IHMO CHAPTER 18 ACTUAL TEST|VERIFIED QUESTIONS AND CORRECT DETAILED ANSWERS ALL GRADED +|LATEST UPDATE |GUARANTEED SUCCESS
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IHMO CHAPTER 18
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IHMO CHAPTER 18
IHMO CHAPTER 18 ACTUAL TEST|VERIFIED QUESTIONS AND CORRECT DETAILED ANSWERS ALL GRADED A +|LATEST UPDATE |GUARANTEED SUCCESS
ASC's are healthcare facilities focused on providing - ANSWER-same day surgical care
There are currently 2 types of ASC.s furnishing outpatient services - ANSW...
IHMO CHAPTER 18 ACTUAL
TEST|VERIFIED QUESTIONS AND
CORRECT DETAILED ANSWERS ALL
GRADED +|LATEST UPDATE 2024-
2025|GUARANTEED SUCCESS
ASC's are healthcare facilities focused on providing - ANSWER-✅same day surgical
care
There are currently 2 types of ASC.s furnishing outpatient services - ANSWER-
✅Hospital-based and Independent
When a new patient is registered at the ASC he or she will complete the patient
information form in the _____________ process - ANSWER-✅Preadmission
T/F Conditions that coexist during the episode of care and effect treatment provided
to the patient is referred to as a second diagnosis - ANSWER-✅True
ASC services which are covered under Part B include all but the following - ANSWER-
✅Simple diagnostic testing performed by ASC on the date of service (not covered)
What does ASC stand for - ANSWER-✅Ambulatory Surgery Center (SPELL WORD)
Which modifier is used when an ASC procedure was discontinued after prep for
surgery - ANSWER-✅73
What is the assistance based federal/state program for low income individuals that
pays for healthcare services - ANSWER-✅Medicaid
T/F A fixed amount of money per patient per unit of time, paid in advance to the
ASC for healthcare services is called capitation - ANSWER-✅True
, What does CMS stand for? - ANSWER-✅Centers for Medicare and Medicaid Services
(SPELL WORD)
CMS developed the ________ to promote national correct coding to control
improper coding leading to wrong payment - ANSWER-✅National Correct Coding
Initiative
ASC claims are submitted to Medicare and Medicaid using the ________ claim form
- ANSWER-✅CMS-1500
The global components of a procedure during the global period include - ANSWER-
✅Preoperative - Postoperative - Interoperative
What are the common ASC specialties include - ANSWER-✅Gastroenterology - Pain
management - Orthopedics - Dermatology
Providers furnishing services to Medicare Part B patients are reimbursed via -
ANSWER-✅Medicare Physician Fee Schedule
Payments made to ASC facilities from private insurers are based on what - ANSWER-
✅Negotiated contract
Physicians who render services to Medicare patients in ASC's will bill and receive
separate reimbursement under which part - ANSWER-✅Part B
T/F Services must be reasonable but not necessary to treat patients medical
condition in order to be considered medically necessary - ANSWER-✅False
What does OPPS stand for - ANSWER-✅Outpatient Prospective Payment System
(SPELL WORD)
T/F The revenue cycle of an ASC begins when the patient receives services -
ANSWER-✅False - when registered and scheduled
Hospital outpatient surgery claims are submitted using the ________ claim for -
ANSWER-✅UB-04
In the absence of an NCD a service may be covered at the discretion of Medicare
Administrative Contractor based on what - ANSWER-✅LCD - Local Coverage
Determination
What does HCPCS stand for - ANSWER-✅Healthcare Common Procedure Coding
System (SPELL WORD)
The most common payment model in the United States is the ______ which
prompts patients to pay for individual services after they are received - ANSWER-
✅Fee for service
, When multiple surgical procedures are performed in the same operative session at
the ASC the second surgery will be paid subject to a multiple procedure discount at -
ANSWER-✅50%
Which modifier is required by Medicaid to identify an ASC facility service - ANSWER-
✅SG
What does RVU - ANSWER-✅Relative Value Units (SPELL WORD)
Under the MPFS payment rate is a sign by RCU's that are calculated under which of
the following three factors - ANSWER-✅Physicians work - malpractice expense -
practice expense
The initial diagnosis documented by the surgeon which determined that surgery was
necessary is called the _____ diagnosis - ANSWER-✅preoperative diagnosis
T/F Related services provided during eh surgical session are bundled together and
paid in one lump sum called packaged - ANSWER-✅True
A photocopy of the CMS-1500 claim form that is processed by the insurance carrier
using scanning equipment is not acceptable. - ANSWER-✅True
According to OCR guidelines, all information on the CMS-1500 claim form should be
typed in upper case. - ANSWER-✅True
OCR guidelines for the CMS-1500 claim form state - ANSWER-✅it should not be
photocopied because it cannot be scanned.
An insurance claim submitted with errors is referred to as - ANSWER-✅a dirty claim.
An insurance company may send a copy service to the physician's office to copy a
patient's medical records. - ANSWER-✅True
A group of insurance claims sent at the same time from one facility is known as a -
ANSWER-✅batch.
Encrypted data often look like gibberish to unauthorized users. - ANSWER-✅True
A clearinghouse is a/an - ANSWER-✅entity that receives transmission of insurance
claims, separates the claims, and sends each one electronically to the correct
insurance payer.
Even if a physician's office does not bill Medicare and does not submit transactions
electronically, directly, or through a third party, the practice is still subject to HIPAA
transaction rules. - ANSWER-✅False
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