Answers Graded A+
CPT defines a separate procedure as - Correct answer-Procedure considered an
integral part of a more major service
No combination code available - Correct answer-Use separate codes for
hypertension and acute renal failure
Documentation from the nursing staff or other allied health professionals' notes can
be used to provide specificity for code assignment for which of the following
diagnoses? - Correct answer-Body Mass Index (BMI)
POA Indicator - Y - Correct answer-Y-Yes, present at the time of inpatient
admission
POA Indicator - N - Correct answer-N-No, not present at the time of inpatient
admission
POA Indicator - U - Correct answer-U-Unknown, documentation is insufficient to
determine if condition is present on admission and you cannot speak to the
physician to figure it out
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,POA Indicator - W - Correct answer-W-Clinically undetermined, provider is unable
to clinically determine whether condition was present on admission or not
POA Indicator - E - Correct answer-E-Exempt, unreported/not used, some facilities
will leave these blank, others will use the letter "E"
Present on Admission Indicator (POA) - Correct answer-A Present On Admission
(POA) indicator is required on all diagnosis codes for the inpatient setting except
for admission. The indicator should be reported for principal diagnosis codes,
secondary diagnosis codes, Z-codes, and External cause injury codes.
The use of the outpatient code editor (OCE) is designed to: - Correct answer-
Identify incomplete and incorrect claims
Medicare's identification of medically necessary services is outlined in: - Correct
answer-Local Coverage Determinations (LCDs)
Medically unlikely edits are used to identify: - Correct answer-Maximum units of
service for a HCPCS code
National Correct Coding Initiative (NCCI) Edits are released how often? - Correct
answer-Quarterly
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, In 2000, CMS issued the final rule on the outpatient prospective payment system
(OPPS). The final rule: - Correct answer-Divided outpatient services into fixed
payment groups
Diagnostic-related groups (DRGs) and ambulatory patient classifications (APCs)
are similar in that they are both: - Correct answer-Prospective payment systems
What are APCs? - Correct answer-APCs or "Ambulatory Payment Classifications"
are the government's method of paying facilities for outpatient services for the
Medicare program.
How do APCs work? - Correct answer-The payments are calculated by multiplying
the APCs relative weight by the OPPS conversion factor and then there is a minor
adjustment for geographic location.
APC Status Indicator - C - Correct answer-Inpatient Procedures, not paid under
OPPS
APC Status Indicator - N - Correct answer-Items and Services Packaged into APC
Rates
APC Status Indicator - S - Correct answer-Significant Procedure, Not Discounted
When Multiple
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