Medicare unlikely edits Study guides, Class notes & Summaries

Medical Billing and Coding Latest Update 100% Pass code linkage connection between a service and a patient's condition or illness correct coding initiative (CCI) computerized Medicare system that prevents overpayment edits computerized system that identifies improper or incorrect codes CC1 column 1/ column 2 code pair edit Medicare code edit where CPT codes in column 2 will not be paid if reported in the same way as the column 1 code CCI mutually exclusive code (MEC) edit Bot...

A 6 year-old is seen in the pediatrician office for the first time. He has insurance coverage through both his mother (DOB: 02/08/86 and his father (DOB: 05/15/85). Whose insurance is primary? A. Mother's insurance plan B. Father's insurance plan C. The policy that has the best benefits D. Either mother's or father's insurance plan depending who brings the child in for medical care. - A. Mother's insurance plan Which managed care plan has the patient receiving care from partici...

AAPC CPB - Chapter 7 Review MUE is the acronym for: a. Medicare Unlikely Edits b. Medically Unnecessary Edits c. Medicare Unnecessary Edits d. Medically Unlikely Edits - correct answer d. Medically Unlikely Edits Based on NCCI edits, when a procedure is bundled and has a CCM indicator of 0 - which of the following Modifiers is allowed? a. 51 b. 59 c. 25 d. Modifiers are not allowed - correct answer d. Modifiers are not allowed Which of the following is considered to be an anat...

Medical Coding Questions and Answers Already Passed Healthcare Common Procedure Coding System (HCPCS) Codes used for Medicare and Medicaid. CMS-1500 Paper claim for physician services. CMS-1450 Paper claim for hospital services. Mutually Exclusive Edits Identifies code pairs unlikely to be performed on the same patient on the same day. HCPCS Healthcare Common Procedure Coding System Evaluation and management service. 00100-01999 CPT-Anesthesia V Code ICD-9-CM Used t...

CPMA QUESTIONS AND ANSWERS 2023 B. If documentation supports the service, have the staff contact the carrier to reprocess the claims. Code 33010 was valid for the date of service billed. Rationale: The effective dates of codes are date of service driven. New CPT® codes become effective January 1st of every year. When auditing, verify codes based on the codes that were valid during the date of service. In February 2020, an auditor is asked to review 10 records for date of service 12/1/2019 to...

AAPC CPB - Chapter 7 Review Questions and answers, rated A+ MUE is the acronym for: a. Medicare Unlikely Edits b. Medically Unnecessary Edits c. Medicare Unnecessary Edits d. Medically Unlikely Edits - -d. Medically Unlikely Edits Based on NCCI edits, when a procedure is bundled and has a CCM indicator of 0 - which of the following Modifiers is allowed? a. 51 b. 59 c. 25 d. Modifiers are not allowed - -d. Modifiers are not allowed Which of the following is considered to be an anato...

CPB PRACTICE EXAM QUESTIONS AND ANSWERS, GRADED A+ WHO IS COVERED BY CHAMPVA? A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES B) ACTIVE DUTY MILITARY AND THEIR FAMILIES C) RETIRED MILITARY AND THEIR FAMILIES D) ACTIVE DUTY MILITARY OVER THE AGE OF 65 A) VETERANS WITH SERVICE - CONNECTED DISABILITIES AND THEIR FAMILIES RATIONALE: THE CIVILIAN HEALTH AND MEDICAL PROGRAM OF THE DEPARTMENT OF VETERANS AFFAIRS (CHAMPVA) COVERS VETERANS WHO ARE PERMANENTLY AND TOTALLY...

AAPC CPB - Practice Exam C. Questions and answers, graded A+ ____________ is incorporated by CMS into the NCCI program to limit the number of times a service or procedure can be reported by a physician on the same date of service to a patient. A. Outpatient Code Editor (OCE) B. Medically Unlikely Edits (MUE) C. Physician Fee Schedule D. National Coverage Determination (NCD) - -B. Medically Unlikely Edits (MUE) A "reasonable" charge in UCR is: A. What Medicare deems reasonable B...

CBCS Exam 2023/2024 with Question and 100% Correct Answers. Medical Billing & Coding as a Career - Correct answer-*Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist What are Medical Ethics? - Correct answer-Standards of conduct based on moral principle. They a...

AAPC CPB - Chapter 7 Exam 2024. MUE is the acronym for: a. Medicare Unlikely Edits b. Medically Unnecessary Edits c. Medicare Unnecessary Edits d. Medically Unlikely Edits -ANSWER d. Medically Unlikely Edits Based on NCCI edits, when a procedure is bundled and has a CCM indicator of 0 - which of the following Modifiers is allowed? a. 51 b. 59 c. 25 d. Modifiers are not allowed -ANSWER d. Modifiers are not allowed Which of the following is considered to be an anatomic modifier?...