CDEO - CHAPTER 5, CODING AND
REIMBURSEMENT EXAM QUESTIONS
AND ANSWERS
RBRVS - Correct Answers -Resource-Based Relative Value Scale
What is RBRVS? - Correct Answers -RBRVS is a system established by Medicare to
reimburse physicians based on the CPT code submitted (FFS). (e.g. the more codes,
the more money paid to providers)
RVU - Correct Answers -Relative Value Unit
What is the RVU? - Correct Answers -Each CPT code has a RVU assigned to it.
What 3 components comprise the RVU? - Correct Answers -The RVU is comprised of:
Physician Work (doctor's work)
Practice Expense (office's overhead)
Professional Liability/Malpractice Insurance
What does NCD do? - Correct Answers -Medicare's determination of items and services
that are reasonable and necessary for a dx or treatment. (NCD supersedes LCD.)
LCD - Correct Answers -Local Coverage Determination
What does LCD do? - Correct Answers -A MAC (Medicare Administrative Contractor)
determination of items and services that are reasonable and necessary for a dx or
treatment. (NCD supersedes LCD.)
What does the RVU do? - Correct Answers -When RVU is multiplied by a conversion
factor and a geographic region adjustment allowance, the reimbursement amount for a
medical service is created.
RVU * CF * GRAA = reimbursement to provider
What is the Global Surgery Package? - Correct Answers -The Global Surgery Package
is a bundled payment for the time, effort and services required to complete a procedure.
What are the preop and postop periods for a Minor Surgical Procedure? - Correct
Answers -Preop - 0 days preoperative period
REIMBURSEMENT EXAM QUESTIONS
AND ANSWERS
RBRVS - Correct Answers -Resource-Based Relative Value Scale
What is RBRVS? - Correct Answers -RBRVS is a system established by Medicare to
reimburse physicians based on the CPT code submitted (FFS). (e.g. the more codes,
the more money paid to providers)
RVU - Correct Answers -Relative Value Unit
What is the RVU? - Correct Answers -Each CPT code has a RVU assigned to it.
What 3 components comprise the RVU? - Correct Answers -The RVU is comprised of:
Physician Work (doctor's work)
Practice Expense (office's overhead)
Professional Liability/Malpractice Insurance
What does NCD do? - Correct Answers -Medicare's determination of items and services
that are reasonable and necessary for a dx or treatment. (NCD supersedes LCD.)
LCD - Correct Answers -Local Coverage Determination
What does LCD do? - Correct Answers -A MAC (Medicare Administrative Contractor)
determination of items and services that are reasonable and necessary for a dx or
treatment. (NCD supersedes LCD.)
What does the RVU do? - Correct Answers -When RVU is multiplied by a conversion
factor and a geographic region adjustment allowance, the reimbursement amount for a
medical service is created.
RVU * CF * GRAA = reimbursement to provider
What is the Global Surgery Package? - Correct Answers -The Global Surgery Package
is a bundled payment for the time, effort and services required to complete a procedure.
What are the preop and postop periods for a Minor Surgical Procedure? - Correct
Answers -Preop - 0 days preoperative period
