CDEO CHAPTER 7 EXAM QUESTIONS
AND ANSWERS
RBRVS - Correct Answers -Resource-Based Relative Value Scale
RBRVS System - Correct Answers -Established by Medicare to reimburse physicians
based on CPT code submitted for reimbursement
RVU - Correct Answers -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 - Correct Answers -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 - Correct Answers -CMS annually publishes Physician Fee Schedule
information on its website and posts the formula for calculating physician fee schedule
amounts.
Physician Fee Amounts - Correct Answers -vary depending on facility vs non-facility
Facility Practice RVU - Correct Answers -expenses include services performed in
emergency rooms , hospitals, SNFs, nursing homes, ASC.
Non Facility RVUs - Correct Answers -include services performed in non-hospital owned
physician practices and privately owned practices.
GPCI - Correct Answers -Geographic Practice Cost Index
Geographic Prctice Cost Index - Correct Answers -is used to realize the varying cost
based on geographic location
CF - Correct Answers -Converstion Factor
, Conversion Factor - Correct Answers -this is a fixed dollar amount used to translate the
RVUs into fees
Other Health Plans - Correct Answers -other than Medicare may choose not to use the
CMS calculations to determine provider reimbursement
Global Surgery Package - Correct Answers -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 - Correct Answers -* 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 - Correct Answers -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 - Correct Answers -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 - Correct Answers -Preoperative visits beginning eith the day
before the day of surgery
Intraoperative services that are a usual and necessary part of a surgical procedure
AND ANSWERS
RBRVS - Correct Answers -Resource-Based Relative Value Scale
RBRVS System - Correct Answers -Established by Medicare to reimburse physicians
based on CPT code submitted for reimbursement
RVU - Correct Answers -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 - Correct Answers -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 - Correct Answers -CMS annually publishes Physician Fee Schedule
information on its website and posts the formula for calculating physician fee schedule
amounts.
Physician Fee Amounts - Correct Answers -vary depending on facility vs non-facility
Facility Practice RVU - Correct Answers -expenses include services performed in
emergency rooms , hospitals, SNFs, nursing homes, ASC.
Non Facility RVUs - Correct Answers -include services performed in non-hospital owned
physician practices and privately owned practices.
GPCI - Correct Answers -Geographic Practice Cost Index
Geographic Prctice Cost Index - Correct Answers -is used to realize the varying cost
based on geographic location
CF - Correct Answers -Converstion Factor
, Conversion Factor - Correct Answers -this is a fixed dollar amount used to translate the
RVUs into fees
Other Health Plans - Correct Answers -other than Medicare may choose not to use the
CMS calculations to determine provider reimbursement
Global Surgery Package - Correct Answers -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 - Correct Answers -* 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 - Correct Answers -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 - Correct Answers -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 - Correct Answers -Preoperative visits beginning eith the day
before the day of surgery
Intraoperative services that are a usual and necessary part of a surgical procedure
