Interview Questions 2

Medical Coding Interview Questions

1)     What is the basic difference between 95 and 97 guidelines?

a.      95 guidelines are based on body systems 97 systems based on bullet points.

2)     What is the basic difference between emergency and outpatient department?

a.      The basic difference between ED outpatient departments is that in Emergency there is no differentiation between new or established, but in outpatient there is new or established.

3)     Abbreviation of HCPCS? Mention about level 1,level 2,level 3?

a.      HCPCS:  Health Care Common Procedure Coding System.

b.      Level 1: Outpatient Setup Modifiers

c.      Level 2: HCPCS National Modifiers Alphanumerical.

d.      Level 3: Local Modifiers.

4)     Difference between inpatient and outpatient?

a.      Outpatient is the patient comes gets treated and leaves the same day.

b.     Inpatient is the patient gets admitted with a overnight stay, gets treated and gets discharged.

5)     What is MDM?

a.   MDM refers to the complexity of establishing a diagnosis or selecting a management option from the History and Examination part.

6)     What is UHDDS?

a.      Uniform Hospital Discharge Data Set(UHDDS) is defined as “all conditions that coexist at the time of admission, that develop subsequently, or that affect the treatment  received or the length of stay”. Diagnoses that relate to an earlier episode which have no bearing on the current hospital stay are to be excluded.

7)     What is 24, 57,62 and 73 modifier?

a.    24 – Unrelated Evaluation and Management Service by the Same Physician during a Postoperative Period

57 – Decision for Surgery

62  - Two Surgeons

73 - Discontinued Outpatient Hospital/Ambulatory Surgery Center (ASC) Procedure prior to the Administration of Anesthesia

8)     Doctor diagnosis foreign body in eye, he prescribed eye drops? What is MDM level?

a.      MDM level is Low or Straight forward(Level 2)

9)     Basic coding guidelines between inpatient and outpatient coding?

a.      Uncertain conditions can be coded such a possible, probable, suggestive when it is documented on discharge day but uncertain conditions should not be coded in Outpatient coding

10)What is abbreviation of NCC coding and use?

a.      NCC-National Correct Coding Initiative. 

Used for identifying bundling and unbundling of services.

11)Lesion is 2X3 cm and the margin is 0.5 mm calculate the lesion size?

a.      Add lesion size and margins size .  Here it is 2 cms.+0.5mm+0.5mm=2.1 cms.

12)Abbreviation of POA?

a.      Present On Admission-POA

13)Brief about E and M?

a.      E/M service Medical practice Any diagnostic and therapeutic procedure that may be performed by a health care provider at a specific location. See History of present illness, General multi-system examination, Past, family and/or social history, Review of Systems, Single organ system examination. Cf Physican test, Procedure.

14)How to define new and established patient?

a.      A new patient is one who has not received any professional service from the physician or another physician of the same specialty who belongs to the same group practice, within the past 3 years

b.      An established patient is one who has received professional services from the physician or another physician of the same specialty who belongs to the same group practice, within the last 3 years.

15)Define consultation?

a.      A Consultation is a type of E/M Service provided by a physician at the request of another physician or appropriate source to either recommended care for a specific condition or problem or to determine whether to accept responsibility for ongoing management of the patient’s entire care or for the care of a specific condition or problem.

16)What is critical care?

a.      Critical care is the direct delivery of service by physician of medical care for a critically ill or critically injured patient.

b.      A Critical illness or injury is one which accurately impairs one or more vital organ systems such that there is a life threatening event in the patient’s condition.

17)What isClosed  fracture and open fracture?

a.      Closed fracture is one in which the fractured site  is not exposed to outside environment.

b.  Open fracture is one in which the fracture site is exposed to outside environment(air)

18)Abbreviation of CCI and CPT?

a.      CCI- Correct Coding Initiative and CPT- Current Procedural Terminology.

19)Difference between principal diagnosis and primary diagnosis?

a.      The Primary Diagnosis is an outdated term in outpatient settings. The term was changed to First-listed Diagnosis some years ago, and it is the main condition treated or investigated during the relevant episode of outpatient (ambulatory)healthcare.

In an inpatient setting, the term "Primary Diagnosis" is still used to reference the condition that was the most serious and/or resource intensive during that hospitalization.

20)What is Surgical pathology?

a.     Surgical pathology involves the gross and microscopic examination of surgical specimens, as well as biopsies submitted by surgeons and non-surgeons such as general internists, medical subspecialists, dermatologists, and interventional radiologists.

21)Abbreviation of BCC?

a.      Basal Cell Carcinoma

22)Common modifiers  used in radiology?

a.      26, TC, 50, LT and RT

23)Difference between critical care and emergency care?

a.      Emergency Care:

·        Emergency department

·  Emergency Physicians (trained and qualified in the specialty of emergency medicine after mbbs graduation) Emergency department

·        Diagnosis is not required for initiation of treatment

Critical Care:

·        Intensive care units

·   Intensivists (qualified in critical care medicine after completion of postgraduation in medicine, surgery or anesthesia)

·        Diagnosis necessary and required for continuation of treatment

24)what is inpatient and emergency room coding?

a.      Emergency Coding is 24-hours without appointment can walk in, get treatment and discharged.

b.      Inpatient Coding is getting admitted with an overnight stay.