Medicaid
How often should we check patients' Medicaid eligibility?
Each time an appointment is made.
Outpatient hospital benefits are provided under
Medicare Part B.
Where do we look up drugs and chemicals?
Table of Drugs and Chemicals
What is the RBRVS nationally uniform relative value based on?
the provider's work, practice cost, and malpractice insurance costs.
CPT codes are used to report the following
medical services.
diagnostic procedures.
surgical procedures.
To receive federal matching funds, what must states cover?
vaccines for children.
emergency services.
prenatal care.
Physicians who participate in the Medicare program must
accept assignment and file claims for beneficiaries.
Where do we find disease descriptions?
Alphabetic Index
The connection between a billed service and a diagnosis is called:
Code Linkage
When selecting an Evaluation and Management code, what three components are considered?
the type of history, the physical examination, and the medical decision making.
Categorically needy people in the Medicaid program usually have
Low Incomes
Who is automatically enrolled in Medicare Part A and eligible for Medicare Part B?
Anyone over age 65 who receives Social Security benefits
A subcategory code in ICD-10-CM is how many characters?
four to five
Payer of last resort
Medicaid
In CPT, E/M is the abbreviation for
Evaluation / Managment
A screening service is defined as one that is
done to discover if a patient has an undiagnosed disease.
advance beneficiary notice.
ICD-10-CM diagnosis coding has as little as __________ and as many as __________ characters.
three; seven
possible consequences of inaccurate coding and incorrect billing
denied claims and reduced payments.
fines.
prison sentences.
coding system that describes specific products, supplies, and services that patients receive
HCPCS
Patient required to see a specific physician and/or use a specific pharmacy is _______ Status
restricted
Medicare Advantage is under which part of Medicare?
Part C
provides code numbers for neoplasms based on their anatomical site and divided by the description
Neoplasm table
What type of coding uses a procedure code that provides a higher reimbursement rate than the correct code?
upcoding
The divisions of CPT, such as Anesthesia and Radiology, are referred to as
sections