Question 1

Ambulatory payment classifications are applied to outpatient services that include:

Accepted Answer

A)  implants. 
B)  chemotherapy. 
C)  preventive screenings. 
D)  all of the above. 
A)  implants. 
B)  chemotherapy. 
C)  preventive screenings. 
D)  all of the above.

Question 2

The type of facility that would use the UB-04 claim form includes all of the following EXCEPT:

Accepted Answer

A)  rehabilitation centers. 
B)  physicians' offices. 
C)  outpatient surgical centers. 
D)  skilled nursing facilities. 
A)  rehabilitation centers. 
B)  physicians' offices. 
C)  outpatient surgical centers. 
D)  skilled nursing facilities.

Question 3

If a patient were admitted to the hospital because of an auto accident, an occurrence code would be used to describe the accident.

Accepted Answer

A) True 
 B)False

Question 4

The Diagnosis Related Group (DRG) system is a type of:

Accepted Answer

A)  utilization review system. 
B)  capitation system. 
C)  prospective payment system. 
D)  retrospective payment system. 
A)  utilization review system. 
B)  capitation system. 
C)  prospective payment system. 
D)  retrospective payment system.

Question 5

Most major diagnostic categories (MDCs) are based on:

Accepted Answer

A)  a particular organ system. 
B)  number of diagnoses. 
C)  age of the patient. 
D)  health status of the patient. 
A)  a particular organ system. 
B)  number of diagnoses. 
C)  age of the patient. 
D)  health status of the patient.

Question 6

A patient whose condition permits adequate time to schedule the service is reported as an urgent admission.

Accepted Answer

A) True 
 B)False

Question 7

A case that cannot be assigned an appropriate DRG because of an atypical situation is referred to as a(n) ________.

Accepted Answer

The answer of A case that cannot be assigned an...

Question 8

The UB-04 claim form is considered a summary document and is supported by an itemized or detailed bill.

Accepted Answer

A) True 
 B)False

Question 9

It is the responsibility of the ________ physician to determine the principal diagnosis for his or her patient.

Accepted Answer

The answer of It is the responsibility of the ________...

Question 10

Match the following
-Reimbursement method that pays for actual charges if services are found to be medically necessary

Accepted Answer

A)  condition code 
B)  value code 
C)  revenue code 
D)  per diem 
E)  occurrence code
F) type of bill code
G) source of admission code
H) type of admission code
I) fee for service
J) prospective payment system (PPS) 
A)  condition code 
B)  value code 
C)  revenue code 
D)  per diem 
E)  occurrence code
F) type of bill code
G) source of admission code
H) type of admission code
I) fee for service
J) prospective payment system (PPS)

Question 11

Match the following
-Establishment of the rate of payment for hospital services before services are rendered

Accepted Answer

A)  condition code 
B)  value code 
C)  revenue code 
D)  per diem 
E)  occurrence code
F) type of bill code
G) source of admission code
H) type of admission code
I) fee for service
J) prospective payment system (PPS) 
A)  condition code 
B)  value code 
C)  revenue code 
D)  per diem 
E)  occurrence code
F) type of bill code
G) source of admission code
H) type of admission code
I) fee for service
J) prospective payment system (PPS)

Question 12

A pre-existing condition that, because of its effect on the principal diagnosis, results in more intensive therapy or a longer stay is a(n):

Accepted Answer

A)  chronic condition. 
B)  complication. 
C)  comorbidity. 
D)  exacerbation. 
A)  chronic condition. 
B)  complication. 
C)  comorbidity. 
D)  exacerbation.

Question 13

Hospice care, billed using a UB-04 claim form, can be delivered as:

Accepted Answer

A)  inpatient only. 
B)  outpatient only. 
C)  either inpatient or outpatient. 
D)  ambulatory care. 
A)  inpatient only. 
B)  outpatient only. 
C)  either inpatient or outpatient. 
D)  ambulatory care.

Question 14

An ambulatory surgical center must be affiliated with a hospital in order to operate.

Accepted Answer

A) True 
 B)False

Question 15

Reimbursement methods for inpatient and outpatient hospital services include all of the following EXCEPT:

Accepted Answer

A)  capitation. 
B)  fee for service. 
C)  per diem. 
D)  prospective payment system. 
A)  capitation. 
B)  fee for service. 
C)  per diem. 
D)  prospective payment system.

Question 16

On form locator 10 of the UB-04 form, the patient birth date is:

Accepted Answer

A)  optional. 
B)  required. 
C)  not applicable. 
D)  not required. 
A)  optional. 
B)  required. 
C)  not applicable. 
D)  not required.

Question 17

TRICARE and other private insurance companies that use DRGs use DRG numbers:

Accepted Answer

A)  200-400. 
B)  300-500. 
C)  500-800. 
D)  600-900. 
A)  200-400. 
B)  300-500. 
C)  500-800. 
D)  600-900.

Question 18

A department in a hospital that provides outpatient surgery services is known as the:

Accepted Answer

A)  ambulatory surgical center. 
B)  ambulatory surgical unit. 
C)  hospital surgical center. 
D)  outpatient surgical facility. 
A)  ambulatory surgical center. 
B)  ambulatory surgical unit. 
C)  hospital surgical center. 
D)  outpatient surgical facility.

Question 19

Occurrence codes are used to:

Accepted Answer

A)  determine liability. 
B)  coordinate benefits. 
C)  administer subrogation clauses. 
D)  all of the above. 
A)  determine liability. 
B)  coordinate benefits. 
C)  administer subrogation clauses. 
D)  all of the above.

Question 20

An emergency room physician who admits a patient to the hospital and has no further involvement in the patient's care is referred to as the attending physician.

Accepted Answer

A) True 
 B)False

Ambulatory payment classifications are applied to outpatient services that include:

The type of facility that would use the UB-04 claim form includes all of the following EXCEPT:

If a patient were admitted to the hospital because of an auto accident, an occurrence code would be used to describe the accident.

The Diagnosis Related Group (DRG) system is a type of:

Most major diagnostic categories (MDCs) are based on:

A patient whose condition permits adequate time to schedule the service is reported as an urgent admission.

A case that cannot be assigned an appropriate DRG because of an atypical situation is referred to as a(n) ________.

The UB-04 claim form is considered a summary document and is supported by an itemized or detailed bill.

It is the responsibility of the ________ physician to determine the principal diagnosis for his or her patient.

Match the following -Reimbursement method that pays for actual charges if services are found to be medically necessary

Match the following -Establishment of the rate of payment for hospital services before services are rendered

A pre-existing condition that, because of its effect on the principal diagnosis, results in more intensive therapy or a longer stay is a(n):

Hospice care, billed using a UB-04 claim form, can be delivered as:

An ambulatory surgical center must be affiliated with a hospital in order to operate.

Reimbursement methods for inpatient and outpatient hospital services include all of the following EXCEPT:

On form locator 10 of the UB-04 form, the patient birth date is:

TRICARE and other private insurance companies that use DRGs use DRG numbers:

A department in a hospital that provides outpatient surgery services is known as the:

Occurrence codes are used to:

An emergency room physician who admits a patient to the hospital and has no further involvement in the patient's care is referred to as the attending physician.

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters

Exam 11: Hospital Medical Billing

Ambulatory payment classifications are applied to outpatient services that include:

The type of facility that would use the UB-04 claim form includes all of the following EXCEPT:

If a patient were admitted to the hospital because of an auto accident, an occurrence code would be used to describe the accident.

The Diagnosis Related Group (DRG) system is a type of:

Most major diagnostic categories (MDCs) are based on:

A patient whose condition permits adequate time to schedule the service is reported as an urgent admission.

A case that cannot be assigned an appropriate DRG because of an atypical situation is referred to as a(n) ________.

The UB-04 claim form is considered a summary document and is supported by an itemized or detailed bill.

It is the responsibility of the ________ physician to determine the principal diagnosis for his or her patient.

Match the following -Reimbursement method that pays for actual charges if services are found to be medically necessary

Match the following -Establishment of the rate of payment for hospital services before services are rendered

A pre-existing condition that, because of its effect on the principal diagnosis, results in more intensive therapy or a longer stay is a(n):

Hospice care, billed using a UB-04 claim form, can be delivered as:

An ambulatory surgical center must be affiliated with a hospital in order to operate.

Reimbursement methods for inpatient and outpatient hospital services include all of the following EXCEPT:

On form locator 10 of the UB-04 form, the patient birth date is:

TRICARE and other private insurance companies that use DRGs use DRG numbers:

A department in a hospital that provides outpatient surgery services is known as the:

Occurrence codes are used to:

An emergency room physician who admits a patient to the hospital and has no further involvement in the patient's care is referred to as the attending physician.

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Auditing

Physician Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters