MEDICAL BILLING AND CODING TEST
ICD-10 QUESTIONS AND ANSWERS
What healthcare organizations collect UHDDS data? - Answer-All non outpatient
settings including acute care. short-term care. long-term care, and psychiatric
hospitals; home health agencies; rehabilitation facilities; and nursing homes
What is a chargemaster? - Answer-A financial management form that contains
information about the organization's charges for the healthcare services it provides to
patients
What is the basic formula for calculating each MS-DRG hospital payment'? - Answer-
DRG relative weight X hospital base rate
What is the maximum number of diagnosis codes that can appear on the UB-04
paper claim form locator 67 for a hospital inpatient principal and secondary
diagnoses? - Answer-25
What is the maximum number of procedure codes that can appear on a UB-O4
institutional claim form via electronic transmission? - Answer-25
What is the name of the national program to detect and correct improper payments
in the Medicare Fee-for-Service (FFS) program? - Answer-Recovery audit
contractors (RACs)
What is the name of the organization that develops the billing form that hospitals are
required to use? - Answer-National Uniform Billing Committee (NUBC)
What is the term used when a Medicare hospital inpatient admission results in
exceptionally high costs when compared to other cases in the same DRG? - Answer-
Cost outlier
What was the goal of the MS-DRG system? - Answer-To improve Medicare's
capability to recognize severity of illness in its inpatient hospital payments. The new
system is projected to increase payments to hospitals for services provided to sicker
patients and decrease payments for treating less severely ill patients.
Which answer is not required for assignment of the MS-DRG? - Answer-Attending
and consulting physicians
Which of the following situations would be identified by the NCCI edits? - Answer-
Billing for two services that are prohibited from being billed on the same day
Which of the following modifiers is not approved for hospital outpatient department
reporting - Answer-Modifier 22 Increased Procedural Services
This modifier is not approved for hospital outpatient department use
ICD-10 QUESTIONS AND ANSWERS
What healthcare organizations collect UHDDS data? - Answer-All non outpatient
settings including acute care. short-term care. long-term care, and psychiatric
hospitals; home health agencies; rehabilitation facilities; and nursing homes
What is a chargemaster? - Answer-A financial management form that contains
information about the organization's charges for the healthcare services it provides to
patients
What is the basic formula for calculating each MS-DRG hospital payment'? - Answer-
DRG relative weight X hospital base rate
What is the maximum number of diagnosis codes that can appear on the UB-04
paper claim form locator 67 for a hospital inpatient principal and secondary
diagnoses? - Answer-25
What is the maximum number of procedure codes that can appear on a UB-O4
institutional claim form via electronic transmission? - Answer-25
What is the name of the national program to detect and correct improper payments
in the Medicare Fee-for-Service (FFS) program? - Answer-Recovery audit
contractors (RACs)
What is the name of the organization that develops the billing form that hospitals are
required to use? - Answer-National Uniform Billing Committee (NUBC)
What is the term used when a Medicare hospital inpatient admission results in
exceptionally high costs when compared to other cases in the same DRG? - Answer-
Cost outlier
What was the goal of the MS-DRG system? - Answer-To improve Medicare's
capability to recognize severity of illness in its inpatient hospital payments. The new
system is projected to increase payments to hospitals for services provided to sicker
patients and decrease payments for treating less severely ill patients.
Which answer is not required for assignment of the MS-DRG? - Answer-Attending
and consulting physicians
Which of the following situations would be identified by the NCCI edits? - Answer-
Billing for two services that are prohibited from being billed on the same day
Which of the following modifiers is not approved for hospital outpatient department
reporting - Answer-Modifier 22 Increased Procedural Services
This modifier is not approved for hospital outpatient department use
