Exam 18: Hospital Billing and the UB-04

Not all hospitals are accredited by nationally recognized accrediting agencies.

A level of maintenance care used when there is no urgent or life-threatening condition that requires medical treatment is called subacute care.

The 72-hour rule states that all services provided for Medicare patients within 72 hours of hospital admission are considered part of the inpatient services and billed on one claim.

The same prospective payment system used for TRICARE and CHAMPVA payments is used in calculating Medicare payments.

The service in which trained professionals or volunteers come into the home to provide short-term care for an older person to allow regular caregivers some time away from their caregiving role is called:

The designated spaces on the UB-04 are commonly called:

As opposed to referring to today's healthcare consumers as patients,some may be more responsive to being referred to as:

Patients who have not already seen a healthcare provider are usually not treated in an ASC.

The type of facility where surgeries are performed that do not require hospital admission is a/an:

All state Medicaid programs use the same method to determine payment for hospital inpatient services.

The types of accommodations offered by most of today's hospitals are:

When the ICD-10 coding system is officially in place,ICD-10-PCS will be used for reporting inpatient diagnoses only.

Preauthorization is not necessary for inpatient hospitalization;however,it is for all outpatient procedures and diagnostic testing.

An independent,nonprofit organization that assesses and reports on the quality of care offered by managed care plans is:

Like ICD-10-CM codes,ICD-10-PCS codes contain _____ characters,which can be numbers or letters and are based on the type of procedure performed,the approach,body part,and other characteristics.

When the DRG rate does not apply,CHAMPVA pays _____% of the billed amount for covered services and supplies.

As required by law,all general acute-care healthcare providers must identify whether a diagnosis was present upon an inpatient admission.

An organization involved with ambulatory healthcare accreditation and that serves as an advocate for the provision and documentation of high-quality health services in ambulatory healthcare organizations is:

State rules and regulations establish health and safety standards for licensed hospitals within a specific state.

Facilities where surgeries that do not require hospital admission are performed are called ambulatory surgery centers (ASCs).