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NUR 613 Test 1 Questions And Correct Answers
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NUR 613 Test 1 Questions And Correct Answers...
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NUR 613 Test 1 Questions And Correct AnswersUnder which act is the NPI required? - ANSWER HIPAA
Who administers the NPI? - ANSWER CMS
How many numbers is the NPI? - ANSWER 10 - intelligence free
Who do you have to share your NPI with? - ANSWER Other providers, health plans,
clearinghouses, and any entity that may need it for billing purposes
What do you need to have to apply for an NPI? - ANSWER an APN license
Do you need a new NPI number if you change practice states? - ANSWER No
Where is the NP scope of Practice found? - ANSWER Nurse practice act and is state
regulated
Steps for credentialing with insurance companies - ANSWER 1. Get NPI number
2. Decide which applications you need: CMS
3. Apply
Components of RAF - ANSWER Age, Sex, disability, medicaid status, institutionalization,
frailty, HCC coding
What does HCC stand for? - ANSWER Hierarchical Condition Categories
, HCC top conditions - ANSWER DM, CHF, asthma, and pulmonary disease, major
depressive and bipolar disorders, rheumatoid arthritis, specific heart arrhythmias,
breast, colon and kidney cancers
How do you determine which level to bill - ANSWER number and types of problems
addressed
complexity of establishing a diagnosis
management decisions made
documentation specifics
99211 - ANSWER doesn't require presence of a provider minimal problem, 5 minutes
99212 - ANSWER Problem-focused history + exam, straightforward medical decision
Requires 2 of 3 components
problem self limiting/minor, 10 minutes
99213 - ANSWER Expanded problem focused history and exam, low complexity medical
decision
Requires 2 of 3 key components
Continued symptoms or extended issue, 15 min
99214 - ANSWER Presenting problem mod- high intensity
Requires 2 of 3 key components (detailed)
Individual symptoms - full clinical picture
25 minutes
99215 - ANSWER Comprehensive history + exam, high complexity medical decision
Assessment is broad in scope or content, extensive understanding of patient's condition
Requires 2 of 3 key components ( comprehensive)
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