CRCR FINAL EXAM 2023 CORRECT ANSWERS A+

Through what document does a hospital establish compliance standards? - ANSWER-Code of Conduct What is the purpose of the OIG work plan? - ANSWER-Communicate Issues that will be reviewed during the year for compliance with Medicare Regulations If a Medicare patient is admitted on Friday, what services fall within the three-day DRG window rule? - ANSWER-Diagnostic services and related charges provided on Wednesday, Thursday and Friday before admission. What does a modifier allow a provider to do? - ANSWER-Report a specific circumstance that affected a procedure or service without changing the code or its definition If outpatient diagnostic services are provided within three days of the admission of a Medicare beneficiary to an IPPS (Inpatient Prospective Payment System) hospital, what must happen to these charges? - ANSWER-They must be combined with the inpatient bill and paid under the MS-DRG (diagnosis related group) system