CDEO Chapter 7 Exam Study Guide with Complete Solutions

CDEO Chapter 7 Exam Study Guide with Complete Solutions RBRVS - Answer️️ -Resource-Based Relative Value Scale RBRVS System - Answer️️ -Established by Medicare to reimburse physicians based on CPT code submitted for reimbursement RVU - Answer️️ -Each CPT code has an assigned relative value unit which, when multiplied by conversion factor and a geographic region allowance , creates the reimbursement for the medical service the CPT code represents RVU Components - Answer️️ -1) Physician work- time, skill, training, and intensity of service provided 2) Practice Expense - reflects the cost of ancillary personnel, supplies, and overhead 3) Professional Liability Malpractice Insurance Using RBRVS - Answer️️ -CMS annually publishes Physician Fee Schedule information on its website and posts the formula for calculating physician fee schedule amounts. Physician Fee Amounts - Answer️️ -vary depending on facility vs non-facility Facility Practice RVU - Answer️️ -expenses include services performed in emergency rooms , hospitals, SNFs, nursing homes, ASC. ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Monday, September 2, 2024 12:59 PM Page | 2 Non Facility RVUs - Answer️️ -include services performed in non-hospital owned physician practices and privately owned practices. GPCI - Answer️️ -Geographic Practice Cost Index Geographic Prctice Cost Index - Answer️️ -is used to realize the varying cost based on geographic location CF - Answer️️ -Converstion Factor Conversion Factor - Answer️️ -this is a fixed dollar amount used to translate the RVUs into fees Other Health Plans - Answer️️ -other than Medicare may choose not to use the CMS calculations to determine provider reimbursement Global Surgery Package - Answer️️ -The time, effort, and services required to complete a procedure are bundled together to form a surgery package . Payment is made for a package of services and not each individual service provided within the package. CPT Surgery Package Description - Answer️️ -* Subsequent tot he decision for surgery, E?M Services on the date immediately prior to or on the date of the procedure including H&P *Local Anesthesia: defined as local infiltration, metacarpal/metatarsal/digital block, or topical anesthesia * Operation Itself ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Monday, September 2, 2024 12:59 PM Page | 3 * Immediate Post-Operative Care, including dictation of operative notes, talking with family and other physicians * Writing Orders * Evaluation of patient post-anesthesia recovery * Normal, uncomplicated follow-up care Minor Surgical Procedures - Answer️️ -defined by Medicare as a service that has 0-10 day postoperative period. Payment for minor procedures includes same-day services or postoperative care, intraoperative care, and care within the global period. Major Surgical Procedures - Answer️️ -defined as having a