Exam 18: Hospital Billing and the UB-04

The book discussed two relatively new rules that will affect hospital coding in the near future.What are they?

A range of medical and/or social services designed for people with disabilities or chronic care needs and provided in a person's home,in the community,or in residential facilities (e.g.,nursing homes or assisted living facilities)is referred to as:

A medical facility smaller than a hospital,generally providing only outpatient services,and typically run by a government agency or a private physician partnership is commonly referred to as a/an:

All rules about how much Medicare Part A pays depend on how many days of inpatient care the beneficiary has during what is called a/an:

Commercial and private insurers typically negotiate contracts establishing inpatient payment methods on a month-to-month basis.

ICD-9-CM Volume 3 is used to assign codes to inpatient hospital procedures.

The letters O and I are not valid values in the ICD-10-PCS coding structure.

When registering for hospital admission,patients typically must provide certain personal information.List at least six of these informational items.

ICD-10-PCS has a ____________________,with each code character having the same meaning within the specific procedure section and across procedure sections to the extent possible.

The hospital billing process begins when the patient is admitted to the facility.

Key elements or words in the patient's hospital health record that identify the medical condition that was ultimately determined,after study,to have caused a patient's admission to the hospital is called the _____ diagnosis.

Discuss the purpose of the new HIPAA edit.

When a medical facility is composed of a single building or campus having a large number of beds,specialized facilities for various care types,and an emergency department,it is referred to as a:

List at least five emerging healthcare trends that are affecting the way healthcare is delivered in terms of cost and customer satisfaction.

ASCs are among the more loosely regulated healthcare facilities.

A nonavailability statement (NAS)is necessary for all TRICARE- and CHAMPVA-covered outpatient procedures.

Explain what a "covered entity" is and list three examples of organizations that fall under this classification.

A facility offering inpatient,overnight care,and services for observation,diagnosis,and active treatment of patients and requiring the daily direction or supervision of a physician is a/n:

When coding inpatient diagnoses,the correct manual(s)to use is/are the:

Hospitals must submit electronic claims in a format that is HIPAA compliant.