CCA Exam Prep-Reimbursement
Methodologies Questions & Answers
2023/2024
If another T procedure were performed, how much would the facility receive for the second T procedure
- ANSWER-50%
Which hospital is excluded from the Medicare inpatient prospective payment system - ANSWER-
Children's
Diagnosis-related groups are organized into - ANSWER-Major diagnostic categories
In processing a Medicare payment for outpatient radiology examinations, a hospital outpatient services
department would receive payment under which - ANSWER-OPPS (outpatient prospective payment
system)
What is not reimbursed according to the Medicare outpatient prospective payment system - ANSWER-
Critical access hospitals
Fee schedules are updated by third party payers how often - ANSWER-Annually
What form would a health record technician use to perform the billing function for a physician's office -
ANSWER-CMS-1500
When a provider accepts assignment, this means the: - ANSWER-The provider agrees to accept as
payment in full the allowed charge from the fee schedule
A coding audit shows that an inpatient coder is using multiple codes that describe the individual
components of a procedure rather than using a single code that describes all the steps of the procedure.
What should be done? - ANSWER-Counsel the coder to stop the practice immediately
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