The FTC Deception Policy States That Any Deceptive Practice Likely

question 355

True/False

The FTC deception policy states that any deceptive practice likely to mislead any consumer will be challenged by Congress.

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Definitions:

Reason Rule

Refers to the purpose or reason for doing a test or procedure, an insurance company criteria for reimbursement; the reason for the patient visit (encounter) is coded first. This is the primary diagnosis; any other issues the patient presents with (comorbidities) are coded next, in order of importance. This includes chronic conditions that must be considered or will be affected by the treatment for the primary diagnosis.

Indexing Rule

Guidelines or principles used in organizing, categorizing, and locating information or data systematically.

Evaluation And Management Service

Medical services provided by healthcare providers to assess and manage a patient's health status typically involving history taking, examination, and medical decision making.

Downcoding

A practice of third-party payers in which the benefits code has been changed to a less complex or lower-cost procedure than was reported; another payer practice in which a reported evaluation & management service is reduced to a lower level based strictly on the diagnosis code reported.