Ub 04 - Study guides, Class notes & Summaries

3-Day Rule - ANSWER Medicare regulation requiring that certain outpatient services within 72 hours of an inpatient admission must be included in the patient's inpatient claim and reimbursed under a DRG. 8371 - ANSWER HIPAA standard transaction used by hospitals to submit claims electronically. 837P - ANSWER HIPAA standard transaction that replaces the 1500 and is required of almost all physicians. 838 - ANSWER quarterly Medicare Credit Balance Report 1450 - ANSWER CMS 1450 form; ano...

Medicare payment for inPt eligible new tech is based on the cost to the hospital for the new tech. Medicare pays: 50% for the costs of the new tech in excess of the full MS-DRG payment Medicare reimbursable drugs are found in this code book. HCPCS Level II Rationale: Medicare reimbursable drugs are found in the HCPCS Level II code book. Medicare reimbursable drugs must be billed in the appropriate dosage amount defined by the long descriptor of their respective HCPCS Level II codes and ...

The correct answer has been verified, selected and highlighted in yellow for all of the questions below.) 1 What form is used to submit a provider’s charge to the insurance carrier? a. ABN b. UB-04 c. CMS-1500 d. Provider reimbursement form 2 AAPC credentialed coders have proven mastery of what information? a. Code sets b. Evaluation and management principles c. Documentation guidelines d. All of the above 3 When coding an operative report, what action would NOT be recommended? a. ...

Facility fee billing- HOPPS- used for nonmedicare B recognized provider who is employed or contrated by hospital health system supervising physician must be the in the BUILDING APC Code 5012 with G0463 "Incident to" or Clinic Billing- Must be in the same SUITE or office CMS Annual Wellness Visit - Initial Preventive Physical Exam only by physician or NP/PA::: NOT PHARMACIST G0402 CMS AWV Initial- can be done by pharm G0438 CMS AWV Follow-up G0439 For...

b) artificial plants and floral arrangements for aesthetics Correct Answer: When creating a reception area for a pediatric clinic, which of the following items should the MA include? a) accessible coffee and tea b) artificial plants and floral arrangements for aesthetics c) stuffed animals and small building blocks d) scented candles to mask odors a) numeric Correct Answer: Which of the following medical record filing systems protects patient's privacy and allows for unlimited expans...

Place of Service Correct Answer: Billing and coding specialists should first divide the E & M Code by Privacy Officer Correct Answer: Compliant with HIPPA the following position should be assigned in each office Principal Diagnosis Correct Answer: Coding on the UB-04 Form, must sequence the diagnosis code. Which is the first listed diagnosis? Urethratresia Correct Answer: Obstruction of the urethra is UB04 Forms Correct Answer: Ambulatory surgery centers, home health center, and hos...

b) artificial plants and floral arrangements for aesthetics - Answer-When creating a reception area for a pediatric clinic, which of the following items should the MA include? a) accessible coffee and tea b) artificial plants and floral arrangements for aesthetics c) stuffed animals and small building blocks d) scented candles to mask odors a) numeric - Answer-Which of the following medical record filing systems protects patient's privacy and allows for unlimited expansion in a high-vo...

AAPC CPB - Chapter 8 ExamWhich statement is TRUE regarding condition codes for the UB-04 claim form? Selected Answer: d. a. A condition code identified the department for the revenue of the procedure. b. Condition codes are listed in the order of occurrence instead of numerical order. c. Condition codes are reported only on the CMS-1500 claim form. d. A condition code is used to indicate an inpatient service is reported on an outpatient claim. - correct answer d. A condition code is used ...

CRCR Certification Exam Study Guide | Questions with 100% Correct Answers | Latest Update 2024 | Verified Overall aggregate payments made to a hospice are subject to a computed "cap amount" calculated by - The Medicare Administrative Contractor (MAC) at the end of the hospice cap period Which of the following is required for participation in Medicaid - Meet Income and Assets Requirements In choosing a setting for patient financial discussions, organizations should first and foremost - ...

3-Day Rule correct answer: a requirement that all diagnostic or outpatient services furnished in connection with the principle admitting diagnosis within three days prior to the hospital admission are bundled with the inpatient services for Medicare billing 837I correct answer: the American National Standards Institute transaction for an institutional claim; as a result of HIPAA, it is replacing the electronic UB-04. 837P correct answer: a former American National Standards Institute tr...