question

The Medicare program was established in?

answer

1965

question

Medicare Part A pays for?

answer

hospital/facility care

question

Medicare Part B pays for?

answer

physician services and durable medical care

question

Who handles the day-to-day operation of the Medicare program for CMS?

answer

MACs

question

Medicare pays for what percentage of covered charges?

answer

80%

question

The incentive to Medicare participating providers is?

answer

*All of the above*, 1)Direct payment on all claims 2) Faster processing 3) A 5% higher fee schedule

question

Part B services are billed using?

answer

ICD-10-CM, CPT, HCPCS

question

Who is the largest third-party payer in the nation?

answer

The government

question

A major change took place in Medicare in __________ with the enactment of the Omnibus Budget Reconciliation Act.

answer

1989

question

The physician fee schedule is updated each April 15 and is composed of?

answer

*All of the Above* 1) The relative value units for each service 2)A geographic adjustment factor to adjust for regional variations in the cost of operating a health care facility 3)A national conversion factor

question

If the surgeon performs more than one procedure on the same patient on the same day, and discounts were made on all subsequent procedures, Medicare would pay what percentages for the first, second, third, fourth, and fifth procedures?

answer

100%, 50%, 50%, 50%, 50%

question

Medicare sets payment level for assistant surgeons at a percentage of the fee schedule amount for the ______ surgical fees?

answer

gobal

question

What edition of the Federal Register would hospital facilities be especially interested in?

answer

October

question

What edition of the Federal Register would outpatient facilities be especially interested in?

answer

November and December

question

What are the three items that the Medicare beneficiaries are responsible for paying before Medicare will begin to pay for services?

answer

Deductibles, Premiums, and Coinsurance

question

CMS handles the daily operation of the medicare program through the use of _________ formerly Fiscal Intermediaries?

answer

Medicare Administrative Contractors

question

Medicare funds are collected by?

answer

Social Security Administration

question

Which of the following is Not a stated goal of the Physician Payment Reform?

answer

Limit provider liabilities

question

If a QIO provider renders a covered service that costs $100 and bills Medicare for the service and Medicare allowed $58, the provider would bill this amount to the patient?

answer

$0

question

The Medicare Prescription Drug, Improvement, and Moderation Act of 2003 established these new benefits available under the Medicare program?

answer

Part D

question

This program is also known as Medicare Advantage?

answer

Part C

question

________ are activities involving the transfer of health care information and ________ means the movement of electronic data between two entities and the technology that supports the transfer.

answer

Transactions, Transmission

question

This maps ICD-9 codes to ICD-10-CM codes?

answer

GEMs

question

Which of the following is true about ICD-10-CM?

answer

There are combination diagnosis/symptom codes.

question

The following are characteristics of the ICD-10-CM index?

answer

*All of the above* -Main terms in bold type -Subterms are indented under the main term -Only the first four characters of some codes are given

question

Which organizaton has been responsible for the development of ICD-10-CM?

answer

NCHS

question

The maximum number of characters in an ICD-10-CM code is?

answer

7

question

A combination code is a single code used to classify?

answer

*All of the above* -Two diagnoses -A diagnosis with an associated secondary process (manifestation) -A diagnosis with an associated complication

question

The following statements is true regarding late effects?

answer

*All of the above* -There is no time limit for the development of a residual -A patient may devepole more than one residual -A residual may occur months after an injury

question

The correct reporting for acute cholecystitis with cholelithiasis with obstruction?

answer

K80.01

question

The correct reporting for stage IV chronic kidney disease associated with diabetes mellitus, type two?

answer

E11.22, N18.4

question

The correct reporting for Staphyloccus pneumonia?

answer

J15.20

question

The correct reporting for COPD with chronic bronchitis and emphysema?

answer

J44.9

question

The correct reporting for hypertensive left heart failure?

answer

I11.0, I50.1

question

The correct reporting for a pathological fracture of the left femur, due to neoplastic bone disease initial encounter?

answer

M84.552A, D49.2

question

The correct reporting for chronic tonsillitis and hypertrophy of the tonsils?

answer

J35.01

question

CMS

answer

Centers for Medicare and Medicaid Services

question

QIO

answer

Quality Improvement Organizations

question

RBRVS

answer

Resource Based Relative Value Scale

question

OBRA

answer

Omnibus Budget Reconciliation Act

question

MAAC

answer

Maximum Actual Allowable Charge

question

RVU

answer

Relative Value Unit

question

OIG

answer

Office of the Inspector General

question

DHHS

answer

Department of Health and Human Services

question

Corneal ulcer with hypopyon of left eye ICD-10-CM Code?

answer

H16.032

question

Screening for respiratory tuberculosis ICD-10-CM Code?

answer

Z11.1

question

Long term (current) use of systemic steroids ICD-10-CM Code?

answer

Z79.52

question

Long term (current) use of aspirin ICD-10-CM Code?

answer

Z79.82

question

Preoperative examination for a patient who will revieve a renal transplant due to ESRD, currently on dialysis ICD-10-CM Codes?

answer

Z01.818, N18.6, Z99.2

question

A multigravida 48 year old patiet presents for routine prenatal visit, first trimester. No complications are noted ICD-10-CM Code?

answer

O09.521

question

Encounter for blood type testing prior to surgery ICD-10-CM Code?

answer

Z01.83

question

Exposure to German measles ICD-10-CM Code?

answer

Z20.4

question

Patient admitted to observation following a highway accident in which he was the driver of the car that was struck by another car. No injuries indicated during this initial encounter ICD-10-CM Code?

answer

Z04.1, V43.52xA

question

Screening coloscopy for colon cancer ICD-10-CM Code?

answer

Z12.11

question

Established patient presents with chest pain. He has a history of previous myocardial infarction and coronary artery bypass surgery? (ID first listed diagnosis)

answer

Chest Pain

question

Initial office visit for patient with nausea and vomiting. Physician documented the nausea and vomiting were due to acute appendicitus (ID first listed diagnosis)

answer

Acute Appendicitis

question

Established patient seen for redness and sensitivity to light in her right eye. The documentation states the diagnosis is iritis. (ID first listed diagnosis)

answer

Iritis

question

An established patient is seen for management of diabetes and hypothyroidism and the physician spends equal time on each diagnosis (ID first listed diagnosis)

answer

Diabetes, hypothyroidism

question

An established patient is seen for migrains and seizures, to rule out the possiblility of a brain tumor.

answer

Migraines, seizures

question

Acute and Chronic systolic (congestive) heart failure ICD-10-CM Code?

answer

I50.23

question

Acute and Chronic respiratory failure ICD-10-CM Code?

answer

J96.20

question

Primary Hypertension ICD-10-CM Code?

answer

I10

question

Hypertensive heart disease NOS ICD-10-CM Code?

answer

I11.9

question

Pseudocyst of the pancreas ICD-10-CM Code?

answer

K86.3

question

Acute and chronic prostatitis due to Escherichia Coli bacterial infection ICD-10-CM Code?

answer

N41.0, N41.1, B96.2

question

Subsequent encounter for malunion of displaced fracture of shaft of the first metacarpal bone, right hand ICD-10-CM Code?

answer

S62.241P

question

Right and left inguinal hernia ICD-10-CM Code?

answer

K40.20

question

Aphasia and cognitive defects, as a result of nontraumatic intracranial hemorrhage ICD-10-CM Code?

answer

I69.220, I69.21

question

Sunsequent encounter for a joint injection for a patient with acute pain due to a sprained right acromioclavicular joint ICD-10-CM Code?

answer

G89.11, S43.51xD

question

Chronic ostemyelitis with draining sinuses of right first tow due to Staphylococcus aureus ICD-10-CM Code?

answer

M89.471, B95.61

question

Osteoarthritis of both knees with pain and swelling ICD-10-CM Code?

answer

M17.0

question

Bilateral carotid Stenosis ICD-10-CM Code?

answer

I65.23

question

Rubella meningoencephalitis ICD-10-CM Code?

answer

B06.01

question

Arteriosclerosis of native arteries of the left leg with gangrene ICD-10-CM Code?

answer

I70.262

Coding Test Ch 1-4 (Med 140) – Flashcards

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