domain prep quiz 2
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School
Bryant & Stratton College *
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Course
MCCG150
Subject
Medicine
Date
Jan 9, 2024
Type
docx
Pages
4
Uploaded by JudgeInternet10832
1.
Each code in the HCPCS has been assigned a(n) _____ that establishes how a service, procedure, or item is paid under the Outpatient Prospective Payment System (OPPS).
Payment status indicator
2.
Two Medicare patients were hospitalized with bacterial pneumonia. One patient was hospitalized for three days, and the other patient was
hospitalized for 30 days. Both cases result in the same MS-DRG with different lengths of stay. Which of the following most closely describes how the hospital will be reimbursed?
The hospital will receive the same reimbursement for the same MS-
DRG regardless of the length of stay.
3.
What are the possible add-on payments that a hospital could receive in addition to the basic Medicare DRG payment?
Additional payments may be made to disproportionate share hospitals for indirect medical education, new technologies, and cost outlier cases.
4.
In the Laboratory section of CPT, if a group of tests overlaps with two or more panels, report the panel that incorporates the greatest number of tests to fulfill the code definition. What would a coding professional do with the remaining test codes that are not part of a panel?
Report the remaining tests using individual test codes.
5.
CMS identified conditions that are not present on admission and could be "reasonably preventable." Hospitals are not allowed to receive additional payment for these conditions when they are not present on admission. What are these conditions called?
Hospital acquired conditions.
6.
An addendum to the health record should be dated.
The day the addendum was created.
7.
A provision of the law that established the resource-based relative value scale (RBRVS) stipulates that refinements to relative value units (RVUs) must maintain _____.
Budget neutrality
8.
On October 1, 2012, the Affordable Care Act established which of the following, requiring CMS to reduce payments to IPPS hospitals with excess admissions?
Hospital Readmissions Reduction Program
9.
The chargemaster, or charge description master (CDM), is a database used by healthcare facilities to house billing information for all services provided to patients (Casto and White 2021, 144–153).
ICD-10-CM Diagnosis codes
10.
The healthcare program for active-duty members of the military and other qualified family members is _____.
Tricare
11.
What is the name of the national program to detect and correct improper payments in the Medicare fee-for-service (FFS) program?
Recovery audit contractors (RACs)
12.
Which of the following software applications would be used to aid
in the coding function in a physician's office?
An encoder
13.
The front end of the revenue cycle management process does not include _____.
Claims appeals
14.
What is the basic formula for calculating each MS-DRG hospital payment?
Hospital payment = MS-DRG relative weight × hospital base rate
15.
What is the name of the organization that develops the billing form that hospitals are required to use?
National Uniform Billing Committee (NUBC)
16.
In fiscal year 2008, Medicare revamped the inpatient payment system to incorporate three severity levels. The grouping is known as _____.
MS-DRGs
17.
CMS developed medically unlikely edits (MUEs) to prevent providers from billing units of service greater than the norm would indicate. These MUEs were implemented on January 1, 2007, and are applied to which code set?
HCPCS/CPT codes
18.
Identify the correct ICD-10-CM diagnosis code(s) and sequencing for a patient with disseminated candidiasis secondary to AIDS-related complex.
B20, B37.7
19.
The status indicator (SI) that identifies procedures, services, and supplies that are packaged into the cost and reimbursement for APC services with which they are most often performed is SI _____.
(N)
20.
The physician has signed a statement that all her dictated reports should be automatically considered approved and signed unless she makes corrections within 72 hours of dictating. This is called _____.
Auto-authentication
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