Medical Coding Practice Test

What are the three major functions of ICD-9-CM for insurance purposes?

1. Assigning physician schedule, defining medical necessity, measuring healthcare quality

2. Establishing medical necessity, measuring healthcare quality, justifying services rendered

3. Assisting in scheduling, ensuring reimbursement, recording patient history

4. Documenting procedures, assessing patient outcomes, establishing medical guidelines

The correct answer is: Establishing medical necessity, measuring healthcare quality, justifying services rendered

The correct answer is B: Establishing medical necessity, measuring healthcare quality, justifying services rendered. ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) codes are used for insurance purposes in medical coding to establish medical necessity, measure healthcare quality, and justify services rendered by healthcare providers. These codes help ensure that the services provided to patients are appropriate, necessary, and of high quality. When medical coders assign ICD-9-CM codes accurately, it helps to support the medical necessity of the services provided, allows for monitoring and measuring of healthcare outcomes and quality of care, and justifies the reimbursement for the services rendered by healthcare providers. The other options are incorrect as they do not accurately represent the major functions of ICD-9-CM for insurance purposes. Option A mentions assigning physician schedules, which is not a primary function of ICD-9-CM. Option C mentions assisting in scheduling and recording patient history, which are also not core functions of ICD-9-CM in the context of insurance. Option D mentions documenting procedures, assessing patient outcomes, and establishing medical guidelines, which are related to other coding systems and processes but are not among the primary functions of ICD-9-CM specifically for insurance purposes.