The reporting of diagnosis codes on the CMS-1500 claim is necessary to demonstrate

Question 1

  1. 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

    temporary pass-through

    transitional additional

    transitioal pass-through

2 points

Question 2

  1. 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.

2 points

Question 3

  1. 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.

2 points

Question 4

  1. 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

2 points

Question 5

  1. Birth dates are entered as ___________ on the CMS-1500 claim depending on block instructions.DD  MM  YYYY or DDMMYYYY




2 points

Question 6

  1. 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.

2 points

Question 7

  1. 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

2 points

Question 8

  1. The ICD-10-CM system classifiesmorbidity

    mortality data

    provider services

    supplies and services

2 points

Question 9

  1. 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

    facility write-off

    outpatient fee reduction

    site-of-service differential

2 points

Question 10

  1. The reporting of diagnosis codes on the CMS-1500 claim is necessary to demonstrateaccuracy of the procedure code

    higher payment

    medical necessity

    quality of care

2 points



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