H08V EXAM 2 ANSWERS - ASHWORTH

H08V EXAM 2 ANSWERS - ASHWORTH

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H08V Medical Coding II Exam 2 Answers (Ashworth)

Question 1

0 / 5 points

A child has insurance through his father’s employer. Which one of the following codes might be used on the CMS-1450 to indicate the relationship to the insurer?

Question options:

	a)  18
	b)  19
	c)  22
	d)  33
Question 2		5 / 5 points

A patient sees a healthcare provider for congestive heart failure. The healthcare provider will be reimbursed based on an expected amount to treat the congestive heart failure. The provider is being reimbursed based on which system?

Question options:

	a)  Per diem
	b)  Ambulatory payment classification
	c)  Fee-for-service
	d)  Prospective payment
Question 3		0 / 5 points

A hospital patient’s record wasn’t coded until 20 days after the patient was discharged. What issue may arise from this?

Question options:

	a)  The claim may be denied.
	b)  The patient may not be reimbursed.
	c)  Physicians may be charged with incomplete records.
	d)  It could create a cash flow problem.
Question 4		5 / 5 points

If you need to find the reimbursement rates for outpatient care, you might use

Question options:

	a)  DRGs.
	b)  OPPS.
	c)  ICD-9-CM.
	d)  CDM.
Question 5		5 / 5 points

In the Type of Bill code example of 0123, which number indicates the submitting facility for this hospitalization?

Question options:

	a)  0
	b)  1
	c)  2
	d)  3
Question 6		5 / 5 points

Which one of the following choices is considered a major revenue code category on the UB-04?

Question options:

	a)  Hospice
	b)  Home care
	c)  Vitamins
	d)  Physical therapy
Question 7		5 / 5 points

If a patient dies at home while in hospice care, what discharge code might be used on the claim form?

Question options:

	a)  40
	b)  41
	c)  50
	d)  51
Question 8		5 / 5 points

In the Type of Bill form locator, you see 0113. What type does this number indicate?

Question options:

	a)  Freestanding inpatient hospital, including Medicare Part A
	b)  Inpatient hospital in a rural area
	c)  Freestanding outpatient facility
	d)  Rural outpatient facility, including Medicare
Question 9		5 / 5 points

Which one of the following revenue categories indicates pharmacy on the UB-04?

Question options:

	a)  0100
	b)  0250
	c)  0420
	d)  0000
Question 10		5 / 5 points

Which one of the following items on the inpatient record could cause an increase in reimbursement?

Question options:

	a)  CMS
	b)  CC
	c)  PCN
	d)  ASU
Question 11		5 / 5 points

When a grouper program searches the information for additional complications, comorbidities, or procedures related to those already coded, this is known as

Question options:

	a)  looping.
	b)  grouping.
	c)  indexing.
	d)  rendering.
Question 12		5 / 5 points

For reimbursement, Medicare determines what happened to the patient after the patient left the hospital by looking at which form locator?

Question options:

	a)  15
	b)  11
	c)  51
	d)  17
Question 13		5 / 5 points

What is the main difference between APCs and DRGs?

Question options:

	a)  APCs are used by physician offices only.
	b)  APCs are based on MDCs.
	c)  APCs are based on procedures.
	d)  APCs assigned comorbidities and complications.
Question 14		5 / 5 points

Which one of the following choices is a payment system based on procedures that group together services?

Question options:

	a)  DRGs
	b)  PPO
	c)  APC
	d)  HCPCS
Question 15		5 / 5 points

Which one of the following choices usually increases a patient’s length of stay and may have a negative effect on the treatment?

Question options:

	a)  DRG
	b)  Comorbidity
	c)  Prognosis
	d)  APC
Question 16		5 / 5 points

A hospital’s CDM hasn’t been changed for the past year. Which one of the following outcomes could result from this?

Question options:

	a)  Improvement in the cost-of-living reimbursement
	b)  Overpayment of claims
	c)  Increase in the number of admissions
	d)  Assignment of procedure codes
Question 17		5 / 5 points

Which one of the following choices is considered a major section for the UB-04?

Question options:

	a)  Prescription information
	b)  Payer information
	c)  Dependent information
	d)  Treatment information
Question 18		5 / 5 points

What is the maximum number of services that can be billed on one UB-04?

Question options:

	a)  25
	b)  22
	c)  15
	d)  7
Question 19		0 / 5 points

Which one of the following choices doesn’t affect DRG classification?

Question options:

	a)  Admitting diagnosis
	b)  Age and sex
	c)  Discharge status
	d)  Number of days in the hospital
Question 20		5 / 5 points

In the form locator for prior payments, what should you do when you have prior payments from other carriers?

Question options:

	a)  Attach the Explanation of Benefits.
	b)  Include the 10-digit NPI.
	c)  Enter the applicable code for the insured.
	d)  Enter “9.”