1. What data set helps improve the outcomes of home healthcare?

HAVEN

2. What is the purpose of the explanation of benefits?

To outline the benefits provided by physician's groups

3. Medical coders and billers would use a CMS-1500 claim form to

report chiropractic services.

4. The process of assigning codes to certain pieces of information in the medical record is called

medical coding.

5. Each reimbursable HCPCS code is assigned a/an

APC for reimbursement purposes.

6. An outpatient coder in Dr. Smith's office will use which codes for procedures?

CPT

7. Patty just had her appendix removed. The appendix removal appears on the claim form as a _______ code.

procedure

8. If a physician is charging for a mole removal procedure based on what other physicians generally charge for this procedure, the physician is probably using

UCR

9. Your grandmother has a question about her Medicare reimbursement, but it's 10:30 P.M. What organization will answer her questions at this time of night?

OIG

10. A medical coder would use HAVEN to

collect, store, and transmit data for home health care evaluation

11. Paul is trying to obtain new insurance, but he fears he'll be denied due to his cancer diagnosis and ongoing treatment. What legislation was put in place to help patients like Paul avoid insurance denial due to their current health conditions?

Affordable Care Act

12. The CMS publishes the relative value units (RVUs) as a part of the

Ambulatory fee schedule

13. Mr. Braun is an 82-year-old retired railroad worker who's having a mole removed at his physician's office. Which Medicare division will the physician's office bill to receive payment for this service?

Medicare Part B

14. What is the standard form used to bill outpatient claims?

CMS-1500

15. What is a principal procedure?

The procedure that most closely relates to the patient's principal diagnosis

16. Which of the following are examples of hospital resources billed to a patient?

Gloves, syringes, and medication

17. You're switching jobs on Monday. Which act was developed, in part, to ensure that you have ongoing insurance coverage during the change?

OCIIO

18. DRGs are grouped into

1 of 25 Major Diagnostic Categories (MDCs).

19. What may lead to claim denials or improper service reimbursement?

Inaccurate physician documentation

20. Which one of the following statements is true of the admitting diagnosis?

The admitting diagnosis may differ from the final diagnoses recorded in the medical record.

	Created by Tabitha Shaw almost 7 years ago

Note on Medical Billing & Health Insurance, created by Tabitha Shaw on 31/01/2019.

Medical Billing & Health Insurance