Exam 12: Hospital Medical Billing

A charge description master includes all of the following information EXCEPT: A)procedure code. B)procedure or service description. C)charge. D)physician identification number.

Comorbidity may affect payment if the condition causes an increase in hospital length of stay by at least 2 days in approximately 50% of cases.

Inpatient care refers to a hospital confinement of more than 24 hours.

For Medicare services, the type of bill code in form locator 4 must include four digits.

The type of facility that would use the UB-04 claim form includes all of the following EXCEPT: A)rehabilitation centers. B)physicians' offices. C)outpatient surgical centers. D)skilled nursing facilities.

In urgent care situations, there is no risk of the patient losing life or limb.

To signify that a patient was discharged from the hospital at midnight, which code would be entered in form locator 16 on the UB-04? A)00 B)12 C)24 D)99

A case that involves a unique combination of diagnoses and procedures that result in higher-than-usual costs is designated as a cost outlier.

On form locator 10 of the UB-04 form, the patient birth date is: A)optional. B)required. C)not applicable. D)not required.

A condition code would be used to describe a situation in which neither the patient nor the spouse is employed.

The UB-04 claim form is required by all private payers and is accepted by the Centers for Medicare and Medicaid Services (CMS).

The number assigned to a patient upon admission to the hospital is the __________ number.

The Ambulatory Payment Classification (APC) system bases payments on: A)usual fees. B)procedures. C)diagnoses. D)number of days.

The four main sections of the UB-04 claim form include all of the following EXCEPT: A)patient information. B)billing information. C)physician information. D)diagnosis information.

What types of institutional facilities use the UB-04 claim form?

When is ICD-9-CM Volume 3 used?

The hospital database that contains information on all admitted patients is the __________ index.

Services covered under the Ambulatory Payment Classification (APC) system include all of the following EXCEPT: A)outpatient surgical procedures. B)inpatient surgical procedures. C)emergency department visits. D)diagnostic services.

The list of Ambulatory Payment Classification (APC) rates is maintained by: A)the American Medical Association (AMA). B)the Blue Cross/Blue Shield Association. C)the Centers for Medicare and Medicaid Services (CMS). D)contracted health plans.

Per diem is a type of reimbursement that pays a fixed rate per day for all services provided by a hospital.