FREE AND STUDY GAMES ABOUT GUNTERMANINS CH 6-7

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FREE AND STUDY GAMES ABOUT GUNTERMANINS CH 6-7

EXAM QUESTIONS

Actual Qs and Ans Expert-Verified Explanation

This Exam contains:

-Guarantee passing score -65 Questions and Answers -format set of multiple-choice -Expert-Verified Explanation

Question 1: connection between a service and a patient's condition or illness

Answer:

code linkage

Question 2: using a lower level code that will result in a lower payment

Answer:

downcoding

Question 3: diagnoses not coded at the highest level of specificity

Answer:

truncated coding

Question 4: to deduct an amount from a patient's account

Answer:

write off

Question 5: setting fees based on relative skill and time required to provide similar services

Answer:

resource-based fee structure Question 6: provide additional information about services, supplies, and procedures

Answer:

Level II modifiers

Question 7: CCI is a program of

Answer:

Medicare

Question 8: The usual fee for excluded services are

Answer:

collected at the time of service Question 9: HCPCS Level II codes available for use but not part of the standard code set

Answer:

temporary national codes Question 10: both services represented by MEC codes that could not have been done during one encounter

Answer:

CCI mutually exclusive code edit

Question 11: MUE stands for

Answer:

medically unlikely edits

Question 12: providing free services to other physicians and their familes

Answer:

professional courtesy

Question 13: computerized system that identifies improper or incorrect codes

Answer:

edits

Question 14: internal augit of claims conducted before transmission

Answer:

prospective audit

Question 15: normal fee charged by the provider

Answer:

usual fee Question 16: Who is ultimately responsible for proper documantation and correct coding

Answer:

Physician Question 17: factor assigned to a medical service based on teh relative skill and required time

Answer:

RVU Question 18: HCPCS level II codes that are available for all government and private payers to use. No changes can be make unless all panel members agree.

Answer:

permanent national codes Question 19: information about Medicare-qualified clinical trials, treatments, therapeutic interventions, diagnostic testing, durable medical equipment, therapies, and services

Answer:

Coverage Issues Manual Question 20: known as a cheat seet, it is a list of a practice's frequently reported procedure and diagnosis codes

Answer:

job reference aid

Question 21: system of assigning unit values to medical services based on their required skill and time

Answer:

RVS

Question 22: HCPCS stands for

Answer:

Healthcare common preocedure coding sytem Question 23: If a participating provider's usual fee is $400, and the allowed amount is $350, and the balance billing is permitted, what is written off?

Answer:

$50

Question 24: relative value scale used for establishing Medicare charges

Answer:

RBRVS

Question 25: Level I codes in HCPCS are

Answer:

CPT codes

Question 26: self conducted by a staff member or consultant hired by the office

Answer:

internal audit

Question 27: PDAC contractor stands for

Answer:

Pricing, Coding Analysis and Coding contractor Question 28: amount used to multiply a relative value unit to arrive at a charge

Answer:

conversion factor