ICD-10-CM/PCS Appendix A and B
Questions & Answers
How are critical access hospitals paid by Medicare? - ANSWERSCAHs may choose to
be paid by Medicare under the "Standard Payment Method" or the "Optional Payment
Method"
What is the correct POA indicator when the documentation is unclear whether the
condition was present on admission and the provider is not available to provide a
response? - ANSWERSU
______ is based on claims and documentation filed by the provider using medical
diagnosis and procedure codes. - ANSWERSReimbursement
Skilled nursing facility is paid on a daily rate for each day the patient is enrolled. -
ANSWERSFalse
Hospitals are reimbursed by Medicare on a fee-for-service basis. - ANSWERSFalse
Which of the following institutions is required to report POA (Present on Admission) for
Medicare? - ANSWERSAcute care hospitals
Home health agency is paid on a predetermined base payment. - ANSWERSTrue
What is the correct POA indicator when the documentation is unclear whether the
condition was present on admission and when the provider is queried and his/her
response is "I do not know"? - ANSWERSW
A patient is admitted to the hospital for surgery. The patient develops a fever after
surgery and the final diagnosis includes "possible postoperative infection". What is the
correct POA indicator for the postoperative infection? - ANSWERSN
A DRG uses the principal diagnosis, secondary diagnosis, and procedures to group
clinically similar patients using similar resources. - ANSWERSTrue
Physicians and other nonhospital providers/suppliers are reimbursed by Medicare and
Medicaid on a prospective payment system. - ANSWERSFalse
Each acute inpatient hospital admission can be grouped to _____ DRG(s). -
ANSWERSOne
Hospitals may be paid more than one ambulatory payment classification (APC) for an
encounter. - ANSWERSTrue
Questions & Answers
How are critical access hospitals paid by Medicare? - ANSWERSCAHs may choose to
be paid by Medicare under the "Standard Payment Method" or the "Optional Payment
Method"
What is the correct POA indicator when the documentation is unclear whether the
condition was present on admission and the provider is not available to provide a
response? - ANSWERSU
______ is based on claims and documentation filed by the provider using medical
diagnosis and procedure codes. - ANSWERSReimbursement
Skilled nursing facility is paid on a daily rate for each day the patient is enrolled. -
ANSWERSFalse
Hospitals are reimbursed by Medicare on a fee-for-service basis. - ANSWERSFalse
Which of the following institutions is required to report POA (Present on Admission) for
Medicare? - ANSWERSAcute care hospitals
Home health agency is paid on a predetermined base payment. - ANSWERSTrue
What is the correct POA indicator when the documentation is unclear whether the
condition was present on admission and when the provider is queried and his/her
response is "I do not know"? - ANSWERSW
A patient is admitted to the hospital for surgery. The patient develops a fever after
surgery and the final diagnosis includes "possible postoperative infection". What is the
correct POA indicator for the postoperative infection? - ANSWERSN
A DRG uses the principal diagnosis, secondary diagnosis, and procedures to group
clinically similar patients using similar resources. - ANSWERSTrue
Physicians and other nonhospital providers/suppliers are reimbursed by Medicare and
Medicaid on a prospective payment system. - ANSWERSFalse
Each acute inpatient hospital admission can be grouped to _____ DRG(s). -
ANSWERSOne
Hospitals may be paid more than one ambulatory payment classification (APC) for an
encounter. - ANSWERSTrue
