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Name: Class: Date:
Chapter 01: Overview of Coding
Test Bank for 3-2-1 Code It!, 2020, 8th Edition, Michelle
Green
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1. A coder acquires a working knowledge of coding systems, coding conventions and guidelines, government regulations,
and third-party payer requirements to ensure that documented diagnoses, services, and procedures are coded accurately for
__________, research, and statistical purposes.
a. compliance
b. continuity of care
c. quality assurance
d. reimbursement
ANSWER: d
2. During internships (or professional practice experiences) at health care facilities, coding students receive __________
training.
a. continuing education
b. on-the-job
c. paid
d. virtual
ANSWER: b
3. Which is the person to whom the student reports at the health care facility internship site?
a. college instructor
b. department manager
c. internship supervisor
d. volunteer coordinator
ANSWER: c
4. Which is the most likely reason a student would be terminated from the internship site, fails internship course, or
suspended and/or expelled from the academic program?
a. arriving late due to weather conditions
b. breaching patient confidentiality
c. contacting the site about an absence
d. dressing in a business casual style
ANSWER: b
5. Coders also have the opportunity to work at home for employers who partner with an Internet-based organization called
a(n) __________, which is a third-party entity that manages and distributes software-based services and solutions to
customers using the Internet.
a. application service provider (ASP)
b. knowledge process outsourcing (KPO)
Copyright Cengage Learning. Powered by Cognero. Page 1
Name: Class: Date:
c. third-party logistics (TPL)

d. wide area network (WAN)
ANSWER: a
6. Which professional is employed by third-party payers to review health-related claims to determine whether the costs
are reasonable and medically necessary based on the patient’s diagnosis?
a. health information technician
b. insurance specialist
c. liability underwriter
d. medical assistant
ANSWER: b
7. Students who join a professional association for a reduced membership fee often receive most of the same benefits as
active members. Which is an example of a benefit of joining a professional association?
a. guaranteed receipt of academic scholarship and grants
b. opportunity to network with members of the association
c. placement by the association at an internship facility
d. waiver provided for certification examination fees
ANSWER: b
8. Which represents an online professional network about a variety of topics and issues?
a. application service provider
b. listserv
c. place-bound conference
d. wide area network
ANSWER: b
9. Which organizes a medical nomenclature according to similar conditions, diseases, procedures, and services, and
contains codes for each?
a. classification system
b. data dictionary
c. hybrid record
d. medical nomenclature
ANSWER: a
10. Which is a vocabulary of clinical and medical terms used by health care providers to document patient care?
a. classification system
b. data dictionary
c. hybrid record
d. medical nomenclature
ANSWER: d
11. Which includes numeric and alphanumeric characters that are reported to health plans for health care reimbursement,
to external agencies for data collection, and internally for education and research?
a. codes
Name: Class: Date:
b. dictionary
c. nomenclature
d. placeholders
ANSWER: a
12. Coding is the assignment of codes to diagnoses, services, and procedures based on __________.
a. federal government regulations
b. health information management
c. patient record documentation
d. third-party payer requirements
ANSWER: c
13. Which is used to classify diagnoses in any health care setting?

a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: c
14. Which is used to classify procedures in an inpatient hospital setting?

a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: d
15. Which is published by the AMA and used to classify procedures and services in an outpatient setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: a
16. Which is managed by CMS and used to classify medical equipment, injectable drugs, transportation services, and
other services in an outpatient setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: b
17. The Centers for Medicare & Medicaid Services (CMS) is a(n) __________ in the federal Department of Health and
Human Services (DHHS).
a. administrative agency
Name: Class: Date:
b. compliance section
c. private organization
d. third-party payer
ANSWER: a
18. Which is an example of a medical nomenclature?

a. CPT
b. DSM-5
c. ICD-10-CM/PCS
d. SNOMED CT
ANSWER: d
19. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is federal legislation that amended the
Internal Revenue Code of 1986 to __________.
a. create privacy and security standards for health information
b. eliminate standards for electronic health information transactions
c. limit access to long-term care services and coverage
d. produce waste, fraud, and abuse in health insurance and health care delivery
ANSWER: a
20. The process of standardizing data by assigning alphanumeric values to text or other information is called __________.
a. encoding
b. mapping
c. potentiating
d. sequencing
ANSWER: a
21. The HIPAA small code set collects information concerning _____.
a. actions taken to prevent, diagnose, treat, and manage diseases and injuries
b. causes of injury, disease, impairment, or other health-related problems
c. diseases, injuries, impairments, and other health-related problems
d. race, ethnicity, type of facility, and type of unit
ANSWER: d
22. The HIPAA large code set collects information concerning _____.
a. actions taken to prevent, diagnose, treat, and manage diseases and injuries
b. privacy and security standards for health information
c. race, ethnicity, type of facility, and type of unit
d. waste, fraud, and abuse in health insurance and health care delivery
ANSWER: a
23. HIPAA requires health plans that do not accept standard code sets to modify their systems to accept all valid codes or
to contract with a(n) _____.
a. electronic data interchange
Name: Class: Date:
b. health care clearinghouse

c. insurance company
d. third-party administrator
ANSWER: b
24. Which is an insurance company that establishes a contract to reimburse health care facilities and patients for
procedures and services provided?
a. clearinghouse
b. health plan
c. provider
d. third-party administrator
ANSWER: b
25. Which is an example of a third-party payer?

a. BlueCross BlueShield
b. Centers for Medicare and Medicaid Services
c. Department of Health and Human Services
d. Workers’ compensation
ANSWER: a
26. Which is an example of another health care professional who performs procedures or provides services to patients?
a. clearinghouse staff
b. health information technician
c. medical assistant
d. nurse practitioner
ANSWER: d
27. Which is another term for a health plan?

a. health care clearinghouse
b. health care provider
c. third-party administrator
d. third-party payer
ANSWER: d
28. Adopting HIPAA’s standard code sets has improved data quality and simplified claims submission for health care
providers who routinely deal with multiple __________.
a. clearinghouses
b. health plans
c. markets
d. physicians
ANSWER: b
29. A third-party administrator (TPA) is an entity that __________ and may contract with a health care clearinghouse to
standardize data for claims processing.

Name: Class: Date:
a. combats waste, fraud, and abuse in health insurance and health care delivery
b. improves portability and continuity of health insurance coverage in group/individual markets
c. processes health care claims and performs related business functions for a health plan
d. simplifies the administration of health insurance by creating unique identifiers
ANSWER: c
30. The medical coding process requires the __________ of patient record documentation to identify diagnoses,
procedures, and services for the purpose of assigning ICD-10-CM, ICD-10-PCS, HCPCS level II, and/or CPT codes.
a. correction
b. entry
c. omission
d. review
ANSWER: d
31. Professional associations establish a code of ethics to help members understand how to differentiate between “right”
and “wrong” and apply that understanding to __________.
a. credentialing
b. decision making
c. documentation
d. focused review
ANSWER: b
32. Concurrent coding is the review of records and/or use of encounter forms and chargemasters to assign codes
__________.
a. after the patient has been discharged from care
b. during an inpatient stay or outpatient encounter
c. following the submission of health insurance claims
d. that results in continuity of the patient’s health care
ANSWER: b
33. Which is used to record data about office procedures and services provided to patients?
a. chargemaster
b. encounter form
c. insurance claim
d. uniform bill
ANSWER: b
34. Which contains a computer-generated list of procedures, services, and supplies and corresponding revenue codes
along with charges for each?
a. chargemaster
b. encounter form
c. insurance claim
d. uniform bill
ANSWER: a
Name: Class: Date:

35. Coders are prohibited from performing assumption coding, which is the assignment of codes based on assuming, from
a review of clinical evidence in the patient’s record, that the patient has certain diagnoses or received certain
procedures/services even though the __________.
a. responsible physician was contacted to confirm diagnoses, procedures, and services
b. physician query process was not implemented by the health care facility or physician
c. provider did not specifically document those diagnoses or procedures and services
d. risk for health care fraud and abuse is assumed by the health care facility or physician
ANSWER: c
36. When coders have questions about documented diagnoses or procedures/services, they use a physician query process
to contact the responsible physician to __________.
a. confirm diagnoses, procedures, and services already documented in the record
b. eliminate the risk for fraud and abuse even though assumed by the facility or physician
c. request clarification about documentation and the code(s) to be assigned
d. document diagnoses, procedures, or services that will increase reimbursement
ANSWER: c
37. Integrating the __________ physician query process with the electronic health record allows physicians to more easily
receive and reply to queries, which results in better and timely responses from physicians.
a. automated
b. complete
c. legible
d. precise
ANSWER: a
38. A physician lists “viral pneumonia” as the final diagnosis. However, the coder notes that laboratory results state
“gram-negative bacteria.” There is also documentation of chest pain, fever, and dyspnea due to pneumonia. What should
the coder do?
a. Assign a code to the final diagnosis of viral pneumonia
b. Code bacterial pneumonia, chest pain, fever, and dyspnea
c. Query the physician regarding the diagnosis of pneumonia
d. Report symptom codes for chest pain, fever, and dyspnea
ANSWER: c
39. The purpose of a clinical documentation improvement (CDI) program is to help health care facilities comply with
government programs and other initiatives with the goal of improving health care quality. Thus, a CDI specialist initiates
concurrent and retrospective reviews of inpatient records to identify __________ provider documentation.
a. abusive and fraudulent
b. conflicting, incomplete, or nonspecific
c. illegible physician queries and
d. redacted health insurance claims and
ANSWER: b

Name: Class: Date:

40. A coding compliance program ensures that the assignment of codes to diagnoses, procedures, and services follows
established coding guidelines, and health care organizations write policies and procedures to assist in implementing the
coding compliance stages of __________.
a. detection, correction, prevention, verification, and comparison
b. portability, continuity, and combating waste, fraud, and abuse
c. legibility, completeness, clarify, consistency, and precision
d. unbundling, upcoding, overcoding, jamming, and downcoding
ANSWER: a
41. An effective coding compliance program monitors coding processes for __________.
a. completeness, reliability, validity, and timeliness
b. diagnostic/management, therapeutic, and education plans
c. record formats, whether automated or manual
d. reporting hospital data for health data collection
ANSWER: a
42. Computer-assisted coding uses software to automatically generate __________ by “reading” transcribed clinical
documentation provided by health care practitioners.
a. data entry
b. insurance claims
c. medical codes
d. validation/audit reviews
ANSWER: c
43. A patient record is the business record for a patient encounter that documents __________.
a. encounter forms data sent to third-party payers
b. inaccurate information that cannot be altered
c. health care services provided to a patient
d. insurance claims submitted to health care plans
ANSWER: c
44. Demographic data is patient identification information that is collected according to facility policy and includes
information such as the __________.
a. insurance claim submitted
b. medical codes reported
c. patient’s date of birth
d. quality of patient care
ANSWER: c
45. The primary purpose of the record is to provide for __________.

a. facility medicolegal interests
b. health care reimbursement
c. patient continuity of care
d. quality review studies

Name: Class: Date:
ANSWER: c
46. A secondary purpose of the patient record is to __________.

a. assist in planning patient care
b. evaluate patient quality of care
c. provide patient continuity of care
d. serve as a communication method
ANSWER: b
47. Patient record documentation must be __________.

a. dated and authenticated by the responsible provider
b. evaluated prior to patient discharge from the facility
c. provided to third-party payers for reimbursement
d. stored using an automated electronic record format
ANSWER: a
48. A teaching hospital is engaged in an approved graduate medical education __________ program in medicine,
osteopathy, dentistry, or podiatry.
a. health care
b. medicolegal
c. residency
d. third-party
ANSWER: c
49. Residents are supervised by a(n) __________ physician during patient care.
a. admitting
b. attending
c. responsible
d. teaching
ANSWER: d
50. Which type of physician participates in an approved GME program?

a. attending
b. emergency
c. resident
d. teaching
ANSWER: c
51. A hospitalist is a physician whose practice emphasizes providing care for hospital __________, and they are often
internal medicine specialists who handle a patient’s entire admission process.
a. clinic patients
b. ED patients
c. inpatients
d. outpatients
Name: Class: Date:
ANSWER: c
52. For medical necessity purposes, the patient record must support codes submitted for third-party payer reimbursement,
and patient diagnoses must __________.
a. evaluate the quality of patient care received in the health care facility
b. justify diagnostic and/or therapeutic procedures or services provided
c. provide clinical evidence for a higher degree of specificity or severity
d. serve the medicolegal interests of the patient, facility, and providers of care
ANSWER: b
53. Which type of record is paper based?

a. automated
b. hybrid
c. manual
d. systematized
ANSWER: c
54. Which type of record uses computer technology?

a. automated
b. hybrid
c. manual
d. systematized
ANSWER: a
55. Patient records that consist of handwritten progress notes and automated laboratory results are an example of
__________ records.
a. automated
b. hybrid
c. manual
d. systematized
ANSWER: b
56. In a source-oriented record, reports are organized according to __________ in labeled sections.
a. documentation source
b. health care provider
c. procedures and services
d. reimbursement type
ANSWER: a
57. Which is a systematic method of documentation that consists of four components: database, initial plan, problem list,
and progress notes?
a. integrated record
b. problem-oriented record
c. sectionalized record

Name: Class: Date:
d. source-oriented record
ANSWER: b
58. Chief complaint, social data, and past medical history are considered part of the problem-oriented record __________.
a. database
b. initial plan
c. problem list
d. progress note
ANSWER: a
59. The table of contents for the problem-oriented record is called the __________, and it is filed at the beginning of the
record and contains a numbered list of the patient’s problems, which helps to index documentation throughout the record.
a. database
b. initial plan
c. problem list
d. progress note
ANSWER: c
60. The problem-oriented record __________ contains the strategy for managing patient care and any actions taken to
investigate the patient’s condition and to treat and educate the patient.
a. database
b. initial plan
c. problem list
d. progress note
ANSWER: b
61. Which is documented about each problem assigned to the patient, using the SOAP structure of the problem-oriented
record?
a. database
b. initial plan
c. problem list
d. progress note
ANSWER: d
62. To learn more about the patient’s condition and the management of the conditions, review the __________ plans in
the problem-oriented record.
a. diagnostic/management
b. follow-up
c. patient education
d. therapeutic
ANSWER: a
63. To determine how the patient will be informed about conditions for which he or she is being treated, review the
__________ plans in the problem-oriented record.
Name: Class: Date:
b. follow-up
d. therapeutic
ANSWER: c
64. To learn more about specific medications, goals, procedures, therapies, and treatments used to treat the patient, review
the __________ plans in the problem-oriented record.
b. follow-up
d. therapeutic
ANSWER: d
65. Observations about the patient’s physical findings or lab results would be found in the __________ portion of a
problem-oriented SOAP note.
a. assessment
b. objective
c. plan
d. subjective
ANSWER: b
66. The patient’s statement about how he or she feels would be found in the __________ portion of a problem-oriented
SOAP note.
a. assessment
b. objective
c. plan
d. subjective
ANSWER: d
67. The judgment, opinion, or evaluation made by the health care provider would be found in the __________ portion of a
a. assessment
b. objective
c. plan
d. subjective
ANSWER: a
68. Diagnostic, therapeutic, and education plans to resolve the problems would be found in the __________ portion of a
a. assessment
b. objective
c. plan
d. subjective
ANSWER: c

Name: Class: Date:

69. The progress notes section of the POR contains a(n) __________ note to summarize the patient’s care, treatment,
response to care, and condition on release from the facility.
a. discharge
b. emergency
c. follow-up
d. transfer
ANSWER: a
70. The progress notes section of the POR contains a(n) __________ note when the patient is relocated to another facility,
and it summarizes the reason for admission, current diagnoses and medical information, and reason for relocation.
a. discharge
b. emergency
c. follow-up
d. transfer
ANSWER: d
71. Integrated record reports are arranged in strict chronological date order (or in reverse date order), which allows for
__________, and many facilities integrate only physician and ancillary services progress notes, which require entries to be
identified by appropriate authentication.
a. collection of information by a number of providers at different facilities about a patient
b. linking of information created at different locations using a unique patient identifier
c. observation about how the patient responds to treatment based on test results
d. summarization of patient care, treatment, response to care, condition on discharge
ANSWER: c
72. The electronic health record is a(n) __________.

a. collection of information by a number of providers at different facilities about a patient
b. linking of information created at different locations using a unique patient identifier
d. summarization of patient care, treatment, response to care, and condition on discharge
ANSWER: a
73. The electronic medical record is a(n) __________.

a. created using vendor software, which also assists in provider decision making
b. linking of information generated at different locations using a unique patient identifier
d. practice management software solution for acute and long-term care hospitals
ANSWER: a
74. Document imaging supplements the EHR or EMR by scanning paper records so that they are __________.
a. converted to an electronic image and saved on storage media
b. linked using a unique patient identifier assigned by the government
c. paper-based solutions for facilities that cannot afford automated records
d. stored on computers at regional health care centers in each state

Name: Class: Date:
ANSWER: a
75. Which is used during the document imaging process to create images of patient reports?
a. index
b. jukebox
c. optical disk
d. scanner
ANSWER: d
76. During the optical disk imaging process, each patient report is __________ with a unique identification number
assigned by the facility.
a. documented
b. indexed
c. scanned
d. tabulated
ANSWER: b
77. Which is performed by health care facilities and providers for the purpose of administrative planning, submitting
statistics to state and federal government agencies, and reporting health claims data to third-party payers?
a. health data collection
b. provider documentation
c. reimbursement processing
d. statistical analysis
ANSWER: a
78. Automated case abstracting software is used by hospitals to __________.

a. collect data for statistical analysis
b. generate accounting aging reports
c. register patients for encounters
d. schedule patient appointments
ANSWER: a
79. The UB-04 claim is submitted by __________ to health plans for reimbursement purposes.
a. departments of health
b. hospitals
c. physician offices
d. third-party payers
ANSWER: b
80. The CMS-1500 claim is submitted by __________ to third-party payers for processing.
a. departments of health
b. government agencies
c. physician offices
d. third-party payers
Name: Class: Date:
ANSWER: c
81. Medical management software is used to _____.

a. automate physician office workflow
b. collect hospital data for analysis
c. generate patient satisfaction surveys
d. process UB-04 outpatient claims
ANSWER: a
Match each statement of purpose with the reference/resource listed below.

a. Conditions of Participation
b. CPT Assistant
c. National Correct Coding Initiative
d. Outpatient Code Editor
e. Coding Clinic for HCPCS Level II
82. Medicare regulations (Centers for Medicare and Medicaid Services)

ANSWER: a
83. Software used by hospitals to help identify CPT/HCPCS coding errors

ANSWER: d
84. Monthly newsletter published by AMA as an official coding resource

ANSWER: b
85. Quarterly newsletter published by AHA as an official coding resource

ANSWER: e
86. Code edits pairs” that cannot be reported on the same claim for payment
ANSWER: c
Match each illegal coding practice with the correct term listed below.
a. Downcoding
b. Jamming
c. Overcoding
d. Unbundling
e. Upcoding
87. Reporting multiple CPT codes to increase reimbursement when a combination code should be reported
ANSWER: d
88. Reporting codes for associated signs and symptoms in addition to an established diagnosis
ANSWER: c
89. Routinely assigning lower-level CPT codes as a convenience instead of reviewing documentation and the coding
manual to determine the proper code to be reported
Name: Class: Date:
ANSWER: a
90. Routinely assigning an unspecified ICD-10-CM disease code instead of reviewing the coding manual to select the
appropriate code number
ANSWER: b
91. Reporting codes that are not supported by documentation in the patient record for the purpose of increasing
reimbursement
ANSWER: e
Match each credential with the corresponding credentialing organization listed below.
a. AAMA
b. AAPC
c. AHIMA
d. AMBA
92. CCS
ANSWER: c
93. CMA
ANSWER: a
94. CPC
ANSWER: b
95. CMRS
ANSWER: d
Match each description with the type of code set listed below.
a. large code set
b. small code set
96. Actions related to disease impairment management, prevention, and treatment

ANSWER: a
97. Causes of injury, disease, impairment, or other health-related problems

ANSWER: a
98. Diseases, injuries, impairments, other health-related problems and their manifestations
ANSWER: a
99. Race, ethnicity, type of facility, and type of unit

ANSWER: b
100. Substances, equipment, supplies, or other items

ANSWER: a

Name: Class: Date:

101. Which provides normalized names for clinical drugs and links its names to many of the drug vocabularies commonly
used in pharmacy management and drug interaction software?
a. NDC
b. NLM
c. NTF-RT
d. RxNorm
ANSWER: d
102. Which classifies health and health-related domains that describe body functions and structures, activities, and
participation and complements ICD-10, looking beyond mortality and disease?
a. DSM
b. HIPPS
c. ICD-O-3
d. ICF
ANSWER: d
103. Which was implemented in 2001 to classify a tumor according to primary site (topography) and morphology
(histology, behavior, and aggression of tumor)?
a. ICD-9-CM
b. ICD-10-CM
c. ICD-10-PCS
d. ICD-O-3
ANSWER: d
104. Which is published by the American Psychiatric Association and contains diagnostic assessment criteria used as tools
to identify psychiatric disorders?
a. CPT
b. DSM
c. HCPCS
d. ICD
ANSWER: b
105. Which provides a new standardized framework and a unique coding structure for assessing, documenting, and
classifying home health and ambulatory care?
a. Alternative Billing Codes
b. ambulatory payment classifications
c. Clinical Care Classification System
d. diagnosis-related groups
ANSWER: c
106. Which is an electronic database and universal standard that is used to identify medical laboratory observations for the
purpose of clinical care and management?
a. CCC
b. LOINC
c. SNOMED
Name: Class: Date:
d. UMLS
ANSWER: b

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absorption of that already present. It is a measure, however, to be
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this method may also be used.
LACERATED WOUNDS.
Lacerated wounds differ from contused in the character of the
tears in the tissues affected and in the exposure to infection by
contact. They vary in extent and severity. Not infrequently tissues or
organs of the greatest importance are lacerated, e. g., the globe of
the eye, the liver, the intestines. The term laceration itself implies
such open injury that part of it may be exposed to infection. The first
danger is from hemorrhage. This may subside spontaneously, or
may have been checked by some first aid, or may prove nearly fatal
by the time the patient is seen by the surgeon. The first measure will
be hemostasis by the readiest and most effective measures at hand.
This may mean the application of compresses or of a tourniquet, or
even of manual pressure, until surgical procedures can be instituted.
Shock should be treated by lowering the head and raising the
extremities, or bandaging the latter, and the subcutaneous
administration of morphine or atropine. Emergency treatment of
these cases should include removal of foreign bodies, and such
cleanliness and attention to antisepsis as may be possible at the
time. Support of the injured part should be effected temporarily until
dressings can be scientifically applied. If cane sugar will keep fruit
and meat from decomposition it will have the same effect in human
tissues, and a laceration with or without compound fracture of bone
may be filled with granulated sugar until a suitable dressing can be
applied.
The surgical treatment of laceration should include the following
measures: Hemostasis; the removal of foreign bodies, as well as of
tissue which is so injured as to make repair impossible or even
questionable; a careful study of nerve supply, in order to be sure that
no nerve suture should be made; a similar study of muscles and
tendons, in order that tendon suture may be promptly made; careful
antisepsis throughout, asepsis being impossible; closure of the
wound by buried and superficial sutures, and such drainage tubes or
outlets as may permit free escape of whatever products of
inflammation or disintegration may result. There should also be
provision for physiological rest of the injured parts as well as of the
patient’s mind and body.
When large areas of skin or deep tissues are destroyed or torn
away, as in scalp wounds, avulsion of limbs or parts of limbs, it may
be necessary to retain that which can be saved and to remove that
which would slough if left to itself, thereby providing for flaps of skin
by which the wound may subsequently be covered, or leaving them
in case removal of a part must be made.
Everything which has vitality should be spared; on the other hand,
that which has lost its vitality should be removed at once. Thus
amputations may be sometimes called for because of extensive
lacerations with destruction of vascular and nerve supply, even
though the bones be uninjured.
In cases where the question of viability of tissues cannot be
promptly decided it is best to keep the injured part immersed in water
as warm as can be borne. In hospitals the entire body may be kept
immersed for days. By the use of warm water parts which have been
seriously injured may be restored. Ulcerations which are seen after
the sloughing process has begun can be best treated by immersion
or by the application of brewers’ yeast upon compresses or cotton.
No other substance, perhaps, will so quickly clear up an indolent or
foul surface as this; it hastens the time of separation of all that is
dead or dying and restores healthful activity to the surrounding
tissues.
Extensive lacerations leave frequent opportunity for operations by
which function may be restored or improvement affected.
PUNCTURED WOUNDS.
The essential features of punctured wounds are sufficiently
indicated by the descriptive name; but harm may be done through a
small external opening. An important subvariety of punctured
wounds is inflicted by gunshot missiles, which will receive
consideration by themselves. Injury to important vessels may lead to
serious hemorrhage; while injuries to nerve trunks may be followed
by paralysis of sensation and motion, or, as in the case of a
sympathetic trunk, by the well-known consequences of division of
vasomotor nerves, e. g., in the neck. When the punctured wound
bleeds freely and externally it may be assumed that some large
vessel has been injured. When it bleeds into one of the cavities of
the body delay in recognition may occur. This is true of a puncture of
the skull by which the middle meningeal artery or one of the sinuses
is wounded, when the symptoms of brain pressure may tardily or
rapidly appear. In the chest the intercostal or internal mammary
artery may be so injured as to bleed into the pleural cavity and cause
death. A puncture of the heart frequently leads to fatal hemorrhage
into the pericardial cavity, and in the abdomen puncture of the
various viscera has led to consequences beyond help save when
prompt relief could be afforded.
The dangers attending punctures pertain to the introduction of
infectious material which may produce sepsis or may slowly produce
tetanus. No ordinary weapon or tool is clean in a surgical sense,
while a rusty nail is even less so. It will be seen, therefore, that the
danger inherent in such a case is not to be measured by either the
size or the depth of the wound.
In dealing with these cases the first attention is to be given to
hemorrhage. Obviously punctures in certain regions are much more
likely to be followed by hemorrhage, and any puncture in the vicinity
of one of the large vessels should be managed with caution,
especially if the surgeon ascertain that it had bled profusely when
first inflicted. Such a puncture, when seen a few hours later, may
have become occluded by clot, or a considerable hematoma may
have formed beneath the skin. It is safe to presume that there is
more danger of septic infection than can accrue from later attention,
and it would be advisable in such cases to anesthetize the patient
and lay open the parts freely under full aseptic precautions, in order
that the clot be turned out and any bleeding vessel secured. A brief
study of such a case will decide the question of injury to the principal
nerve trunks. A principal nerve which has been injured or divided
should be carefully sought for and its ends freshened and sutured.
This is true also of any tendon whose function is evidently lost. If the
thorax have been punctured and the physical signs indicate the
presence of fluid, i. e., blood in the pleural cavity, it should be incised
and the blood withdrawn. This method should also be applied to
punctures of the heart. These measures will be more completely
dealt with in treating of the surgery of the chest and its contents.
Punctured wounds of the abdomen may give rise to great anxiety.
If none of the viscera have been injured they may be let alone, but if
doubt exists as to the safety or injury of any of them the abdomen
should be opened. (See Surgery of the Abdomen.)
Treatment.—For emergency purposes antiseptic occlusion is the
best procedure, and all punctures inflicted by ragged
and infectious materials, as rusty nails, should be treated by free
incision, with thorough cleansing and packing with antiseptic
material, that the wounds may heal by granulation.
INCISED WOUNDS.
Incised wounds are those inflicted by a sharp object which divides
the tissues abruptly and with a minimum amount of disruption. They
invariably bleed, sometimes seriously, even to a fatal degree, the
hemorrhage in such cases being due to severance of large vascular
trunks. Like contused wounds they vary as infinitely in extent as in
locality. According to their locality and dimensions important
structures may be severed, e. g., the trachea, the large nerve trunks
of the body, the tendons, etc., while visceral and joint cavities may
be more or less widely opened. When death occurs soon after injury
it is generally from hemorrhage. They are attended by the same
dangers of septic infection as are punctures, especially when there is
neglect in the emergency dressing. Should the pleural cavity be
opened there may be collapse of the lung.
Hemostasis is the paramount indication in all incised wounds
which bleed seriously. Hemorrhage is to be controlled temporarily by
any expedient, later by ligation or suture, or both. The remarks
above in relation to possible injury to vessels and nerves are of
equal force in this consideration. Every divided nerve trunk, as well
as every severed tendon, should be reunited by suture. If a joint
have been opened it should be cleansed and drained, even though
the incision be closed. Should there be injury to any of the viscera,
the wound may be enlarged in order that exploration may be made
and suitable remedies applied. This is true of every punctured or
incised wound. No hesitation need be felt about enlarging it so as to
permit of investigation. Hemorrhage having been checked and all
required attention having been given, the closure of an incised
wound may be made partial or complete according to its condition. If
fresh and clean it may be almost completely reunited, using deep
and buried sutures in order to bring into contact its deeper portions,
while superficial sutures will suffice for the skin. Drainage may be by
tubes or gauze or by loose suturing of the surface; but no incised
wound whose surfaces have become contaminated should be
completely closed by primary suture until all such surfaces have
been freely cut away and appear healthy and uninfected. An old
infected and gaping incised wound may be cleaned by the
application of brewers’ yeast, and when granulating it may be closed
secondarily with sutures, by which granulating surfaces are brought
into close contact.
Of wounds in general it may be said that there are mixed types as
well as illustrative examples. Thus a wound made by a hatchet or
axe may partake of the nature of contusion and of incision. In
instances where personal violence has been applied multiple
wounds of varied character may complicate the case. The
statements made above pertain to their conventional and common
characteristics. Treatment which would be proper in one case may
be impossible in another. There is always room for discretion and
good judgment, though there are fundamental rules which apply to
all cases, and include exact hemostasis, surgical cleanliness, repair
of severed nerves and tendons, removal of foreign bodies and
involved tissue, and the enforcement of physiological rest.
REPAIR OF WOUNDS.
The process of repair is essentially the same, being modified only
by the needs of the wound and the tissues involved, and by their
environment. Whether soft tissues or bones are being repaired the
differences are apparent rather than real, as bony tissue is
temporarily decalcified, and then, as soon as the process permits, is
once more stiffened by deposition of calcium salts.
The process of repair should be begun immediately after the
cessation of the disturbance which has produced the wound, and as
soon as the bleeding is checked. It may be materially influenced and
retarded by the presence of bacteria or other foreign bodies, but its
character remains unchanged. Healing has been described as
occurring by primary union, or by “the first intention,” and by
granulation, or the “second intention.”
Wounds which have been permitted to remain clean, with their
edges brought together so that the surfaces are in contact, are
healed with a minimum of waste of reparative material, the process
being as follows: The small vessels are occluded with thrombi up to
the first collateral branches; the leukocytes begin to penetrate the
film of blood, which, having coagulated, serves as a cement to help
hold the surfaces together. By their proliferation and more complete
organization the gap between the surfaces is bridged with both
fibrous and capillary bloodvessels, and within sixty or seventy hours
the clot has become largely replaced by organized cells. Meantime
from the endothelial cells of the vessels and vascular spaces, as well
as from the fixed cells of the connective tissue, the so-called
fibroblasts are formed, which are later converted into connective
tissue. Many of the cells which have wandered to the scene of
activity, or have been there reproduced in unnecessary numbers,
disappear again, either into the circulation or they serve as food for
the fibroblasts. Branching cells attach themselves more intimately,
and thus the original clot is completely converted into fibrous and
connective tissue, and this becomes a scar, which extends as deeply
as did the original injury. New capillaries are rapidly formed by a
budding process, and supply the pabulum required for nourishment
of the new cells. By fusion or amalgamation of neighboring vascular
buds complete new vessels are formed, extending through the new
tissue from one side to the other, while around them the fibroblasts
or connective-tissue elements arrange themselves. From this it will
appear that the coagulum which forms within a wound is desirable as
a scaffolding upon which the process of repair may be begun. But it
is desirable that this coagulum should be small in amount, in order
that these processes may not be too long delayed; hence the
advisability of removing all clots within a wound when closing it, and
preventing the formation or leaving of dead spaces in the tissues in
which blood clots may collect.
The process of granulation is not dissimilar to that described
above, save only in its gross appearances. Granulations consist of
vascular buds surrounded by leukocytes and lightly covered by
them, while around the base of each bud epithelioid and spindle cells
arrange themselves, these fixed cells organizing themselves more
and more, as the wound fills up, with the more superficial layers of
granulations. In time they are converted into a dense fibrous tissue
which forms later what is known as the scar. As before, also, the
spaces between the young capillary loops are filled with large
nucleated cells derived from the fixed cells of the tissue, and from
the endothelial lining of the newly formed vessels. Thus fibroblasts
are produced in each case, and are often more or less mingled with
giant cells, especially if some foreign body, such as a silk ligature, be
embodied in the tissues. The particular function of the leukocytes
seems to be the removal of red corpuscles and fibrin from the
original clot.
The granulation tissue thus constituted by capillary loops and
proliferating cells constitutes the basis of all wound repair. Later this
tissue assumes more of the fibrous and less of the cellular character,
while the fibroblasts arrange themselves in accordance with the
mechanical requirements of the tissues and the stress or strain
placed upon them. This tissue is at first vascular, but as it condenses
its capillaries become less numerous and smaller, and the final white
fibrous scar is usually almost bloodless.
When there has been loss of skin, or when skin edges are not
brought together, the deeper process of granulation needs an
epithelial covering, which cannot be afforded by mesoblastic or
endothelial cells. The formation of an epithelial or epidermal covering
is a process peculiar to epithelial tissue alone, and takes place
mainly from the cells of the rete Malpighii.
Epithelial elements of the skin will afford a large amount of
covering, and yet even their activity sometimes is insufficient and
has to be atoned for by skin grafting. Should the granulating surface
be small, and so situated that the fluid upon its surface may dry by
evaporation, there will result a crust or scab, which, while it conceals
from observation what is going on beneath, serves as an admirable
protection, beneath which proliferation of epithelium takes place. A
spontaneous detachment of the scab may take place when this
process is complete, and with the loosening of the crust it is
apparent that repair has become complete. This is known as healing
under a scab or under a crust.
Two clean and healthy granulating surfaces may be so placed in
contact with each other as to blend together by exactly the same
process as that by which granulations are first formed. This is called
secondary adhesion, or by the older writers the “third intention.”
Advantage is taken of this possibility in the application of what are
called secondary sutures, which may be placed some days before
they are utilized, with the intent to bring together surfaces so soon as
they shall present granulations.
One of the most interesting of all healing processes is that by
which severed tissues, when promptly replaced, often reëstablish
vascular communication and grow again in a satisfactory manner.
Thus a severed ear, nose, or finger-tip may be replaced, and, if
carefully held in situ, the parts being kept at rest, will prevent
disfigurement and the loss of important tissues. In these cases the
severed tissue remains passive several days until it has become
vascularized. Meantime its nutrition seems to be maintained through
the medium of the living tissues to which it has been affixed,
probably by absorption of their blood plasma.
Two human tissues are essentially non-vascular, the cornea and
cartilage. The former appears to be nourished by cellular interspaces
which may admit leukocytes from the surrounding tissues, and
through these proliferation and vascularization occur; while a scar in
the cornea remains permanent, and the new tissue by which repair is
brought about never becomes transparent like the cells composing
the cornea proper. In cartilage scar tissue is produced, as in other
tissues, by a similar process, in spite of the extent of the
cartilaginous layer and its non-vascularity. In general the more
specialized a tissue the less completely does it heal, and the
specialized tissues, like the retina, etc., seem to be incapable of
reproducing themselves. Low down in the animal scale some parts
can be more or less reproduced. In the ascending forms there is less
tendency in this direction; in man there is little reproduction of an
original tissue, scar tissue taking the place of most of that which has
been lost. An apparent exception to this is seen in the osseous
system, where a large amount of bone may often be reproduced.
Epithelium, also, whether on the external or internal surfaces of the
body, can regenerate itself in large degree and amount. From every
small island or mass of epithelial cells which can be retained new
cells may thus be reproduced; hence accrues the advantage of
leaving such epithelial collections whenever possible, and wherever
they may be beneficial. If upon a burnt area it happens that
epithelium has not been completely destroyed, new skin may be
confidently looked for from each clump of epidermal cells. It should
be remembered, however, that with the epidermization of a surface
under these circumstances merely an epithelial covering is secured.
The distinctively dermal appendages, such as hair, sweat glands,
and sebaceous glands, are not reproduced. If the highest ideal
results are to be secured in any case the parts must be put in the
most favorable condition, which means early surgical attention to
every wound.
INJURIES TO VESSELS.
Bloodvessels are subject to contusion, to laceration, and to
incision. They may be contused by superficial blows, compressed
against underlying bone, torn in the replacement of old dislocations,
or punctured or incised by accidental or homicidal injuries. A vessel
which is not abruptly divided but is seriously injured will usually
sustain a separation of its internal and middle coats, which curl up
within the external coat, occlude the channel, and lead to
thrombosis. A vessel thus occluded may tend to gangrene of the
parts supplied by it or to a temporary ischemia, with numbness and
pallor if an artery, or to passive edema if a vein. In cases of such
injury it is always hoped that the blood supply will be provided
through the collateral circulation. If a vessel be torn or cut across
there may result a hematoma which may lead to immediate
prostration, from hemorrhage, and to gangrene by stopping the
blood supply. Such blood tumor rarely pulsates, but may cause
extreme pain. The character and the size of the swelling will depend
upon the tissues which surround the injured vessel. Cessation of the
pulse on the distal side of an injury nearly always implies temporary
occlusion. Traumatic aneurysm may be produced by lateral injury to
an arterial trunk, by which its continuity as such is yet not completely
disrupted.
If a large outpour of blood has occurred it will be safer to incise
and turn out the clot and secure the injured vessel. In milder cases
the surgeon should do all that he can by rest and by position to favor
restoration of blood circulation. After the subsidence of acute
symptoms massage and gentle motion will serve to promote
absorption of the escaped blood. Cases will occasionally occur in
which the principal arterial trunk of a limb should be tied, hoping
thereby to save the member. Amputation may be the last resort
when gangrene is impending.
Injury to the veins is of a less serious nature in so far as immediate
consequences are concerned; nevertheless a punctured wound or a
large vein is always a serious matter. The pressure of the blood may
produce gangrene, or cause so large a hematoma that it should be
incised.
Fine silk sutures may be applied to wounded vessels, arteries or
veins, when they have been partially severed.
The healing process in all these cases is essentially the same. It
may mean the formation of a clot in or around a vessel, followed by
absorption of its principal portion and organization of what remains.
A vessel itself which has once been occluded by thrombus will
usually remain closed, a cord of fibrous tissue taking its place. Only
in rare instances is continuity of the blood channel preserved or
regained. In such cases the collateral circulation affords the life-
saving feature. The granulations which intrude themselves into the
clot gradually substitute tissue for coagulum, the conversion
beginning promptly, but often occupying weeks for its completion.
Lymph vessels may be lacerated in almost any injuries and more
or less lymph escape with the blood. When the skin is torn from the
underlying parts lymph collects in the cavity thus made, while its wall
may undergo more or less organization, and formation of a lymph
cyst results. Should one of these connect with a good-sized lymph
duct, as, for instance, in the neck the thoracic duct, then lymph cysts
of considerable size might form. Should these rupture or be opened
lymph fistulæ might result.
INJURIES OF NERVES.
By small hemorrhages into a nerve sheath nerve function may be
either temporarily or permanently disturbed. A compression too long-
continued may lead to degeneration within the nerve fibers.
Providing this do not occur there may be complete restoration of
function, or there may result chronic neuritis, with pain and irritation.
A later consequence of all nerve injuries is more or less serious
disturbance of sensation, while still later parts supplied by the
affected nerves may undergo more or less atrophy as well as spastic
contraction, by which loss of function and deformity are produced.
There is a form of nerve injury which is due to the temporary
pressure of the elastic tourniquet, frequently applied around limbs
previous to operations, or to pressure which is made by crutch
handles upon the axillary plexus, and called crutch paralysis. Limbs
carelessly allowed to hang over the edge of the operating table
during prolonged operations also have suffered in the same way.
Such lesions are of the character of a contusion, but are often
followed by paresis, paralysis, and by various sensory disturbances.
Injury to a nerve trunk having been recognized by a study of the
local features of a given case requires special treatment in case
laceration or more localized division can be assumed. The nerve
known to be lacerated and torn across should have its ends
freshened and be reunited by fine catgut sutures; also a nerve trunk
known to be punctured or divided. Such injury is not necessarily
inflicted from without, as it may be produced by a fragment of bone;
in this case the operation should be directed toward the bone as well
as toward the nerve trunk itself. A divided nerve trunk, if neatly
sutured, heals by the organization of blood clot, as in other
instances, actual nerve communication being made across the
intervening clot by a process of regeneration or reduplication of the
true nerve elements, the peripheral neurilemma playing an important
part. Autogenetic power decreases with the age of the individual. By
careful nerve suturing disability may be prevented.
Even months after injury much can be accomplished by nerve
suture properly performed. Symptoms similar to those of division
may occur when a nerve trunk is surrounded and compressed by
bone callus after fracture, as when the ulnar nerve is thus caught. If
too long a time have intervened it may be necessary to exsect the
injured portion and then bring the ends into apposition by sutures.
Other methods of atoning for these nerve injuries by nerve grafting,
etc., will be described in the chapter on Surgery of the Peripheral
Nerves.
Neuritis may be overcome by counterirritation, preferably with the
actual cautery, i. e., the “flying cautery,” by massage, and by
galvanization. The pain in many of these cases can be mitigated, if
not completely relieved, by the x-rays, or by the high-frequency
current. In some cases nerve elongation may be brought to bear and
a tender and irritable nerve be thus brought under subjection.
INJURIES TO MUSCLES AND TENDONS.

Lacerations or divisions of muscles are usually repaired at first by
fibrous tissue, the result of organization of a clot. Later a true muscle
regeneration takes place and muscle scar finally disappears. Atrophy
of a muscle is not a sign of injury directly to itself, but often results
from injury to the nerve which supplies it; for example, the circumflex
nerve may be injured in shoulder dislocations, while the deltoid
muscle, which is supplied by it, speedily undergoes atrophy.
Muscle fibers may be torn by violent exertion. Such an accident
may be followed by pain and loss of function. An interval can often
be felt, even from the outside, between the torn muscle ends. The
injury will produce considerable hemorrhage. The amount of function
regained in a muscle will depend to some degree on the extent of its
injury. If it have been injured by an incised wound it will depend upon
the way in which it is brought together after an open incision. The
origin and insertion of such a muscle should be approximated by
proper position, and so maintained by the dressings, in order that
perfect rest may be more easily maintained. When a portion of the
fascia or aponeurosis is torn the muscle fiber may protrude and form
a hernia of muscle.
Tendons often suffer from contusion, in consequence of which
they may become adherent within their tendon sheaths; this leads to
stiffness of the part and more or less loss of function. Sometimes
they calcify, as does the adductor magnus tendon in the formation of
the so-called rider’s bone. The tendon most frequently injured is that
of the quadriceps, near the knee.
If it can be decided that a tendon has been divided or torn across
its prompt reunion by suture should be always practised. Also a
divided muscle, if exposed, should be drawn together with sutures,
chromic or hardened, so as to make them more reliable. Tears of
aponeuroses and fasciæ should also be sutured. Tendon suturing is
nearly always successful, especially if it can be done in a cleanly
manner; while tendon grafting is a measure which may be reserved
to overcome the consequences of injuries to muscles and tendons
not disposed to repair.
INJURIES TO BONES.
Aside from simple and compound fractures, which are essentially
bone wounds, there may be seen hemorrhages beneath the
periosteum or in the immediate vicinity of bones, which are usually
small in amount, yet may cause considerable disturbance. The
traumatic hematoma of the scalp which often follows delivery is an
illustration of an injury of this class, the periosteum itself being
sometimes separated. Collections of blood under these
circumstances which fail to disappear by absorption may be incised
and the contained clot turned out.
PLATE XII
FIG. 1
Young Granulation Tissue Following Bur., a, aa, thin-walled capillaries. Large

nuclei, fibroblasts horseshoe nuclei, leukocytes. × 250.
FIG. 2
Young Scar. Numerous capillaries perpendicular to surface. Spindle elements,
fibroblasts considerably smaller than in Fig. 1. × 250.
FIG. 3
Mature Scar. Dense fibrous connective tissue with a few fibroblasts. At a, a small
bloodvessel. × 250.
Granulation Tissue organizing into Cicatricial

Tissue. (Karg and Schmorl.)
Illustrating statements made on several of the foregoing pages.
CONTUSIONS OF THE VISCERA.

Contusions of the viscera may be followed by many and
disastrous consequences. They compromise such lesions as rupture
of the liver, kidney, spleen, laceration of the bowel, bladder, or gall-
bladder, and may occur by blows which do not break the surface; or
any of the viscera may be lacerated, punctured, or gashed by
gunshot, punctured, or incised wounds. These will be more
completely considered in Chapter XLV.
CHAPTER XXII.
GUNSHOT WOUNDS.
Gunshot wounds are usually considered with the special subject of
military surgery. Military surgery as such, however, consists in the
application of general surgical principles. Nevertheless a gunshot
wound is essentially the same whether it be received upon the
battle-field or in civil life, and the injury inflicted by a piece of flying
shell is in no sense different from that which may be received in a
blasting accident.
A gunshot wound is always contused and lacerated, and often
punctured. According to its size and shape, its location, the nature
and velocity of the missile, the distance at which the weapon was
discharged will depend its severity and prognosis.
Shot vary in size from those which weigh but a fraction of a grain
to buckshot which weigh nearly one-third of an ounce. Revolver and
pistol bullets vary in diameter from 0.22″ to 0.45″, and in weight from
twenty-five grains to ten times that amount, and nearly always of
conical form. They are usually made of compressed lead, sometimes
hardened by the addition of tin or antimony.
The old military weapons, such as the Springfield rifle, have been
entirely abandoned, and for them have been substituted rifles of
smaller bore, projecting bullets of from 0.25″ to 0.31″, varying in
weight from one-fourth to one-half ounce and attaining a muzzle
velocity of nearly 2500 feet per second. They have, therefore, a
much increased range and may kill at two miles. Their trajectory is
flatter and the character of the wound caused by these modern
weapons is different from those inflicted, for instance, during the Civil
War. The bullets now in use in the armies and navies of the world are
nearly all encased in a thin covering of steel, copper, etc., which is
known as the jacket or mantle. They are from 3.5″ to 4″ in length,
possessing a much greater range than a shell bullet, while the rifling
of the weapon is so made as to give them a more rapid rotation. In
active service, moreover, these are usually fired with smokeless
powder. The so-called “dangerous zone,” i. e., that where mounted
men or infantry can be injured, is much wider than formerly.
In India the practice has been introduced of leaving the point of the
bullet uncovered by the mantle, so that when it strikes it would
“mushroom”—especially in the bone. These “Dumdum bullets,” as
they are called, from the place of manufacture, inflict much more
serious injuries than do the relatively smooth perforations made by
the others, and have been considered so cruel that they are
excluded from use in civilized warfare.
During the Russo-Japanese war, in which nearly all previous
records were broken, the deaths from gunshot wounds constituted
but a small proportion of the entire loss in camp and warfare, a larger
number of soldiers dying from disease and exposure. Statistics also
show that out of every 100 cases of gunshot wounds 12 per cent.
have been produced by bullets, the remaining portion being caused
by shell, etc. De Nancrède has epitomized some interesting figures
which may be here quoted: In the United States army during the
Spanish war 4750 casualties were accurately studied; of these
wounds of the lower extremities constituted nearly 33 per cent.,
those of the upper extremities nearly 30 per cent., those of the trunk
a little over 22 per cent., and those of the head and neck a little over
15 per cent. During the South African campaign the mortality among
the wounded was 5.7 per cent., essentially the same as that during
our Cuban and Filipino campaigns, and in marked contrast to the 14
per cent. mortality of the Civil War. Considering that with our Mauser
weapons the trajectory is practically flat up to 500 yards, and they
may kill up to a distance of two miles, it will be seen that this
difference in figures is important. The British discovered in their
campaign against the Afghans, who were using antiquated weapons,
that their own Lee-Metford bullets would pass through their enemies
without disabling them, while the British soldiers who were once
struck by the large, soft-lead bullets of their antagonists were far
more seriously injured or absolutely disabled.
As one explanation of the injury inflicted by modern projectiles
there has been advanced the theory that a bullet with a high-muzzle
velocity, striking an object while it still retains most of its original
speed, compresses and forces ahead of it into the wounded tissues

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ATI RN Med-Surg Proctored Exam (10

Chapter 01: Overview of Coding

Chapter 01: Overview of Coding

c. third-party logistics (TPL)

Chapter 01: Overview of Coding

13. Which is used to classify diagnoses in any health care setting?

14. Which is used to classify procedures in an inpatient hospital setting?

Chapter 01: Overview of Coding

18. Which is an example of a medical nomenclature?

Chapter 01: Overview of Coding

b. health care clearinghouse

25. Which is an example of a third-party payer?

27. Which is another term for a health plan?

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Chapter 01: Overview of Coding

Chapter 01: Overview of Coding

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Chapter 01: Overview of Coding

45. The primary purpose of the record is to provide for __________.

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Chapter 01: Overview of Coding

46. A secondary purpose of the patient record is to __________.

47. Patient record documentation must be __________.

50. Which type of physician participates in an approved GME program?

Chapter 01: Overview of Coding

53. Which type of record is paper based?

54. Which type of record uses computer technology?

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Chapter 01: Overview of Coding

Chapter 01: Overview of Coding

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Chapter 01: Overview of Coding

72. The electronic health record is a(n) __________.

73. The electronic medical record is a(n) __________.

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Chapter 01: Overview of Coding

78. Automated case abstracting software is used by hospitals to __________.

Chapter 01: Overview of Coding

81. Medical management software is used to _____.

Match each statement of purpose with the reference/resource listed below.

82. Medicare regulations (Centers for Medicare and Medicaid Services)

83. Software used by hospitals to help identify CPT/HCPCS coding errors

84. Monthly newsletter published by AMA as an official coding resource

85. Quarterly newsletter published by AHA as an official coding resource

Chapter 01: Overview of Coding

96. Actions related to disease impairment management, prevention, and treatment

97. Causes of injury, disease, impairment, or other health-related problems

99. Race, ethnicity, type of facility, and type of unit

100. Substances, equipment, supplies, or other items

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Chapter 01: Overview of Coding

Chapter 01: Overview of Coding

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INJURIES TO MUSCLES AND TENDONS.

Young Granulation Tissue Following Bur., a, aa, thin-walled capillaries. Large

Granulation Tissue organizing into Cicatricial