CCS EXAM - MEDICAL BILLING AND
REIMBURSEMENT SYSTEM QUESTIONS
AND CORRECT ANSWERS (100%
VERIFIED ANSWERS) | SCORED A+ |
LATEST UPDATE 2025
The prospective payment system used to reimburse home health agencies -
ANSWERS OASIS (Outcome and Assessment Information Set).
Home Health Agencies (HHAs) utilize a data entry software system called -
ANSWERS HAVEN (Home Assessment Validation and Entry)
These are assigned to every HCPCS/CPT code under the Medicare hospital
outpatient prospective payment system to identify how the service or procedure
described by the code would be paid - ANSWERS payment status indicator
When the MS-DRG payment received by the hospital is lower than the actual
charges for providing the inpatient services for a patient with Medicare, then the
hospital - ANSWERS absorbs the loss; this is commonly known as a write-off.
Code used to identify the procedure, service, or treatment - ANSWERS
HCPCS/CPT code
, The following type of hospital is considered excluded when it applies for, and
receives, a waiver from CMS. This means that the hospital does not participate in
the inpatient prospective payment system (IPPS) - ANSWERS cancer hospital
The prospective payment system used to reimburse hospitals for Medicare
hospital outpatients is called - ANSWERS APCs
This is a 10-digit, intelligence-free, numeric identifier designed to replace all
previous provider legacy numbers. This number identifies the physician universally
to all payers. This number is issued to all HIPAA-covered entities. It is mandatory
on the CMS-1500 and UB-04 claim forms - ANSWERS National Provider
Identifier (NPI)
This prospective payment system replaced the Medicare physician payment
system of "customary, prevailing, and reasonable (CPR)" charges whereby
physicians were reimbursed according to their historical record of the charge for
the provision of each service - ANSWERS Medicare Physician Fee Schedule
(MPFS)
Under APCs, payment status indicator "V" means - ANSWERS clinic or
emergency department visit (medical visits)
When a provider, knowingly or unknowingly, uses practices that are inconsistent
with accepted medical practice and that directly or indirectly result in unnecessary
costs to the Medicare program, this is called - ANSWERS abuse
When a patient is discharged from the inpatient rehabilitation facility and returns
within three calendar days (prior to midnight on the third day) this is called a(n) -
ANSWERS interrupted stay
REIMBURSEMENT SYSTEM QUESTIONS
AND CORRECT ANSWERS (100%
VERIFIED ANSWERS) | SCORED A+ |
LATEST UPDATE 2025
The prospective payment system used to reimburse home health agencies -
ANSWERS OASIS (Outcome and Assessment Information Set).
Home Health Agencies (HHAs) utilize a data entry software system called -
ANSWERS HAVEN (Home Assessment Validation and Entry)
These are assigned to every HCPCS/CPT code under the Medicare hospital
outpatient prospective payment system to identify how the service or procedure
described by the code would be paid - ANSWERS payment status indicator
When the MS-DRG payment received by the hospital is lower than the actual
charges for providing the inpatient services for a patient with Medicare, then the
hospital - ANSWERS absorbs the loss; this is commonly known as a write-off.
Code used to identify the procedure, service, or treatment - ANSWERS
HCPCS/CPT code
, The following type of hospital is considered excluded when it applies for, and
receives, a waiver from CMS. This means that the hospital does not participate in
the inpatient prospective payment system (IPPS) - ANSWERS cancer hospital
The prospective payment system used to reimburse hospitals for Medicare
hospital outpatients is called - ANSWERS APCs
This is a 10-digit, intelligence-free, numeric identifier designed to replace all
previous provider legacy numbers. This number identifies the physician universally
to all payers. This number is issued to all HIPAA-covered entities. It is mandatory
on the CMS-1500 and UB-04 claim forms - ANSWERS National Provider
Identifier (NPI)
This prospective payment system replaced the Medicare physician payment
system of "customary, prevailing, and reasonable (CPR)" charges whereby
physicians were reimbursed according to their historical record of the charge for
the provision of each service - ANSWERS Medicare Physician Fee Schedule
(MPFS)
Under APCs, payment status indicator "V" means - ANSWERS clinic or
emergency department visit (medical visits)
When a provider, knowingly or unknowingly, uses practices that are inconsistent
with accepted medical practice and that directly or indirectly result in unnecessary
costs to the Medicare program, this is called - ANSWERS abuse
When a patient is discharged from the inpatient rehabilitation facility and returns
within three calendar days (prior to midnight on the third day) this is called a(n) -
ANSWERS interrupted stay
