Exam 17: Hospital Billing

The patient care representative should obtain a copy of the front and back of the patient's health identification card, but a copy of the driver's license is optional.

____________________ are used for CPT and HCPCS codes to modify or provide more detailed information on the procedure and/or medical supply.

One AEP criterion that needs to be met to certify severity of illness (SI) in an admission is

Confidential information about patients should never be discussed with

The significant reason for patient admission to the hospital is coded as the

On the CMS 1450 (UB-04) claim form, the second digit of the four-digit bill code in Field 4 indicates the type of ____________________.

The hospital department that conducts an admission and concurrent review on all cases and prepares a discharge plan to determine whether admissions are justified is called the ____________________ department.

On the CMS 1450 (UB-04) claim form, the patient's date of birth should be entered using six digits in block 14.

______________________ are DRG cases that cannot be assigned properly because of an atypical situation.

The __________________________________________________ is used to list procedural codes for Medicare patients on hospital insurance claims that are not in the CPT book.

An unethical practice of upcoding a patient's DRG category for a more severe diagnosis to increase reimbursement is called _____________________.

Match the type of reimbursement method with the correct description below. -An interim per diem is paid for each day in the hospital.