CDEO Chapter 7 exam with correct
answers
RBRVS |- |VERIFIED |ANSWER✔✔-Resource-Based |Relative |Value |Scale
RBRVS |System |- |VERIFIED |ANSWER✔✔-Established |by |Medicare |to |reimburse |physicians |based |on |
CPT |code |submitted |for |reimbursement
RVU |- |VERIFIED |ANSWER✔✔-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 |- |VERIFIED |ANSWER✔✔-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 |- |VERIFIED |ANSWER✔✔-CMS |annually |publishes |Physician |Fee |Schedule |information |on |
its |website |and |posts |the |formula |for |calculating |physician |fee |schedule |amounts.
Physician |Fee |Amounts |- |VERIFIED |ANSWER✔✔-vary |depending |on |facility |vs |non-facility
Facility |Practice |RVU |- |VERIFIED |ANSWER✔✔-expenses |include |services |performed |in |emergency |
rooms |, |hospitals, |SNFs, |nursing |homes, |ASC.
Non |Facility |RVUs |- |VERIFIED |ANSWER✔✔-include |services |performed |in |non-hospital |owned |
physician |practices |and |privately |owned |practices.
GPCI |- |VERIFIED |ANSWER✔✔-Geographic |Practice |Cost |Index
Geographic |Prctice |Cost |Index |- |VERIFIED |ANSWER✔✔-is |used |to |realize |the |varying |cost |based |on |
geographic |location
CF |- |VERIFIED |ANSWER✔✔-Converstion |Factor
Conversion |Factor |- |VERIFIED |ANSWER✔✔-this |is |a |fixed |dollar |amount |used |to |translate |the |RVUs |
into |fees
Other |Health |Plans |- |VERIFIED |ANSWER✔✔-other |than |Medicare |may |choose |not |to |use |the |CMS |
calculations |to |determine |provider |reimbursement
, Global |Surgery |Package |- |VERIFIED |ANSWER✔✔-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 |- |VERIFIED |ANSWER✔✔-* |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
* |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 |- |VERIFIED |ANSWER✔✔-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 |- |VERIFIED |ANSWER✔✔-defined |as |having |a |1 |day |operative |period |and |a |
90-day |postoperative |period |
Payment |for |major |medical |procedures |include |all |related |preoperative |care, |postoperative |care |, |and
|intraoperative |services.
Global |Fee |Includes |- |VERIFIED |ANSWER✔✔-Preoperative |visits |beginning |eith |the |day |before |the |day
|of |surgery
answers
RBRVS |- |VERIFIED |ANSWER✔✔-Resource-Based |Relative |Value |Scale
RBRVS |System |- |VERIFIED |ANSWER✔✔-Established |by |Medicare |to |reimburse |physicians |based |on |
CPT |code |submitted |for |reimbursement
RVU |- |VERIFIED |ANSWER✔✔-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 |- |VERIFIED |ANSWER✔✔-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 |- |VERIFIED |ANSWER✔✔-CMS |annually |publishes |Physician |Fee |Schedule |information |on |
its |website |and |posts |the |formula |for |calculating |physician |fee |schedule |amounts.
Physician |Fee |Amounts |- |VERIFIED |ANSWER✔✔-vary |depending |on |facility |vs |non-facility
Facility |Practice |RVU |- |VERIFIED |ANSWER✔✔-expenses |include |services |performed |in |emergency |
rooms |, |hospitals, |SNFs, |nursing |homes, |ASC.
Non |Facility |RVUs |- |VERIFIED |ANSWER✔✔-include |services |performed |in |non-hospital |owned |
physician |practices |and |privately |owned |practices.
GPCI |- |VERIFIED |ANSWER✔✔-Geographic |Practice |Cost |Index
Geographic |Prctice |Cost |Index |- |VERIFIED |ANSWER✔✔-is |used |to |realize |the |varying |cost |based |on |
geographic |location
CF |- |VERIFIED |ANSWER✔✔-Converstion |Factor
Conversion |Factor |- |VERIFIED |ANSWER✔✔-this |is |a |fixed |dollar |amount |used |to |translate |the |RVUs |
into |fees
Other |Health |Plans |- |VERIFIED |ANSWER✔✔-other |than |Medicare |may |choose |not |to |use |the |CMS |
calculations |to |determine |provider |reimbursement
, Global |Surgery |Package |- |VERIFIED |ANSWER✔✔-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 |- |VERIFIED |ANSWER✔✔-* |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
* |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 |- |VERIFIED |ANSWER✔✔-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 |- |VERIFIED |ANSWER✔✔-defined |as |having |a |1 |day |operative |period |and |a |
90-day |postoperative |period |
Payment |for |major |medical |procedures |include |all |related |preoperative |care, |postoperative |care |, |and
|intraoperative |services.
Global |Fee |Includes |- |VERIFIED |ANSWER✔✔-Preoperative |visits |beginning |eith |the |day |before |the |day
|of |surgery
