CRCR
Through what document does a hospital establish compliance standards? - Answer-code of conduct
What is the purpose of OIG work plan - Answer-Identify acceptable compliance programs in various
provider settings
If a Medicare patient is admitted on Friday, what service falls within the three day DRG window rule? -
Answer-Non-diagnostic services provided on Thursday through Friday
What does a modifier allow a provider to do? - Answer-Report a specific circumstances that affected a
procedure or service without changing the code or its definition.
If outpatient diagnostic services are provided within three days of an admission of a Medicare
beneficiary on an IPPS (inpatient perspective payment system) hospital, what must happen? - Answer-
They must bill separately to the part B carrier
What is a recurring or series registration? - Answer-One registration record is created for multiple days
of service.
What are non-emergency patients who come for service without prior notification to the provider
called? - Answer-Unscheduled patients
Which of the following statements applies to the observation patient type? - Answer-It is used to
evaluate the need for an inpatient admission.
Through what document does a hospital establish compliance standards? - Answer-code of conduct
What is the purpose of OIG work plan - Answer-Identify acceptable compliance programs in various
provider settings
If a Medicare patient is admitted on Friday, what service falls within the three day DRG window rule? -
Answer-Non-diagnostic services provided on Thursday through Friday
What does a modifier allow a provider to do? - Answer-Report a specific circumstances that affected a
procedure or service without changing the code or its definition.
If outpatient diagnostic services are provided within three days of an admission of a Medicare
beneficiary on an IPPS (inpatient perspective payment system) hospital, what must happen? - Answer-
They must bill separately to the part B carrier
What is a recurring or series registration? - Answer-One registration record is created for multiple days
of service.
What are non-emergency patients who come for service without prior notification to the provider
called? - Answer-Unscheduled patients
Which of the following statements applies to the observation patient type? - Answer-It is used to
evaluate the need for an inpatient admission.
