Medical Billing Forms and Eye Ointment Administration Best Practices

A medical assistant is preparing to submit a patient's insurance claim. Which of the following forms should the assistant use for this purpose? A. CPT4 B. ICD-10 C. CMS 1500 D. Explanation of benefits So, a lot of acronyms and numbers here. What do we remember? CMS 1500 is the universal claim form and that's what's going to be used to submit billing for services to insurance companies. CPT4 is the coding system that's used on the CMS 1500 form, and there are different five and six-digit codes that are used to identify the types of procedures and services the providers did that are going to be submitted on the CMS 1500. ICD-10 and there's also the ICD-9, it's a system for diagnosing encoding health conditions. So this is different than procedural codes. The CPT codes are procedural codes, ICD codes are diagnostic codes. So for example, if a patient had hypothyroidism, there would be an ICD diagnostic code to say, "This is what the patient has." Then there would be a separate CPT code, which is a procedure code to charge for the fact that the physician made the diagnosis and then offered some sort of treatment. So remember, ICD codes are diagnostic codes, they represent the diagnosis that's being made, versus CPT codes are procedural codes. These represent the procedures and services that the provider delivered. CMS 1500, that's that standard Universal Insurance claim form, and an explanation of benefits is a statement from the insurance company after the claim form has been submitted, saying, "This is what actually is going to be covered." Okay, next high yield question: Which of the following actions should a medical assistant take when administering eye ointment on a patient? A. Apply ointment from the outer to inner canthus. B. Apply ointment underneath the upper eyelid. C. Have the patient close her eyes during the application. D. Apply a thin ribbon of ointment along the conjunctival sac. So let's take a look at this question, which is pretty much the exact same, and the answer is apply from the inner campus to the outer canthus. And we try and use diagrams like this. So we have our air campus on the inner portion of the eye, the outer canthus represents that outer corner of the eye, and the conjunctival sac is that area underneath the lower eyelid. And we will apply a thin ribbon of ointment in the conjunctual sack from the inner campus to the outer canvas. And that way, we're going to apply the ointment exactly where it needs to be in the most effective way that will be absorbed by the eye without causing contamination. And so if we go back to our original question here and look at some of the incorrects in this question: A. Apply an ointment from the outer to inner canthus. That could cause spread of infection because the outer area is less clean than the inner area. So you always want to go from the inside to the out, not the opposite direction. B. Apply ointment underneath the upper eyelid. No, we know that we're going to use that conjunctival sac, which is underneath the lower eyelid, and apply an ointment underneath the upper eyelid wouldn't allow the medication to stay as in place, and it can cause the patient a lot of discomfort. C. Have the patient close her eyes during the application. No, we're not going to do that. That would prevent the medication from getting where we need to, and also, if the eyelids are closed, it's going to be harder to get access to that conjunctival sac. And we know that D. Apply a thin ribbon of ointment along the conjunctual sac from the inner to outer canthus is the proper way to do it. This way, it's going to be evenly distributed in the eye and ensure the medication is going to go where we want it to. Next question: Which of the following circumstances may cause an oximeter to inaccurately measure low oxygen saturation? A. Warm room B. Cold fingers C. Battery at 50% charge D. Deep breathing Take a second and think about it. And the answer is B, cold fingers. Why? What is a pulse oximeter? So, a pulse oximeter goes on the fingertip and it measures oxygen saturation by shining light through that fingertip and seeing how that light is scattered. A patient with cold fingers is going to have reduced circulation, right? When you have cold fingers, picture what they look like. They're white, they're not as red. If you've ever been outside in the cold for a long time with decreased circulation, there's going to be less blood flow through the finger, and that can lead to an inaccurate measurement. And so, whenever we take a pulse oximeter, if we feel that the patient has decreased circulation, we should warm their fingertips up by running warm water over top of them or by using some sort of a heating pad. Additional high-yield point that comes up on the test: What else is something that could interfere with a pulse oximeter? The answer is nail polish. If a patient has nail polish on, that can interfere with the reading, as well as artificial nails. And these other answer choices aren't going to negatively affect a pulse oximeter reading. Next question: Which of the following symptoms may indicate that a patient is experiencing heat stroke? A. Swelling of the face B. Hot skin C. Pallor D. Sunburn And our answer is hot skin. So first off, what is heat stroke? It's a serious condition that occurs when someone has been in a very hot environment for a long time. It doesn't necessarily need to be outside, right? Someone could be some baby could be trapped in a hot car for too long. And one of the key symptoms I'm looking for is that hot, dry skin. Swelling, pale skin, and sunburn aren't common things that are experienced with heat stroke. While sunburn can occur if someone's been out in the hot weather for too long, that's not necessarily a sign that someone has heat stroke. Just because they're sunburned doesn't mean anything. But if they come in, they've been out of the sun for too long, and their skin is incredibly hot to the touch, which is a byproduct of their body, their internal temperature being hot, that plush dry skin is a telltale sign that heat stroke might be occurring. So we have all of these questions and topics in our practice tests and question banks, as well as so many more. Question: A medical assistant is composing a letter in the simplified letter style. Which of the following represents proper formatting? A. Center-align subject line B. Paragraphs are indented C. Salutation is replaced by all capital subject line D. The signature is right-justified