MidTerm-MED1850 Word Scramble

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Question	Answer
A patient control number is a unique identifier assigned to each hospital patient at the time of:	admission
Individuals eligible for medicare may be classified into one or more of the following categories EXCEPT	Low-income
the abbreviation for ERSD stands for	End-stage renal disease
The Medicare coverage that consists of hospital insurance is	Medicare Part A
The process of collecting a patient's personal information and entering it into the hospital's database is referred to as:	registration
The Medicare coverage that pays for physician services is	Medicare Part B
It is necessary for a professional coder to exhibit ethical behavior when coding for services and procedures. T/F	True
HCPCS stands for health care providers code sets. T/F	False
HCPCS was developed by the AMA T/F	True
There is only one level of codes in the HCPCS. T/F	False
It is not permissible to use "assumption coding" T/F	True
An audit or formal examination of services billed, along with the codes submitted, is not necessary in a medical office setting, as all billing is always accurate. T/F	False
The chief complaint is the reason for the encounter. T/F	True.
Surgical codes may trigger an audit because they are used frequently. T/F	False
There is only one kind of audit. T/F	False.
One of the top coding and documentation errors is that the chief complaint is missing. T/F	True.
If a patient is covered by more than one insurance policy, a physician's office will always file both the primary and secondary/ T/F	False
Medicare prescription drug coverage is offered through	Medicare Part D
The Medicare profram that provides expanded benefits through private managed care health plans is	Medicare Advantage (MA)
The role of the centers for Medicare and Medicaid Services (CMS) includes all of the following EXCEPT	paying claims for Medicare beneficiaries
HCPCS level 2 codes are updated by who	CMS
A clean claim has no mistakes or missing information. T/F	True
The patient and the guarantor are always the same. T/F	False.
Superbills are also referred to as encounter forms, charge slips, or routing slips. T/F	True
The CMS-1500 was developed by Blue Cross Blue Shield. T/F	True
HCPS is the acronym for the.	Health Common Procedure Coding System.
The five-digit CPT codes used to report services and procedures performed by healthcare providers are also known as:	Level 1 HCPCS.
HCPCS was developed to achieve all of the following goals EXCEPT.	implementing standard fee structures for all providers across all plans.
Level 1 HCPCS codes are also known as the	American Medical Association's CPT code.
HCPCS level 1 codes were developed by the.	American Medical Association (AMA)
HCPCS level 2 codes are updated annually by the.	Centers for Medicare and Medicaid Services (CMS)
The code for durable medical equipment(DMA) would be found in the	Level 2 HCPCS code book.
A coder who needs to find the codes for prosthetic devices and related procedures would find it in the	Level 2 HCPCS code book.
HCPCS level 2 codes would include all of the following EXCEPT codes for:	surgical services.
HCPCS level 2 national codes consist of.	One alphabetic character and four digits.
The person who is ultimately responsible for payment to the medical office is called the:	Guarantor.
If an insured patient signs an assignment of benefits form, the insurance carrier will send payment directly to the:	Physician.
A claim can only be submitted to an insurance carrier on the patient's behalf if the patient has signed a (n):	Release of information form
The individual who purchases an insurance policy is known as the:	Policyholder
If needed information is missing from a claim when it is submitted to an insurance carrier, it is referred to as a(n).	Dirty claim.
When a patient has more than one insurance policy, one policy is considered the primary coverage and the additional policy is:	Secondary insurance
On the CMS-1500 claim form, the abbreviation NPI indicates that:	The National Provider Identifier must be entered.
The CMS-1500 claim form is mandatory for all Medicare claims.	A) True
Most providers submit healthcare claims electronically.	A) True
The majority of hospital reimbursement comes from:	Insurance companies.
A patient control number (PCN) is a unique identifier assigned to each hospital patient at the time of.	Admission.
The process of collecting a patient's personal information and entering it into the hospital database is referred to as:	Registration.
A hospital will bill for patient services:	After the discharge paperwork is completed and signed by the physician.
A charge description master includes all of the following information except:	Physician identification number.
Reimbursement methods for inpatient hospital services include all of the following EXCEPT:	Capitation.
The method of reimbursement that establishes the rate of payment to a hospital before services are rendered is:	Prospective payment system.
The method of reimbursement that pays hospitals a fixed rate per day for all services provided is.	Per Diem.
The ambulatory Payment classification (APC) system bases payments on:	Procedures.
Services covered under the ambulatory payment classification (APC) system include all of the following EXCEPT:	Inpatient surgical procedures.
OPPS Stands for:	Outpatient payment for preventive services.
The list of Ambulatory payment classification (APC) rates is maintained by:	The centers for medicare and medicaid services (CMS)
The diagnosis related group (DRG) system is a type of.	prospective payment system.
Most major diagnostic categories (MDCs) are based on	A particular organ system.
Diagnosis related group (DRG) classification takes into account all of the following criteria EXCEPT:	social status and family support.
The physician who is primarily responsible for a patient's care while in the hospital is referred to as the:	Attending physician
The UB-04 claim form allows for a maximum of:	10 diagnoses.
A facility's case mix is based on all of the following EXCEPT:	discharge status.
Software that is used to calculate the diagnosis related group (DRG) payment group is called a(n)	Grouper.
A case that cannot be assigned an appropriate diagnosis related group (DRG) because of the typical situation is called a(n)	Cost outlier.
When referring to diagnosis related groups (DRGs), the abbreviation CC is used to indicate:	complications or comorbidities.
Individuals eligible for medicare may be classified into one or more of the following categories EXCEPT:	Low Income.
The abbreviation ESRD stands for	end-stage renal disease.
The medicare coverage that consists of hospital insurance is	Medicare Part A
The medicare coverage that pays for physician services is	Medicare Part B
The medicare program that provides expanded benefits through private managed care health plans is	Medicare Advantage (MA)
Medicare prescription drug coverage is offered through.	Medicare Part D.
The role of the Centers for medicare and medicaid (CMS) includes all of the following EXCEPT:	Paying claims for medicare beneficiaries.
The organization that enrolls new medicare beneficiaries into the program is the	Social Security Administration (SSA)
Organizations that are hired by the CMS to carry out day-to-day medicare program operations are known as:	Contractors.
A spouse of a deceased, retired, or disabled individual who was or is eligible for medicare benefits:	Is also eligible for medicare coverage.
Medicare part A provides coverage for all of the following services EXCEPT:	Inpatient physician services.
Individuals age 65 and older qualify for medicare if they have paid FICA taxes for at least:	40 calendar quarters.
To qualify for medicare, disabled adults must have been receiving social security disability benefits for:	More than 2 years.
Coverage for hospice care is provided by:	Medicare Part A.
Hospice services covered under medicare part a may by provided as:	Short-term hospital care, Inpatiet respite care, In-home care. ALL THE ABOVE.
Private-duty nursing care is:	Not covered by medicare.
Medicare Advantage plans ( Part C) offer which of the following benefits?	Hospital coverage (Part A); Medical coverage ( Part B); Prescription drug coverage; ALL THE ABOVE.
Medicare Part D consists of:	Prescription drug coverage.
Medicare patients with Part B fee-for-service benefits are responsible for what percentage of the medicare fee schedule (MFS) after the deductible has been met and services are rendered by a provider who accepts assignment?	20%
Medicare Part B provides agree to accept as payment in full the amount paid by:	Medicare plus the patient's share.

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