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Ashworth College

Medical billing and coding lesson group 4 MCV04 / Hospital medical billing

QuestionAnswer
Which form locator provides a description for the revenue code? a) 43 b) 17 c) 28 d) 13 a) 43
a patient sees... for congestive heart failure. The healthcare provider will be reimbursed based on an expected amount to treat the congestive heart failure. a)Per diem b)Ambulatory payment classification c)Fee-for-service d)Prospective payment d) Prospective payment
In the Type of Bill code example of 0123, which number indicates the submitting facility for this hospitalization? a) 0 b) 1 c) 2 d) 3 b) 1
What is the main difference between APCs and DRGs? a) APCs are used by physician offices only. b) APCs are based on MDCs. c) APCs are based on procedures. d) APCs assigned comorbidities and complications. c) APCs are based on procedures.
Which one of the following choices contributes to a hospital's CMI? a) Admitting diagnosis b) Principal diagnosis c) Trim points d) Resource intensity d) Resource intensity
Which one of the following choices is considered a major section for the UB-04? a) Prescription information b) Payer information c) Dependent information d) Treatment information b) Payer information
Which one of the following choices usually increases a patient's length of stay and may have a negative effect on the treatment? a) DRG b) Comorbidity c) Prognosis d) APC b) Comorbidity
In the form locator for prior payments, what should you do when you have prior payments from other carriers? a) Attach the Explanation of Benefits. b) Include the 10-digit NPI. c) Enter the applicable code for the insured. d) Enter "9." a) Attach the Explanation of Benefits.
What is the maximum number of services that can be billed on one UB-04? a) 25 b) 22 c) 15 d) 7 b) 22
Which one of the following physicians holds the primary responsibility for the patient's care while the patient is in the hospital? a) Attending b) Rendering c) Admitting d) Operating a) Attending
When a grouper program searches the information for additional complications, comorbidities, or procedures related to those already coded, this is known as a) looping. b) grouping. c) indexing. d) rendering. a) looping.
If a patient dies at home while in hospice care, what discharge code might be used on the claim form? a) 40 b) 41 c) 50 d) 51 a) 40
Which one of the following form locators is not required by Medicare? a) Provider name and address b) Type of bill c) Patient name d) None of the above d) None of the above
A hospital's CDM hasn't been changed for the past year. Which outcome could result from this? a)Improvement in the cost-of-living reimbursement b)Overpayment of claims c)Increase in the number of admissions d)Assignment of procedure codes b) Overpayment of claims
Which one of the following choices pays actual charges based on treatment given to a patient? a) Prospective payment b) Fee-for-service c) Per diem d) Outpatient prospective payment b) Fee-for-service
Which one of the following choices is considered a major revenue code category on the UB-04? a) Hospice b) Home care c) Vitamins d) Physical therapy d) Physical therapy
Services listed with the corresponding HCPCS and revenue codes can be found on the a) CDM. b) CPT. c) PCN. d) POA. a) CDM.
If you need to find the reimbursement rates for outpatient care, you might use a) DRGs. b) OPPS. c) ICD-9-CM. d) CDM. b) OPPS.
If you wanted to look at all of the patients in a hospital, you could access the a) PAS b) MPI c) PCN d) HAC b) MPI
hospital patient's record wasn't coded until 20days after the patient was discharged. What issue... a)The claim may be denied b)The patient may not be reimbursed c)Physicians may be charged with incomplete records d)It could create a cash flow problem d) It could create a cash flow problem.
Created by: HoneyCocainee