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AHIMA CCA: Reimbursement Methodologies questions and answers rated A+ 2025/2026
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AHIMA CCA: Reimbursement Methodologies questions and answers rated A+ 2025/2026
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AHIMA CCA: ReimbursementMethodologies
1. Given the subsequent statistics, which of the following statements is accurate?
191, MCD: 04, Type: MED MS-DRG, Title: Chronic obstructive pulmonary disease w/ CC,
Weight: zero.9757, Discharges: 10, Geometric Mean: 4.1, Arithmetic Mean: 5.0,
192, MCD: 04, Type: COPD w/o CC/MCC, Weight: 0.7254, Discharges: 20, Geometric Mean:
3.Three, Arithmetic Mean: four.0
193, MCD: 04, Type: MED, Weight: Simple pneumonia & pleurisy w/ MCC, Weight: 1.4327,
Discharges: 10, Geometric Mean: five.Four, Arithmetic Mean: 6.7
194, MCD: 04, Type: MED, MS-DRG Title: Simple pneumonia & pleurisy w/ CC, Weight: 1.0056,
Discharges: 20, Geometric Mean: 4.4, Arithmetic Mean: five.Three
195, MCD: 04, Type: MED, MS-DRG Title: Simple pneumonia & pleurisy w/o CC/MCC, Weight:
zero.7316, Discharges: 10, Geometric Mean: 3.Five, Arithmetic Mean: four.1
a. In every MS-DRG the geometric imply is decrease than the mathematics imply.
B. In each MS-DRG the arithmetic mean is decrease than the - ANSa. In every MS-DRG the
geometric mean is decrease than the mathematics mean.
The GEOMETRIC MEAN LOS is define as the whole days of service, apart from any outliers or
transfers, divided by using the entire quantity or sufferers.
2. If every other repute T technique have been performed, how a good deal might the facility
acquire for the second one repute T technique?
998323-billing#, V-reputation indicator, 99285-25-CPT/HCPCS, 0612-APC.
998324-billing#, T-repute indicator, 25500-CPT/HCPCS, 0044-APC.
998325-billing#, X-fame indicator, 72050-CPT/HCPCS, 0261-APC.
998326-billing#, S-popularity indicator, 70450-CPT/HCPCS, 0283-APC.
, 998327-billing#, S-fame indicator, 70450-CPT/HCPCS, 0283-APC
a. 0%
b. 50%
c. Seventy five%
d. A hundred% - ANSb. 50%
Multiple surgical procedures with charge reputation indicator T performed throughout the
identical operative consultation are discounted. The highest-weighted manner is fully
reimbursed. All different techniques with charge fame indicator T are reimbursed at 50%.
3. A health records technician is processing bills for health center outpatient services to be
reimbursed by using Medicare for a affected person who had two doctor visits, underwent
radiology examinations, clinical laboratory assessments, and who acquired take-domestic
surgical dressings. Which of the following offerings is reimbursed under the outpatient
prospective price device?
A. Clinical laboratory checks
b. Physician office visits
c. Radiology examinations
d. Take-domestic surgical dressings - ANSc. Radiology examinations
Radiology processes are recognized below the outpatient angle charge machine with a standing
indicator X. Status indicator X identifies ancillary services which are one by one paid .
4. Which of the subsequent varieties of hospitals are excluded from the Medicare inpatient
prospective charge gadget?
A. Children's
b. Rural
c. State supported
d. Tertiary - ANSa. Children's
Psychiatric and rehabilitation hospitals, lengthy-time period care hospitals, kid's hospitals,
cancer hospitals, and crucial get admission to hospitals are paid on the basis of affordable
value, challenge to payment limits consistent with discharge or below separate PPS.
5. Diagnosis-related agencies are organized into:
a. Case-mix classifications
b. Geographic practice cost indices
c. Major diagnostic categories
d. Resource-based totally relative values - ANSc. Major diagnostic categories
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