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Billing and coding

Medicare insurance

QuestionAnswer
What organization determines the content of both HIPAA 837 and CMS-1500 claims? The National Uniform Claim Committee (NUCC)
A ____ fee structure reflects the amounts that providers typically charge for services and procedures. Charge-based
GPCI is the abbreviation for? Geographic practice cost index.
A HIPAA-mandated electronic transaction for claims may also be called HIPAA X12 837 Health Care Claim.
A conversion factor is multiplied by a _________Blank to arrive at a charge. Relative value unit (RVU)
The Medicare Physician Fee Schedule is based on RBRVS fees.
RBRVS is the abbreviation for Resource-based relative value scale.
The last step in the coding process is Determine the need for modifiers.
To calculate RBRVS fees, multiply each RVU by its ___ add the three adjusted totals, and multiply the sum by the conversion factor. GPCI
Medical necessity is based on The relationship between the diagnosis and the treatment provided.
Created by: InstructorWatson
 

 



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