- Temporary additional payments over and above the OPPS payment made for certain innovative medical devices, drugs, and biologicals provided to Medicare beneficiaries are known as __________pass-through
- Prospective price-based rates are established by theactual charges for inpatient care reported to payers after discharge of the patient from the hospital.
payer, based on a particular category of patient.
reported health care costs from which a per diem rate has been determined.
- When reporting CPT codes on the CMS-1500 claim, medical necessity is proven byattaching a special report to the CMS-1500 claim.
linking the CPT code to its ICD-10-CM counterpart.
reporting ICD-10-CM codes for the patient’s condition.
sequencing CPT codes in a logical, chronological order.
- The deadline for filing Medicare claims issix months from the date of service
three years from the date of service
there is no deadline
none of the above
- Birth dates are entered as ___________ on the CMS-1500 claim depending on block instructions.DD MM YYYY or DDMMYYYY
MM DD YYYY or MMDDYYYY
MM DD YY or MMDDYY
YYYY MM DD or YYYYMMDD
- A black triangle located to the left of a CPT code indicates that the codehas been deleted and should not be used.
has been revised from previous CPT publications.
has special rules that apply to its use.
is new to this edition of CPT.
- Hospice provides which services for patients?medical care in the home with the goal of keeping the patient out of the acute or long-term care setting
medical care, as well as psychological, sociological, and spiritual care
no copay if the patient has had a three-day minimum qualifying stay in an acute care facility
temporary hospitalization for a terminally ill, dependent patient for the purpose of providing relief from duty for the nonpaid caregiver of that patient
- The ICD-10-CM system classifiesmorbidity
supplies and services
- When office-based services are performed at a facility other than the physician’s office, Medicare payments are reduced because the physician did not provide the supplies, drugs, utilities, or overhead. This payment reduction is called a(n)ambulatory payment classification
outpatient fee reduction
- The reporting of diagnosis codes on the CMS-1500 claim is necessary to demonstrateaccuracy of the procedure code
quality of care