Chapter 1 CPMA Exam Prep Questions
and Answers | 100% Pass
12.1% - Answer-# of improper Medicare Fee-For-Service claim payments,
according to Federal Government.
FFS - Answer-Fee-For-Service
Prepayment Review - Answer-Review of claims prior to payment. Prepayment
reviews result in an initial ...
NCCI Edits are performed by - Answer✔✔-Macs, ZPICs, CERT, and Medicare FFS
Complexity: Non-complex
CMS developed the NCCI to - Answer✔✔-Promote national correct coding methods
and to control improper coding that leads to inappropriate payment in Medicare Part B
claims. NCCI Edits prevent improper payments when incorrect code combinations are
reported. The NCCI Edits are updated quarterly.
The coding policies are based on the following coding conventions... - Answer✔✔-
*American Medical Association (AMA) Current Procedure Terminology (CPT) Manual
*National and local Medicare policies and edits
*Coding guidelines developed by the National societies, standard medical and surgical
practice, and current coding practice.
PTP - Answer✔✔-Procedure-to-Procedure edits
Column One/Column Two edit pair - Answer✔✔-If a claim contains the two codes of
an edit pair, the Column One code is eligible for payment, but CMS will deny the
Column Two code
NCCI edit pairs that are both appropriate - Answer✔✔-If both codes are clinically
appropriate, you must append with an appropriate NCCI-associated modifier to be
eligible for payment.
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