IHMO CH 17 REVIEW true or False

Emergency department charges are billed along with the inpatient stay on the CMS-1500 claim form.
False

When admitted as a workers compensation case the patient will not have an insurance card.
True

A patient who is covered under and HMO plan must have authorization prior to admission unless the patient is admitted for an emergency.
True

The patient care representative should obtain a copy of the front and back of the patients health identification card but a copy of the drivers licences is optional.
False

Surgical procedures preformed in the hospital operating room are billed by the hospital billing department.
True

Elective surgeries are deferrable.
True

A patient has a right to request an itemized bill from a hospital stay with no cost to the patient.
True

Insurance from different state have the same standards for reimbursement.
False

On the CMS-1450 (UB-04) claim form, the patients date of birth should be entered using sex digits in block 14?
False

On the CMS-1450 (UB-04) claim form in Field 17, code 20 (patient expired) is used to indicate the patients discharge status?
True

Information such as “condition is employment-related” (code 02), listed in Fields 18-28 of the On the CMS-1450 (UB-04) claim form, is called a condition code?
True

The MS-DRG is assigned using an automated system called the DGR selector
False

The MS-DRG system is designed to increase reimbursement for sicker patients?
True

MS-DRG are weighted to reflect the average costs for impatient care
True

Ambulatory payment classification (APCs) are based on the principal diagnosis?
False

The coder’s responsibility is to ensure that the data are as acurate as possible not only for classification and study purposes but also to obtain appropriate reimbursement. True The Federal Register is the official publication for all Presidential Documents, Rules …

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