WGU C784 -APPLIED HEALTHCARE STATISTICS OBJECTIVE
ASSESSMENT #1 NEWEST VERSION 2024-2025 ACTUAL EXAM
COMPLETE
equipment that can withstand repeated use, is primary used to serve a medical
purpose, is used in the patient's home, and would not be used in the absence of illness
or injury. - durable medical equipment (DME)
include artificial limbs, braces, medications, surgical dressings, and wheelchairs -
durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)
branch of medicine that deals with the design and fitting of orthopedic devices -
orthotics
branch of medicine that deals with the design, production, and use of artificial body
parts. - prosthetics
Why did CMS create HCPCS Level II codes? - For services and procedures that will
never be assigned a CPT code and to determine the volumes and costs of newly
implemented technologies
HCPCS Level II codes are developed and maintain by this group, which is composed of
representatives of the major components of CMS, Medicaid State agencies, the VA, and
the Medicare Pricing, Data Analysis and Coding (PDAC) contractors. - CMS HCPCS
Workgroup
What are the 4 types of HCPCS Level II codes? - Permanent national codes,
miscellaneous codes, temporary codes, and modifiers.
for the use of all private and public health insurers. New codes are implemented
annually on Jan 1 - permanent national codes
include miscellaneous/not otherwise classified codes that are reported when a
DMEPOS dealer submits a claim for a product or service for which there is no existing
HCPCS Level II code. Allow DMEPOS dealers to submit a claim for a product or service
as soon as it is approved by the FDA, even though there is no code that describes the
product or service. The usage of these codes helps avoid the inefficiency of assigning
codes for items and services that are rarely furnished or for which payers except to
receive few claims. - miscellaneous codes
What is the medical coding classification system that is used to report services, medical
equipment, and supplies not included in CPT? - HCPCS Level II
, What is designed to quickly direct the coder to drug names and their corresponding
codes in the HCPCS Level II codebook? - Table of Drugs and Biologicals
What is the branch of medicine that deals with the design, production, and use of
artificial body parts? - Prosthetics
What are the HCPCS Level II modifiers used to identify procedures performed on paired
body organs? - LT and RT
national codes; reporting professional services, procedures, supplies, and equipment.
Used to describe common medical services and supplies not classified in CPT. 5
characters in length, and begin with letters A-V, followed by 4 numbers. Identify services
performed by physician and nonphysician providers; ambulance companies; and
durable medical requipment companies. - HCPCS Level II
responsible for providing suppliers and manufacturers with assistance in determining
HCPCS codes to be used. - Medicare Pricing, Data Analysis and Coding (PDAC)
Contractor
What must be provided for use in the review process of miscellaneous codes? -
Complete description of product or service, pricing information for product or service,
and documentation to explain why the item or service is needed by the beneficiary.
allow payers the flexibility to establish codes that are needed before implementation of
the next Jan 1 annual update. Serve the purpose of meeting the short-time-frame
operational needs of a particular payer. - temporary codes
What are the different categories of temporary codes? - C codes, G codes, H codes, K
codes, Q codes, S codes, and T codes
permit implementation of section 201 of the Balanced Budge Refinement Act of 1999,
and they identify items that may qualify for transitional pass-through payments under
the hospital outpatient prospective payment system (OPPS). Used exclusively for OPPS
purposes and are only valid for Medicare claims submitted by hospital outpatient
departments. - C codes
identify professional health care procedures and services that do not have codes
identified in CPT. Reported to all payers. - G codes
reported to state Medicaid agencies that are mandated by state law to establish
separate codes for identifying mental health services - H codes
reported to MACs when existing permanent codes do not include codes needed to
implement a MAC medical review coverage policy - K codes
ASSESSMENT #1 NEWEST VERSION 2024-2025 ACTUAL EXAM
COMPLETE
equipment that can withstand repeated use, is primary used to serve a medical
purpose, is used in the patient's home, and would not be used in the absence of illness
or injury. - durable medical equipment (DME)
include artificial limbs, braces, medications, surgical dressings, and wheelchairs -
durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS)
branch of medicine that deals with the design and fitting of orthopedic devices -
orthotics
branch of medicine that deals with the design, production, and use of artificial body
parts. - prosthetics
Why did CMS create HCPCS Level II codes? - For services and procedures that will
never be assigned a CPT code and to determine the volumes and costs of newly
implemented technologies
HCPCS Level II codes are developed and maintain by this group, which is composed of
representatives of the major components of CMS, Medicaid State agencies, the VA, and
the Medicare Pricing, Data Analysis and Coding (PDAC) contractors. - CMS HCPCS
Workgroup
What are the 4 types of HCPCS Level II codes? - Permanent national codes,
miscellaneous codes, temporary codes, and modifiers.
for the use of all private and public health insurers. New codes are implemented
annually on Jan 1 - permanent national codes
include miscellaneous/not otherwise classified codes that are reported when a
DMEPOS dealer submits a claim for a product or service for which there is no existing
HCPCS Level II code. Allow DMEPOS dealers to submit a claim for a product or service
as soon as it is approved by the FDA, even though there is no code that describes the
product or service. The usage of these codes helps avoid the inefficiency of assigning
codes for items and services that are rarely furnished or for which payers except to
receive few claims. - miscellaneous codes
What is the medical coding classification system that is used to report services, medical
equipment, and supplies not included in CPT? - HCPCS Level II
, What is designed to quickly direct the coder to drug names and their corresponding
codes in the HCPCS Level II codebook? - Table of Drugs and Biologicals
What is the branch of medicine that deals with the design, production, and use of
artificial body parts? - Prosthetics
What are the HCPCS Level II modifiers used to identify procedures performed on paired
body organs? - LT and RT
national codes; reporting professional services, procedures, supplies, and equipment.
Used to describe common medical services and supplies not classified in CPT. 5
characters in length, and begin with letters A-V, followed by 4 numbers. Identify services
performed by physician and nonphysician providers; ambulance companies; and
durable medical requipment companies. - HCPCS Level II
responsible for providing suppliers and manufacturers with assistance in determining
HCPCS codes to be used. - Medicare Pricing, Data Analysis and Coding (PDAC)
Contractor
What must be provided for use in the review process of miscellaneous codes? -
Complete description of product or service, pricing information for product or service,
and documentation to explain why the item or service is needed by the beneficiary.
allow payers the flexibility to establish codes that are needed before implementation of
the next Jan 1 annual update. Serve the purpose of meeting the short-time-frame
operational needs of a particular payer. - temporary codes
What are the different categories of temporary codes? - C codes, G codes, H codes, K
codes, Q codes, S codes, and T codes
permit implementation of section 201 of the Balanced Budge Refinement Act of 1999,
and they identify items that may qualify for transitional pass-through payments under
the hospital outpatient prospective payment system (OPPS). Used exclusively for OPPS
purposes and are only valid for Medicare claims submitted by hospital outpatient
departments. - C codes
identify professional health care procedures and services that do not have codes
identified in CPT. Reported to all payers. - G codes
reported to state Medicaid agencies that are mandated by state law to establish
separate codes for identifying mental health services - H codes
reported to MACs when existing permanent codes do not include codes needed to
implement a MAC medical review coverage policy - K codes
