your body's surfaces.Whereas endocrine glands secrete their substances/hormones directly into your bloodstream
How many lobes of lungs ?
The right lung consists of three lobes:
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Right upper lobe (RUL),
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Right middle lobe (RML),
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Right lower lobe (RLL).
The left lung consists of two lobes:
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Left upper lobe (LUL)
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Left lower lobe (LLL)
How many part in which human brain is divided ?
Forebrain
Midbrain
Hindbrain
B.Diseases/Procedure
Difference between Acute and Chronic disease ?
The diseases that occur suddenly and last for a few days are known as acute diseases, like Cyst, Laceration etc. The diseases that stay with you for a longer period of time and you can say it will be forever/lifetime are callsed as Chronic disease like Diabetes, Hypertension,Gerd.
What is cholelithiasis ?
The term is used for the calculus/stone found in the gallbladder
What is cholecystectomy ?
Cholecystectomy is the surgery to remove gallbladder.
What is Atherosclerosis ?
Atherosclerosis is the thickening or hardening of the arteries caused by the accumulation of plaque on the lining of the artery..
What is Glaucoma ?
Glaucoma is a disease that damage the optic nerves of eye, the reason behind this is to due to high intraocular pressure.
What is Hysterectomy ?
Hyster means uterus , so hysterectomy means surgical removal of uterus.
Medical Terminology
1.Kidney : Nepro
2.Testis : Orchi
3.Hepato : Liver
4.Myo : Muscle
5.Cholecyst : Gallbladder
Procedure Abbreviation
1.TURP : Transuretheral resection of prostate
2.ORIF : Open Reduction and Internal Fixation
3.CABG : Coronary artery Bypass graft
4.EGD: Esophagoduodenoscopy
5. I&D : Incision and drainage
C.ICD 10 -CM guideline
What is placeholder character ?
The ICD-10-CM utilizes a placeholder character “X”. The “X” is used as a placeholder at certain codes to allow for future expansion.
What is NEC or NOS?
NEC “Not elsewhere classifiable”
This abbreviation in the Tabular List represents “other specified”. When a specific code is not available for a condition, the Tabular List includes an NEC entry under a code to identify the code as the “other specified” code.
NOS “Not otherwise specified”
This abbreviation is the equivalent of unspecified.
What is Exclude 1?
A type 1 Excludes note is a pure excludes note. It means “NOT CODED HERE!” An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
What is Exclude 2?
A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
What is Sequela?
A sequela is the residual effect (condition produced) after the acute phase of an illness or injury has terminated. There is no time limit on when a sequela code can be used. The residual may be apparent early, such as in cerebral infarction, or it may occur months or years later, such as that due to a previous injury. Examples of sequela include: scar formation resulting from a burn, deviated septum due to a nasal fracture, and infertility due to tubal occlusion from old tuberculosis. Coding of sequela generally requires two codes sequenced in the following order: the condition or nature of the sequela is sequenced first. The sequela code is sequenced second.
D.Abbreviation/Suffix/Prefix
What is the abbreviation for HIPPA ?
Health insurance Portability and accountability act
What is the abbreviation for CMS?
Centre for medicare and medicaid services
What is the abbreviation for ICD 10 CM?
international classification of diseases 10th Clinical Modification
What is the abbreviation for ICD 10 CM?
international classification of diseases 10th Clinical Modification
E.Modifiers
What is Modifier?
A modifier provides the means to report or indicate that a service or procedure that has been performed has been altered by some specific circumstance but not changed in its definition or code.
What is Modifier 22?
Increased Procedural Services: When the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. Documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient’s condition, physical and mental effort required). Note: This modifier should not be appended to an E/M service.
What is Modifier 25?
It may be necessary to indicate that on the day a procedure or service identified by a CPT code was performed, the patient’s condition required a significant, separately identifiable E/M service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed
What is Modifier 51?
Multiple Procedures: When multiple procedures, other than E/M services, Physical Medicine and Rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed.
What is Modifier 52?
Reduced Services: Under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. Under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced.
What is Modifier 53?
Discontinued Procedure: Under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. Due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. This circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure.
What is Modifier 57?
Decision for Surgery: An evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of E/M service.
What is Modifier 59?
Distinct Procedural Service: Under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to identify procedures/services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances. Documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. However, when another already established modifier is appropriate it should be used rather than modifier 59. Only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used.
What is Modifier 62?
Two Surgeons: When 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons.
3.What is Modifier 76 ?
Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional: It may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. This circumstance may be reported by adding modifier 76 to the repeated procedure or service.
F.Compliance
What is MUE?
MUE is the maximum units of service (UOS) reported for a HCPCS/CPT code on the vast majority of appropriately reported claims by the same provider/supplier for the same beneficiary on the same date of service
What is NCCI Edit?
National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits prevent inappropriate payment of services that should not be reported together. Each edit has a Column One and Column Two HCPCS/CPT code. If a provider reports the two codes of an edit pair for the same beneficiary on the same date of service, the Column One code is eligible for payment, but the Column Two code is denied unless a clinically appropriate NCCI PTP-associated modifier is also reported.
What is LCD coverage?
A Local Coverage Determination (LCD) is a decision made by a Medicare Administrative Contractor (MAC) on whether a particular service or item is reasonable and necessary, and therefore covered by Medicare within the specific jurisdiction that the MAC oversees.
What is HIPPAA?
HIPAA stands for Health Insurance Portability and Accountability Act. Passed in 1996 HIPAA is a federal law that sets a national standard to protect medical records and other personal health information. The rule defines "protected health information" as health information that: 1. Identifies an individual and 2. Is maintained or exchanged electronically or in hard copy.