An ulcer is a sore that forms on the surface of a skin or mucous membrane. It happens when the tissue breaks down and doesn’t heal properly. Ulcers can be caused by a variety of factors, including infection, poor circulation, and certain medical conditions. There are several different types of ulcers, each with its own cause and treatment.
I can share some key points for the recognition and management of a potential heart attack to establish medical protocols:
Early intervention: It is crucial when experiencing some chest pain, pressure or discomfort, call emergency service right away.
Diagnosis: In the meantime, healthcare professionals will perform tests to confirm a heart attack and determine the type of Myocardial Infarction such as ST-segment elevation or non-ST-segment elevation.
Treatment strategies: It depends on the diagnosis, treatment may involve medications to dissolve blood clots, procedures to open blocked arteries, and medications to manage heart function and prevent future events.
Long-Term Care: Following a heart attack, lifestyle changes and ongoing medication are essential for recovery and preventing future complications.
When coding, it should be reflected on providers MI types documentation while acute MI is specifically coded and past MI should be coded separately.
As per coding guidelines, BMI assignment for ICD-10-CM coding relies solely on the provider’s documented diagnosis (overweight, obesity, etc.) and not calculations based on weight and height.
Deep vein thrombosis (DVT), also known as leg clot, is a serious condition that can occur when a blood clot forms in a deep vein, usually in the legs..
Sepsis is potentially a life-threatening condition which is specifically caused by the body’s response to an infection.
A Cerebrovascular Accident (CVA) or stroke is a sudden interruption of blood supply to part of the brain, causing brain tissue to die.
Here is a list of some critical conditions are: Acute respiratory distress syndrome, Acute liver failure, Acute pancreatitis, Cardiac Arrest, Diabetic Ketoacidosis, Hemorrhagic shock, Kidney failure, Myocardial infarction, Septic shock, Stroke and more.
Here is the list of 10 acute conditions: Acute pyelonephritis, Acute otitis media, Acute sinusitis, Appendicitis, Bronchitis, Cellulitis, Influenza, Kidney infection, pneumonia, Tonsillitis and others.
Alzheimer’s disease, Asthma, Arthritis, COPD, Cancer, Depression, Diabetes, Hypertension, Heart Disease, Kidney Disease
Here are some of the valid and invalid providers credentials
Valid are MD, DO, NP, and PA. Invalid are: RN, LPN, and MA.
Exclude in Medical Coding means “Not Coded Here”! In medical coding, Excludes 1 note denotes the code excluded should never be used simultaneously as the code above the Excludes 1 note. A type 2 Excludes note represents “Not included here”. The conditions of an excludes 2 note is the conditional represented by the code.
It’s a lingering after-effect of an illness or injury that sticks around even after the worst part is over.
People naturally tend to favor one side of their body for certain tasks. This can be their left hand, right hand, or even both!
If the morbid obesity is a BMI above 40 or higher should be coded only when it affects patient care. It indicates a person is morbidly obese and therefore a candidate for bariatric surgery.
HIV is particularly the virus that can lead the patient to AIDS. HIV/AIDS codes should be used when the provider has documented the same condition. If the patient has developed HIV-related illness for every subsequent encounter, then I must assign the code B20. You must remember not to assign R75 or Z21 to a patient with an earlier diagnosis of AIDS or symptomatic HIV following ICD-10-CM guidelines.
DM Linkage known as Diabetes mellitus is the linkage between oxidative stress, inflammation, hypercoagulability, and vascular complications.
In medical coding, by default linkage means assumptions of certain relatable conditions before documentation. For instance, we can assume that kidney disease is linked to diabetes by default.
A fracture is specifically a break in a bone. Fracture has four types: open, closed, displaced, and non-displaced. The 7th character in ICD-10 coding represents fracture encounter types and its healing status.
Pancytopenia is a medical condition that shows lower-than-normal number of red & white blood cells and platelets in the blood. This medical condition may occur when there is a problem with the blood-forming stem cells in the bone marrow.
Different types of paralysis can affect varying parts of the body. Monoplegia refers to paralysis in a single limb, while hemiplegia affects one entire side of the body. Paraplegia results in paralysis of both legs, and quadriplegia causes paralysis in all four limbs.
5 oral hypoglycemic drugs are Metformin, Glipizide, Glyburide, Pioglitazone, Sitagliptin.
Ostomy surgery offers a solution for digestive or urinary issues by creating a stoma, an opening in the abdomen, for waste elimination. This surgery can be permanent or temporary.
An operation to cut out a body part or tissue. Examples include removing a lump (lumpectomy), tonsils (tonsillectomy), or appendix (appendectomy).
A disorder called thrombocythemia disrupts normal platelet production in the bone marrow, leading to an excess of these clotting cells. This imbalance can cause either blood clots or uncontrolled bleeding, with symptoms ranging from clotting events to easy bruising, blood in the stool, and general weakness.
Thromboembolism is a serious condition where a blood clot travels through the veins and lodges somewhere, blocking blood flow. Deep vein thrombosis (DVT) and pulmonary embolism (PE) are two examples of this, both affecting veins and potentially causing dangerous blockages.
Facet joints, which connect your spinal bones, are crucial for bending and twisting. Arthritis in these joints (facet arthropathy) can limit your movement and cause discomfort.
According to my knowledge 5 types of insulin are rapid-acting insulin, short-acting insulin, intermediate-acting insulin, mixed insulin and long-acting insulin.
Usually secondary sites for cancer by default are the bone, brain, liver, lungs, etc.
Remission describes a stage where cancer is under control and there is a minimal to no sign of active cancer cells. Treatment may still be ongoing, but the cancer is not actively progressing. Whole relapse indicates the return of cancer after remission. Cancer cells become detectable again, and the disease might require renewed treatment. As a medical coder, I can proceed with the dedicated codes for remission like C90.01 (for multiple myeloma in remission) and relapse like C90.02 (for multiple myeloma in relapse).
When a pathologist is unable to diagnose the mass as benign and malignant, it is documented as neoplasm of uncertain behaviors (of cancer) as Benign or malignant. A pathologist may not be able to figure out as this diagnosis tops the list whether a skin mass is or it has the potential to become cancerous from biopsy. Medical codes are ICD-10 for malignant (primary) neoplasm, C80 is for unspecified, and AAPC 1-Codify.
It is a group of abnormal cells specifically found where they first formed within the body, and these abnormal cells may become cancerous and spread to nearby normal tissues.
A few individuals will have only one treatment for cancer. However, most people have a combination of treatment approaches, such as surgery with chemotherapy and radiation therapy. As a cancer patient people may also have immunotherapy, targeted therapy, or hormone therapy.
Bones can be categorized based on their shape:
Long bones :are slender and elongated, like those found in the arms and legs (excluding wrists, ankles, and kneecaps).
Short bones: are roughly cube-shaped, such as those in the wrists and ankles.
Flat bones: are thin and broad, with examples including the ribs, shoulder blades, and skull bones.
Irregular bones: have complex shapes that don’t fit into the other categories, like the vertebrae.
A joint is the body part where two or more bones meet allowing movement. In general, it depends on the range of movement. If it is greater, the risk of injury is higher because of the reduction in joint strength. Here are six types of movable joints including ball and socket, saddle, hinge, condyloid, pivot and gliding.
Small intestine includes the duodenum, Jejunum, and ilenum. Here are some codes for Small intestines.
C17 – Malignant neoplasm of small intestine
C17.0 – Malignant neoplasm of duodenum
C17.1 – Malignant neoplasm of jejunum
C17.2 – Malignant neoplasm of ileum
C17.3 – Meckel’s diverticulum, malignant
C17.8 – Malignant neoplasm of overlapping sites of small intestine
C17.9 – Malignant neoplasm of small intestine, unspecified
In the context of the American Medical Association, cardiovascular surgical procedures range from 33016 to 37799. Its procedures include implementation of a pacemaker or defibrillator, coronary artery bypass grafting, excision of a cardiac tumor, and more as an example.
Amputation is the surgical removal of a body part, such as a finger, toe, hand, foot, arm, or leg.
Atherosclerosis is a condition where arteries become thick and hard due to a buildup of plaque. This buildup can be influenced by factors like high cholesterol, high blood pressure, smoking, diabetes, obesity, lack of exercise, and consuming saturated fats.
An arteriovenous fistula is an abnormal direct connection between an artery and a vein, bypassing the usual capillary network. When this occurs between the coronary artery and the heart chambers, it’s called a coronary cameral fistula.
The cardiac cycle consists of two phases: diastole, when the heart chambers fill with blood, and systole, when they contract to pump blood out. Both phases occur in both the right and left sides of the heart, but the pressure involved in each is significantly different.
An occlusion is a blockage that can partially or completely obstruct blood flow in veins or arteries. Arterial occlusions are particularly dangerous as they can severely limit or halt the supply of oxygen-rich blood to vital organs like the heart, brain, and limbs.
Cerebrovascular disease is unspecified, and its code is 167.9 that indicates a diagnosis for reimbursement purposes.
The full form of DVT is Deep Vein Thrombosis. It is a blood clot that forms in a deep vein, usually in the leg.
A pulmonary embolism is a dangerous condition where a blood clot forms in a blood vessel, usually in the leg, breaks off, travels to the lungs, and blocks a lung artery.
A transient ischemic attack (TIA) is a brief, temporary interruption of blood flow to the brain, causing stroke-like symptoms that usually resolve within a few minutes without lasting damage.
The musculoskeletal system is a complex network of bones and muscles that work together to provide structure, support, and mobility for the human body.
The urinary system, consisting of the kidneys, ureters, bladder, and urethra, cleanses the blood by removing waste and excess water, which are subsequently eliminated as urine.
Congestive heart failure (CHF) is a long-term condition in which your heart cannot pump blood in a well condition to meet your body needs. Heart can still work, but it can handle only the amount of blood it should and it builds up in other parts of your body.
The full form of CKD is Chronic Kidney disease. It occurs when your kidneys are damaged and unable to effectively filter your blood. In general, people with high blood pressure, heart disease, or a family history of kidney failure are at high risk of conditional failure.
Multiple Sclerosis is a long-term condition that damages the protective covering around nerves in the brain and spinal cord. This damage can lead to problems with movement, vision, balance, sensation, and thinking.
It refers to the presence of interrelated conditions or diseases of a patient.
The central nervous system, composed of the brain and spinal cord, is the body’s command center, managing both internal functions and external interactions.
The circulatory, respiratory, digestive, excretory, nervous, endocrine, immune, integumentary, skeletal, muscular, and reproductive systems are 11 distinct yet interdependent components of the human body, working harmoniously to preserve overall health and stability.
These are some common disease abbreviations including: CHF (Congestive Heart Failure), DM (Diabetes Mellitus), CKD (Chronic Kidney Disease), CAD (Coronary Artery Disease) and COPD (Chronic Obstructive Pulmonary Disease).
The twelve pairs of cranial nerves carry signals between the brain and the head, neck, chest, and abdomen. They also facilitate communication with the sensory organs, including the eyes, ears, nose, and tongue.
There are two primary coronary arteries, the right coronary artery (RCA) and the left main coronary artery (LMCA). Both of these originate from the root of the aorta. The RCA emerges from the anterior ascending aorta and supplies blood primarily to the right atrium, right ventricle.
The nephron transforms blood into urine through a four-step process: filtration, reabsorption, secretion, and excretion. These processes affect a wide range of substances.
The spine is divided into three main sections. The cervical spine, composed of seven vertebrae, is located at the top. The thoracic spine, with twelve vertebrae, is in the middle. The lumbar spine is the lower section.
The three main parts of vertebra is:
* A drum-shaped structure that supports the weight of the body.
* A curved bone that protects the spinal cord.
* Star-shaped extensions that serve as attachment points for muscles.
Located between the chest and pelvis, the lumbar spine is the lower part of the back. It’s made up of five vertebrae numbered L1 to L5 and has a natural inward curve known as lordosis.
The colon includes the ascending colon, cecum, transverse colon, descending colon, sigmoid colon, and rectum.
The wrist, ankle, and hip are common sites for bone fractures, which happen when applied force surpasses the bone’s strength.
A stable fracture occurs when the broken bone ends align closely, while an open fracture involves the bone piercing the skin. Fractures can also be classified by their shape, such as transverse (straight across), oblique (angled), or comminuted (shattered into multiple pieces).
The ICD (International Classification of Diseases) guidelines provide a system for classifying diseases and health problems in a consistent way, allowing for easy storage, retrieval, and analysis of health information.
In ICD coding, parentheses () are used to enclose supplementary words that may be present or absent in the statement of a disease or procedure, without affecting the code number. Brackets [ ] are used to enclose synonyms, alternative wording, or explanatory phrases.
Pregnancy guidelines in ICD coding require that a code from category O00-O9A, Pregnancy, Childbirth, and the Puerperium, be the principal diagnosis for inpatient admissions that occur because of pregnancy.
Pediatric conditions are health issues that occur in children and adolescents. These include common illnesses like colds and flu, as well as more serious conditions like asthma, diabetes, and congenital heart disease.
Retrospective coding involves reviewing medical records after a patient’s discharge and assigning codes based on the documentation. Prospective coding, on the other hand, involves coding at the point of care or during a patient’s hospital stay.
Part A covers hospital stays, Part B covers outpatient services, Part C (Medicare Advantage) allows private health insurance companies to provide Medicare benefits, and Part D covers prescription drugs.
HCC stands for Hierarchical Condition Category and is a model used to estimate future healthcare costs for patients. RxHCC stands for prescription Hierarchical Condition Category and is used to adjust Medicare capitation payments based on prescription drug cost risk.
A: CHEDDAR and SOAP are formats for documenting medical notes. CHEDDAR stands for Chief Complaint, History, Examination, Details, Drugs and Dosages, Assessment, and Return Visit Information. SOAP stands for Subjective, Objective, Assessment, and Plan.
MEAT stands for Monitor, Evaluate, Assess/Address, and Treat, it’s a tool to document and assess the effectiveness of care management services. TAMPER stands for Treatment, Allergies, Medications, Past medical history, Events leading to present illness/Last menstrual period, and Review of systems, it is a method of obtaining a patient’s medical history.
HIPAA is the Health Insurance Portability and Accountability Act, which provides data privacy and security provisions for safeguarding medical information. CMS stands for the Centers for Medicare & Medicaid Services, the federal agency that administers the nation’s major healthcare programs.
In medical coding, etiology refers to the cause or origin of a disease, and manifestation refers to the symptoms or conditions that result from the disease. Both are important for accurate disease coding.
ICD updates are revisions to the International Classification of Diseases, which may include additions, deletions, or changes to disease codes. Updates are released periodically to reflect advances in medical knowledge.
The specific code will depend on the details in the documentation, such as which condition is most severe or if a condition is a complication of another. However, in general, COPD (Chronic Obstructive Pulmonary Disease) is often coded as the primary condition, with other conditions like asthma, emphysema, and bronchitis potentially reported as additional codes if they contribute significantly to the patient’s condition.
A: The cranial nerves are 12 pairs of nerves that come out from the cerebral cortex and traverse through the skull to various parts of the head, neck and trunk. They control a range of functions including sensory and motor functions of the face and the six senses.
The main coronary arteries are the left main coronary artery (which branches into the left anterior descending artery and the circumflex artery) and the right coronary artery.
A nephron is the functional unit of the kidney. It is made up of the renal corpuscle (which includes the glomerulus and Bowman’s capsule) and a long tubule that includes the proximal tubule, loop of Henle, and distal tubule. The nephron filters blood, reabsorbs needed substances, and excretes waste in urine.
The spine, or vertebral column, is made up of 33 vertebrae that are divided into five regions: cervical, thoracic, lumbar, sacral, and coccyx. Each vertebra is separated by intervertebral discs and they collectively support the body’s weight and protect the spinal cord.
Medical coding is the conversion of detailed patient medical information into standardized codes. These codes facilitate insurance claims processing, reimbursement, and are utilized for research and data analysis by healthcare institutions, research organizations, and government bodies.
These are major skills that a medical coder must possess are as follows:
-In-depth knowledge and understanding of medical terminologies, physiology, and anatomy.
-Effective communication skills in retaining information with the assertion of knowledge and skills
-Must be able to tackle complex tasks and processing while navigating day-to-day interactions.
-They possess the skills in healthcare softwares for billing, coding, document management software, microsoft office, and ICD-10.
-They are expected to have understanding of the classification and coding conventions including ICD-9, DSM-5, and CDC.
These are some common jargons which is specifically used in day-to-day life that forms a part of day-to-day medical coder’s job given below:
Abstraction – Assessing a patient’s health status using various medical documents such as patient history, imaging studies, lab results, and operative notes.
Assignment – Every procedure is categorized by a corresponding code that is entered into the system.
Review – A careful review is conducted to ensure assigned codes accurately represent the patient’s condition and prescribed treatment, guaranteeing error-free data submission.
The World Health Organization (WHO) developed the International Classification of Diseases (ICD) system to classify diseases, injuries, and causes of death. ICD codes, consisting of 5-7 alphanumeric characters beginning with a letter, are used to categorize these health conditions. The ICD system comprises two main components: ICD-10-CM for diagnosing illnesses and ICD-10-PCS for coding inpatient procedures.
The Healthcare Common Procedure Coding System (HCPCS) is divided into three levels.
*Level I, managed by the American Medical Association, consists of 5-digit numerical codes (CPT codes) used to identify medical services and procedures performed by healthcare providers.
*Level II uses 4-character alphanumeric codes to classify services, products, and supplies not covered by Level I.
*Level III, composed of 5-character alphanumeric codes beginning with W, X, Y, or Z, is employed for diagnosing and specifying procedures when Level I and II codes are insufficient.
HCPCS modifiers provide essential details about the procedures and services administered to a patient, including the treatment area, the number of procedures performed, and the reason for treatment termination.
DRG, which stands for Diagnostic Related Groups, is a classification system categorizing hospital cases into approximately 500 groups. Used exclusively for inpatient claims from admission to discharge, DRG codes are critical for accurate insurance reimbursement as many insurers base payments solely on these codes.
Medical coding is a versatile tool with far-reaching implications. Financially, it underpins insurance claim processing and billing, ensuring accurate reimbursement. Beyond finance, it serves as a cornerstone for medical research, allowing for the analysis of disease patterns and informing public health strategies.
The WHO’s International Classification of Diseases (ICD) is a global standard for classifying and diagnosing medical conditions, while the Current Procedural Terminology (CPT) is a specific coding system used to report medical procedures and services.
J codes are HCPCS Level II codes used to identify non-orally administered medications, including chemotherapy drugs.
Epistaxis, commonly known as a nosebleed, happens when blood vessels in the nasal lining rupture. This is often caused by dry air. Although inconvenient, nosebleeds typically aren’t a cause for concern.
ICD-10 is the tenth version of the International Classification of Diseases system developed by the World Health Organization. This standardized coding system is used worldwide to classify and track diseases.
There are two common medical billing errors are its incomplete insurance information and incorrect costs or codes. As it is crucial to prevent these issues, I need to thoroughly review documentation and codes before submission.
Due to the varied bill payment organization methods employed in different offices, including digital portals and paper systems, medical coders need proficiency in both formats.
Medical coders are essential to healthcare organizations like hospitals and clinics, handling patient information and billing. To excel in this role, aspiring coders must master coding systems such as ICD, CPT, DSM, and HCPCS, as these are the foundation of most technical interview questions. Experienced coders should thoroughly review their resumes to confidently discuss their experience, job duties, and accomplishments.
In addition to technical questions, medical coding interviews often include behavioral components. Questions about your motivation for joining the company, stress management, and work-life balance are typically part of the HR interview process. It’s important to approach these questions with confidence and provide clear, well-thought-out answers.
Technical coding interviews are notoriously challenging due to a combination of factors. They often require a deep understanding of complex algorithms and data structures, skills not always frequently used in day-to-day development roles. Additionally, the high-pressure environment and limited time constraints can exacerbate anxiety, hindering performance. The focus on theoretical problem-solving can also mismatch with the practical nature of many software development jobs. Furthermore, the subjective nature of evaluating code and problem-solving approaches can introduce inconsistency across interviewers.
Medical coding requires a strong grasp of medical terminology. Consequently, with a genuine interest in the field of healthcare, I want to contribute my knowledge and skills. My passion for the field is a driving force to make me successful.
Medical coding encompasses three primary systems: HCPCS (with its three levels), ICD-9, ICD-10, and CPT. A medical coder’s expertise in these systems varies based on their experience and the specific coding system predominantly used within their healthcare organization.
Medical coders play a significant role in healthcare settings by translation documents for physician reports into relevant medical codes. These medical codes have various applications, from being used by insurance companies to clinical research organizations. Medical coders specifically communicate with healthcare professionals, such as physicians, insurance companies or insurers, and patients to provide updates about the medical billing status.
Do you aspire to become a successful medical coding professional? By going through some important interview questions and answers for medical coding which will help you well-prepared for appearing in different organizations. These sample interview questions and answers guide you to exhibit your knowledge. It will also display your interest and aptitude to showcase your skills. These are some of the most common interview questions for medical coding to help you ace your interview.
Avg. Salary Hike
Hiring Partners
Experienced Career Growth
Career Transitions
WhatsApp us