Across
- 3. is of utmost importance and must support the level of services reported in the patient's medical record.
- 4. time starts with the administration of moderate sedation agent(s), requires continuous face-to-face attendance.
- 6. early dark green first feces of a newborn infant.
- 9. key component of the CMS documentation guidelines for E/M services lies in the examination.
- 11. face to face services rendered by physicians /QHP who may report E/M services. solely for the purposes of distinguishing between new and established patients.
- 15. problem at the time of the patient encounter with or without a diagnosis being established, conveys the reason for the encounter.
- 16. score given to a newborn, immediately after birth, occurs in the delivery room.
- 18. physician that directs all transport services.
- 21. patient that has received professional services from the physician or another physician of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.
- 22. department, organized hospital based facility for unscheduled episodic services to patients who present for immediate medical attention
- 24. complaint describing the symptom(s), problem(s), condition(s), diagnosis, or other factors that are the reason for the patient encounter.
- 25. care management designed to last 29 days, post discharge, when health care provider takes charge of the patient’s care.
- 26. facilities are required to conduct thorough assessments of all patients on admission and readmission to the nursing facility.
- 28. examination performed as part of the preventative medicine evaluation and management service, multisystem, extent based on age and risk factors identified.
Down
- 1. care planning involves discussing and preparing for future decisions about a patient's medical care if they become seriously ill or unable to communicate their wishes.
- 2. factors in most patient encounters: counseling, coordination of care, and nature of presenting problem.
- 5. problem of which the physician or other qualified healthcare professional may not need to be present in the room.
- 7. patients need to be observed in order to determine whether they should be admitted to the hospital, transferred to another facility, or sent home. Not all hospitals have this designated area.
- 8. not meant to be used to select the level of E/M services reported.
- 10. step to determine the level of E/M service is to determine the category or subcategory of service.
- 12. components are identified in the E/M services’ code descriptors.
- 13. patient not received any professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past three years.
- 14. care provided when services are performed by more than one physician/nonphysician practitioner in the same group practice on the same date of service, for the same patient.
- 15. objective evaluation of a physician’s clinical competence by another responsible party that represents and is responsible to the medical staff
- 17. decision making by providers to rate the degree of complexity in establishing a patient's diagnosis and treatment plan.
- 19. will only reimburse for the actual procedure performed, not the hospitalization that may have occurred prior to the need for the procedure.
- 20. history, examination, and medical decision-making; components to be considered when determining the level of E/M service to report.
- 23. discussion with the patient, family, or both that covers either: diagnostic results, impressions, recommended or diagnostic studies, prognosis, risk and benefits treatment options.
- 24. care provided directly by a physician for a critically ill or critically injured patient impairing one or more vital organ systems, with a high probability of the patient's deterioration.
- 27. services codes used to report provisions of E/M services in the patient's private residence by a qualified physician or agency.