IHMO Ch. 17 true/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 patient’s health identification card but a copy of the driver’s license is optional
false

Surgical procedures performed in the hospital operating room are billed by the hospital billing department.
true

Elective surgeries are deferrable.
true

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

Insurances from different states have the same standards for reimbursement.
false

On the CMS-1450 (UB-04) claim form, the patient’s date of birth should be entered using six 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 through 28 of the CMS-1450 (UB-04) claim form, is called a condition code.
true

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

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

MS-DRGs are weighted to reflect the average costs for inpatient care
true

Ambulatory payment classifications (APCs) are based on the principal diagnosis
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 WE WILL WRITE A CUSTOM ESSAY SAMPLE ON …

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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