CPAT Prep Hospital And Clinic Billing Pfs

Reviewed by Editorial Team
The ProProfs editorial team is comprised of experienced subject matter experts. They've collectively created over 10,000 quizzes and lessons, serving over 100 million users. Our team includes in-house content moderators and subject matter experts, as well as a global network of rigorously trained contributors. All adhere to our comprehensive editorial guidelines, ensuring the delivery of high-quality content.
Learn about Our Editorial Process
| By Brandy Cummins
B
Brandy Cummins
Community Contributor
Quizzes Created: 1 | Total Attempts: 757
| Attempts: 757
Quiz Flashcard
SettingsSettings
Please wait...
  • 1/84 Questions

    The uniform billing form is also known as the UB-04.

    • True
    • False
Please wait...
About This Quiz

This CPAT Prep quiz focuses on Hospital and Clinic Billing PFS, testing knowledge on UB-04 forms, including data elements, condition codes, and revenue codes. It's designed to enhance billing accuracy and compliance in healthcare settings.

CPAT Prep Hospital And Clinic Billing Pfs - Quiz

Quiz Preview

  • 2. 

    MSP is the acronym for:

    • Medicaid secondary payer

    • Medicare seasonal payer

    • Miscellaneous secondary payer

    • Medicare secondary payer

    Correct Answer
    A. Medicare secondary payer
    Explanation
    The correct answer is Medicare secondary payer. MSP refers to Medicare secondary payer, which is a provision that requires certain types of insurance to pay claims as secondary to Medicare. This means that if someone has Medicare coverage along with another type of insurance, such as employer-sponsored insurance or Medicaid, Medicare will act as the primary payer and the other insurance will act as the secondary payer. This ensures that Medicare is not responsible for covering costs that should be covered by another insurance source.

    Rate this question:

  • 3. 

    In a divorce or separation which plan is primary?

    • Father

    • The parent who has custody

    • Mother

    • The parent that presented the child for treatment

    Correct Answer
    A. The parent who has custody
    Explanation
    The parent who has custody is considered the primary plan in a divorce or separation. This means that they have the responsibility and authority to make decisions regarding the child's well-being, including medical treatment. They are the one who has the legal right to make decisions for the child and are responsible for their day-to-day care. The parent who presented the child for treatment may have a role in the child's healthcare, but ultimately, the parent with custody has the primary authority.

    Rate this question:

  • 4. 

    Medicare is secondary payer to which of the following:

    • Federal Black Lung

    • Workers’ Compensation

    • Automobile medical, no-fault or liability insurance

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    Medicare is considered a secondary payer to Federal Black Lung, Workers' Compensation, and Automobile medical, no-fault or liability insurance. This means that if an individual has any of these types of insurance coverage, Medicare will only pay for healthcare services after the primary insurance has paid its share. In other words, Medicare will step in to cover any remaining costs that the primary insurance does not cover. Therefore, the correct answer is "All of the above."

    Rate this question:

  • 5. 

    Inaccurate or inappropriate coding will impact your facility's bottom line.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Inaccurate or inappropriate coding can have a negative impact on a facility's financial performance. This is because incorrect coding can lead to billing errors, claim denials, and delays in reimbursement. These issues can result in lost revenue and increased costs for the facility. Therefore, it is important to ensure accurate and appropriate coding practices to maintain a healthy bottom line.

    Rate this question:

  • 6. 

    What is a written authorization, signed by the policyholder to an insurance company, to pay benefits directly to the hospital?

    • Assignment of Benefits

    • Medicare Secondary Payer

    • Conditional Payments

    • Medicare Administrative Contractor

    Correct Answer
    A. Assignment of Benefits
    Explanation
    Assignment of Benefits is a written authorization, signed by the policyholder, that allows an insurance company to pay benefits directly to the hospital. This means that the policyholder assigns their right to receive the insurance benefits to the hospital, so the hospital can directly receive the payment for the services provided. This is commonly used in healthcare settings where the hospital wants to ensure they receive payment for services rendered without relying on the patient to pay and then seek reimbursement from the insurance company.

    Rate this question:

  • 7. 

    The assignment of benefits is usually acquired at what time?

    • Discharge

    • Admission

    • After Surgery

    • None of the above

    Correct Answer
    A. Admission
    Explanation
    The assignment of benefits is usually acquired at the time of admission. This means that when a patient is admitted to a healthcare facility, they typically sign an agreement that allows the healthcare provider to directly bill their insurance company for the services rendered. This ensures that the healthcare provider will receive payment from the insurance company, rather than the patient having to pay out of pocket and then seek reimbursement.

    Rate this question:

  • 8. 

    ICD-9 CM is updated how often:

    • Bi-annually

    • Annually

    • Every 2 years

    • None of the above

    Correct Answer
    A. Annually
    Explanation
    ICD-9 CM is updated annually. This means that the International Classification of Diseases, 9th Revision, Clinical Modification is revised and updated on a yearly basis. This update ensures that the coding system remains current and reflects any changes in medical practices, procedures, and diagnoses. By updating the ICD-9 CM annually, healthcare professionals can accurately code and classify diseases and medical conditions, facilitating effective communication and data analysis in the healthcare industry.

    Rate this question:

  • 9. 

    CWF is the acronym for:

    • Common Working Field

    • Constant Working File

    • Conditional Working File

    • Common Working File

    Correct Answer
    A. Common Working File
    Explanation
    CWF stands for Common Working File. This term refers to a shared workspace or storage area where multiple users can access and collaborate on documents, data, or projects. It is a central location that allows for easy communication and coordination among team members, ensuring that everyone is working with the most up-to-date information. The use of a Common Working File promotes efficiency, productivity, and effective teamwork.

    Rate this question:

  • 10. 

    A clean claim is one which:

    • If investigated does not require contact with the provider

    • Will pass all front end edits

    • Is processed electronically

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    A clean claim is one that meets all the criteria mentioned in the options. It does not require contact with the provider when investigated, passes all front-end edits, and is processed electronically. Therefore, the correct answer is "All of the above."

    Rate this question:

  • 11. 

    The Medicare Part A deductible for days 1 through 60 is:

    • $1000

    • $1132

    • $1200

    • $1500

    Correct Answer
    A. $1132
    Explanation
    The Medicare Part A deductible for days 1 through 60 is $1132. This means that if a person is admitted to the hospital and stays for less than 60 days, they will be responsible for paying this deductible amount before Medicare coverage kicks in.

    Rate this question:

  • 12. 

    Who is primary according to the birthday rule?

    • Mother

    • Father

    • The plan that has covered the parent longer

    • The parent born first in the calendar year

    Correct Answer
    A. The parent born first in the calendar year
    Explanation
    According to the birthday rule, the primary coverage is determined by the parent who was born first in the calendar year. This means that if both parents have coverage through different plans, the plan of the parent who has their birthday earlier in the year will be considered primary. This rule is used to determine which insurance plan will be responsible for paying claims first when a dependent child is covered by both parents' plans.

    Rate this question:

  • 13. 

    Blood deductible for Medicare Part A and Part B is:

    • 1 pint per year

    • 2 pints per year

    • 3 pints per year

    • 4 pints per year

    Correct Answer
    A. 3 pints per year
    Explanation
    Medicare Part A and Part B have a blood deductible of 3 pints per year. This means that Medicare beneficiaries are responsible for the cost of the first 3 pints of blood they receive in a calendar year. After the deductible is met, Medicare will cover the cost of any additional blood transfusions. This deductible helps to ensure that Medicare resources are used efficiently and encourages beneficiaries to use blood transfusions judiciously.

    Rate this question:

  • 14. 

    The OBRA Act of 1986 requires HCPCS coding on the UB-04 Medicare claims by which facilities:

    • Tertiary Care Hospitals

    • Acute Care Hospitals

    • Hospital Based Rural Health Clinics

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    The OBRA Act of 1986 requires HCPCS coding on the UB-04 Medicare claims by all of the mentioned facilities, including Tertiary Care Hospitals, Acute Care Hospitals, and Hospital Based Rural Health Clinics. This means that these facilities are obligated to use the Healthcare Common Procedure Coding System (HCPCS) when submitting their claims to Medicare using the UB-04 form.

    Rate this question:

  • 15. 

    ICD-9 codes are used to identify:

    • Procedures

    • Diagnosis

    • Supplies

    • Office Visits

    Correct Answer
    A. Diagnosis
    Explanation
    ICD-9 codes are a standardized system of alphanumeric codes used to classify and identify medical diagnoses. These codes are used by healthcare providers, insurance companies, and researchers to accurately document and track diagnoses for various purposes such as billing, statistical analysis, and patient care management. Therefore, the correct answer is "Diagnosis."

    Rate this question:

  • 16. 

    NCCI identifies:

    • Codes that should not be billed together

    • Unbundled Costs

    • Mutually exclusive codes

    • Both A and C

    Correct Answer
    A. Both A and C
    Explanation
    The correct answer is "Both A and C." NCCI (National Correct Coding Initiative) identifies codes that should not be billed together and mutually exclusive codes. This means that certain codes should not be reported together because they represent similar or overlapping services. NCCI also identifies unbundled costs, which refers to the practice of separately reporting components of a service that should be reported as a single code. Therefore, the correct answer is that NCCI identifies both codes that should not be billed together and mutually exclusive codes.

    Rate this question:

  • 17. 

    The UB-04 contains how many data elements?

    • 78

    • 81

    • 92

    Correct Answer
    A. 81
    Explanation
    The UB-04 contains 81 data elements.

    Rate this question:

  • 18. 

    The first digit in the type of bill indicates:

    • Frequency

    • Type of facility

    • Bill classification

    • None of the above

    Correct Answer
    A. Type of facility
    Explanation
    The first digit in the type of bill indicates the type of facility. This means that the first digit in the bill number corresponds to the specific type of healthcare facility where the services were provided. This classification helps in identifying the type of facility and streamlining the billing process accordingly.

    Rate this question:

  • 19. 

    A Critical Care hospital can determine the time it offers services:

    • True

    • False

    Correct Answer
    A. False
    Explanation
    A Critical Care hospital cannot determine the time it offers services as it needs to be available 24/7 to provide emergency medical care to critically ill patients. Critical care hospitals operate round the clock to ensure that patients receive immediate and specialized treatment whenever required. Therefore, the correct answer is False.

    Rate this question:

  • 20. 

    A UB-04 code which identifies the condition(s) relating to the bill that may affect payer processing:

    • Condition code

    • Occurrence code

    • Value code

    • Revenue code

    Correct Answer
    A. Condition code
    Explanation
    A condition code is a UB-04 code that is used to identify specific conditions or circumstances related to a medical bill that may impact how the payer processes the claim. These codes provide additional information to the payer about the patient's condition or the services provided, helping them determine the appropriate payment or reimbursement for the claim.

    Rate this question:

  • 21. 

    A claim that contains complete and necessary information but the information is illogical or incorrect is:

    • Clean claim

    • Incomplete claim

    • Invalid claim

    • None of the above

    Correct Answer
    A. Invalid claim
    Explanation
    An invalid claim refers to a statement that contains all the necessary information but is illogical or incorrect. This means that the claim might have all the required details, but the information provided is not accurate or does not make sense. It is important to distinguish between incomplete claims, which lack necessary information, and invalid claims, which have incorrect or illogical information.

    Rate this question:

  • 22. 

    When a person with VA benefits and Medicare receives healthcare, they can use both benefits:

    • True

    • False

    Correct Answer
    A. False
    Explanation
    A person with VA benefits and Medicare cannot use both benefits simultaneously. When receiving healthcare, they must choose to use either their VA benefits or Medicare. This is because VA benefits are specifically designed to provide healthcare services to veterans, while Medicare is a federal health insurance program available to all individuals aged 65 and older, as well as certain younger individuals with disabilities. Therefore, the correct answer is False.

    Rate this question:

  • 23. 

    What is a payment made by Medicare where another payer is responsible for payment and the claim is not expected to be paid promptly:

    • Assignment of Benefits

    • Medicare Secondary Payer

    • Conditional Payments

    • Medicare Administrative Contractor

    Correct Answer
    A. Conditional Payments
    Explanation
    Conditional Payments refer to payments made by Medicare when another payer is responsible for payment, but the claim is not expected to be paid promptly. These payments are made on a temporary basis and are subject to reimbursement by the primary payer once they have made their payment. Conditional Payments are typically made when there is a delay or dispute in determining the primary payer, and Medicare steps in to cover the costs in the meantime.

    Rate this question:

  • 24. 

    Resource Utilization Groups are used to assess payment for which facilities:

    • Skilled Nursing Facility

    • Inpatient Hospital

    • Outpatient Hospital

    • Ambulatory Surgical Facility

    Correct Answer
    A. Skilled Nursing Facility
    Explanation
    Resource Utilization Groups (RUGs) are a classification system used to assess payment for Skilled Nursing Facilities (SNFs). RUGs categorize patients based on their level of care needs, such as therapy services, nursing care, and activities of daily living. This classification helps determine the appropriate reimbursement rate for each patient in an SNF. RUGs are not used to assess payment for Inpatient Hospitals, Outpatient Hospitals, or Ambulatory Surgical Facilities.

    Rate this question:

  • 25. 

    The RBRVS contained which major elements:

    • Limits on the amount that a non-participating physician can charge benficiaries

    • Fee schedule for the payment of physician services

    • MVPS for the rates of increase in Medicare expenditures for physician services

    • All of the above

    Correct Answer
    A. All of the above
    Explanation
    The RBRVS (Resource-Based Relative Value Scale) contained three major elements. First, it included limits on the amount that a non-participating physician can charge beneficiaries. This helps to ensure that healthcare costs remain reasonable and affordable for patients. Second, it established a fee schedule for the payment of physician services. This fee schedule helps to standardize and regulate the reimbursement rates for different medical procedures and services. Finally, the RBRVS implemented MVPS (Medicare Volume Performance Standards) to control the rates of increase in Medicare expenditures for physician services. These measures aim to control healthcare costs and ensure the sustainability of the Medicare program.

    Rate this question:

  • 26. 

    MUE's were designed to:

    • Reduce errors due to clerical errors

    • Increase reimbursement

    • Reduce incorrect coding based on anatomic consideration

    • Both A and C

    Correct Answer
    A. Both A and C
    Explanation
    MUE's, or Medically Unlikely Edits, were designed to reduce errors due to clerical errors and reduce incorrect coding based on anatomic considerations. By implementing MUE's, healthcare providers can decrease the likelihood of mistakes caused by human error during the coding and billing process, as well as ensure that codes are accurately assigned based on the specific anatomical details of each patient's condition. Therefore, the correct answer is "Both A and C."

    Rate this question:

  • 27. 

    A UB04 code used to identify values of monetary nature:

    • Condition code

    • Occurrence code

    • Value code

    • Revenue code

    Correct Answer
    A. Value code
    Explanation
    Value code is a UB04 code used to identify values of monetary nature. This code is used to indicate specific monetary amounts related to services provided, such as charges, payments, or adjustments. It helps in accurately documenting and billing for the financial aspects of healthcare services.

    Rate this question:

  • 28. 

    A UB04 code used which identifies the specific date defining a significant event relating to the bill that my affect payment processing:

    • Condition code

    • Occurrence code

    • Value code

    Correct Answer
    A. Occurrence code
    Explanation
    An occurrence code is a UB04 code used to identify a specific date that defines a significant event related to the bill. This code helps in determining the payment processing for the bill.

    Rate this question:

  • 29. 

    The type of bill code is how many digits:

    • 2

    • 3

    • 4

    • 5

    Correct Answer
    A. 3
    Explanation
    The type of bill code consists of three digits.

    Rate this question:

  • 30. 

    The Critical Hospital Access Program was created to assure Medicare benficiaries access to health care services in which areas:

    • Suburbs

    • Rural

    • Urban

    • All of the above

    Correct Answer
    A. Rural
    Explanation
    The Critical Hospital Access Program was created to assure Medicare beneficiaries access to health care services in rural areas. This program recognizes the challenges faced by individuals living in rural communities, where access to healthcare facilities and services may be limited. By focusing on improving access to healthcare in rural areas, the program aims to ensure that Medicare beneficiaries in these areas have equal opportunities to receive the necessary medical care and services they need.

    Rate this question:

  • 31. 

    Level II HCPCS codes are:

    • Alpha

    • Numeric

    • Alpha-Numeric

    • All of the above

    Correct Answer
    A. Alpha-Numeric
    Explanation
    Level II HCPCS codes are alpha-numeric, meaning they consist of both letters and numbers. These codes are used to identify medical supplies, equipment, and services that are not covered by CPT codes. The alpha characters in the code represent the category or type of item or service, while the numeric characters provide additional information such as the specific item or service being billed. Using alpha-numeric codes allows for a more detailed and specific identification of medical items and services, making it easier for healthcare providers and insurers to accurately bill and track these items.

    Rate this question:

  • 32. 

    ICD-9 coding has no effect on reimbursement.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    ICD-9 coding does have an effect on reimbursement. ICD-9 codes are used to classify and report medical diagnoses and procedures for billing purposes. Insurance companies and other payers use these codes to determine the appropriate reimbursement for healthcare services. Accurate and detailed ICD-9 coding is crucial for healthcare providers to receive proper reimbursement for the services they provide. Therefore, the statement that ICD-9 coding has no effect on reimbursement is false.

    Rate this question:

  • 33. 

    Type of bill code 227, the third digit 7 indicates:

    • Final claim for a home health PPS episode

    • Interim-last claim

    • Replacement of prior claim

    • Late charge only

    Correct Answer
    A. Replacement of prior claim
    Explanation
    The correct answer is "Replacement of prior claim." The third digit of the type of bill code 227 indicates that it is a replacement of a prior claim. This means that the current claim is being submitted to replace a previously submitted claim for the same episode of care.

    Rate this question:

  • 34. 

    Hospital, Swing bed, Interim-first claim:

    • 251

    • 182

    • 145

    • 262

    Correct Answer
    A. 182
  • 35. 

    Problems with electronic billing include all of the following except:

    • Creates challenges

    • Less paper

    • Vendor reporting is inflexible and/or not available

    • Upload / download issues

    Correct Answer
    A. Less paper
    Explanation
    The correct answer is "Less paper". This is because electronic billing actually reduces the need for paper, as it allows for digital invoices and transactions to be sent and received electronically. The other options listed all highlight potential issues or challenges that can arise with electronic billing, such as creating challenges, vendor reporting being inflexible or unavailable, and upload/download issues.

    Rate this question:

  • 36. 

    Level II HCPCS codes are used to identify all of the following except:

    • Product

    • Office Visits

    • Supplies

    • DME

    Correct Answer
    A. Office Visits
    Explanation
    Level II HCPCS codes are used to identify products, supplies, and DME (Durable Medical Equipment). However, they are not used to identify office visits. Office visits are typically categorized and billed using Evaluation and Management (E&M) codes. Therefore, the correct answer is "Office Visits".

    Rate this question:

  • 37. 

    Type of bill code 131 indicates:

    • Skilled Nursing, Outpatient, Interim –first claim

    • Hospital, outpatient, nonpayment zero claims

    • Hospital, inpatient, admit through discharge claim

    • Hospital, outpatient, admit through discharge claim

    Correct Answer
    A. Hospital, outpatient, admit through discharge claim
    Explanation
    Type of bill code 131 indicates a Hospital, outpatient, admit through discharge claim. This means that the claim is being submitted for services provided at a hospital on an outpatient basis, starting from the admission of the patient to their discharge. This type of bill code is used to report the entire episode of care for a patient who is admitted to the hospital as an outpatient and undergoes various treatments or procedures before being discharged.

    Rate this question:

  • 38. 

    Type of bill code 333, the second digit 3 indicates:

    • Outpatient

    • Inpatient Part B

    • Swing bed

    • Inpatient Part A

    Correct Answer
    A. Outpatient
    Explanation
    The correct answer is Outpatient. In the type of bill code 333, the second digit 3 indicates that the bill is for an outpatient service. Type of bill codes are used in medical billing to categorize the type of services provided to the patient. In this case, the code 333 specifically identifies outpatient services.

    Rate this question:

  • 39. 

    Who is primary if both parents have the same birthday?

    • Mother

    • Father

    • The plan that has covered the parent longer

    • The parent born first in the calendar year

    Correct Answer
    A. The plan that has covered the parent longer
    Explanation
    If both parents have the same birthday, the primary parent would be determined by the plan that has covered the parent longer. This means that the parent who has been covered by the insurance plan for a longer period of time would be considered the primary parent.

    Rate this question:

  • 40. 

    NCCI is the acronym for:

    • National Correct Coding Initiative

    • National Corrected Coding Issues

    • National Correct Coding Issues

    • National Corrected Coding Initiative

    Correct Answer
    A. National Correct Coding Initiative
    Explanation
    The correct answer is National Correct Coding Initiative. NCCI is an acronym that stands for National Correct Coding Initiative. This initiative was developed by the Centers for Medicare and Medicaid Services (CMS) to promote correct coding methodologies and prevent improper coding practices in medical claims. It includes coding edits and guidelines that help ensure accurate and consistent coding, reducing the risk of fraud and abuse in healthcare billing.

    Rate this question:

  • 41. 

    APC is the acronym for:

    • Automatic payment classification

    • Ambulatory Patient Classification

    • Automatic Patient Classification

    • Ambulatory Payment Classification

    Correct Answer
    A. Ambulatory Payment Classification
    Explanation
    APC stands for Ambulatory Payment Classification. Ambulatory refers to medical care provided on an outpatient basis, meaning that patients do not require overnight hospitalization. Payment classification refers to the system used to categorize and determine reimbursement for healthcare services. Ambulatory Payment Classification is a specific payment system used by Medicare to determine the payment rates for outpatient services. This system groups similar services together based on clinical similarity and resource use, allowing for more accurate reimbursement.

    Rate this question:

  • 42. 

    V- codes are used when?

    • Describe an illness

    • Describe a procedure

    • Circumstances other than diseases or injury

    • All of the Above

    Correct Answer
    A. Circumstances other than diseases or injury
    Explanation
    V-codes are used to describe circumstances other than diseases or injury. These codes are used to indicate reasons for encounters that are not due to a specific illness or injury. They are used to provide additional information about the patient's condition, such as a history of a certain disease, a family history of a certain condition, or a need for a specific service, like a vaccination or screening. V-codes help in capturing important information about the patient's health status, which can be useful for research, public health monitoring, and reimbursement purposes.

    Rate this question:

  • 43. 

    The third digit in the type of bill indicates:

    • Frequency

    • Type of facility

    • Bill classification

    • None of the above

    Correct Answer
    A. Frequency
    Explanation
    The third digit in the type of bill indicates the frequency. This means that it represents how often a bill is being generated or how often a certain service is being provided. It is used to classify bills and determine the billing cycle for a particular facility or service. The third digit helps in organizing and tracking the frequency of bill generation or service provision, making it easier for administrative purposes.

    Rate this question:

  • 44. 

    The 72 hour rule does not apply to all of the following except:

    • Children's Hospital

    • Cancer Hospitals

    • Psychiatric Hospitals

    • Inpatient Hospitals

    Correct Answer
    A. Inpatient Hospitals
    Explanation
    The 72 hour rule is a regulation that applies to psychiatric hospitals, stating that a patient must stay for at least 72 hours to be eligible for insurance coverage. However, this rule does not apply to inpatient hospitals. Therefore, the correct answer is "Inpatient Hospitals" because they are not subject to the 72 hour rule.

    Rate this question:

  • 45. 

    The CWF contains all of the following except:

    • Part A and B deductible information

    • Date of birth

    • Date of service

    • Benefit periods and days remaining in the current benefit period

    Correct Answer
    A. Date of service
    Explanation
    The Correct answer is "Date of service". The reason for this is that the CWF (Common Working File) is a database used by Medicare to store and track beneficiary information. It contains various details such as Part A and B deductible information, date of birth, and benefit periods and days remaining in the current benefit period. However, it does not include the specific date of service, which refers to the date on which a particular medical service or treatment was provided to the beneficiary.

    Rate this question:

  • 46. 

    The Medicare Part A Lifetime Reserve 91 through 150 days:

    • $275 per day

    • $350 per day

    • $550 per day

    • $1100 per spell of illness

    Correct Answer
    A. $550 per day
    Explanation
    The correct answer is $550 per day. Medicare Part A provides coverage for hospital stays, and the Lifetime Reserve days are additional days of coverage that can be used after the initial 90 days. During these reserve days, Medicare covers a portion of the cost, and the beneficiary is responsible for the daily coinsurance. In this case, the coinsurance amount is $550 per day.

    Rate this question:

  • 47. 

    RBRVS is the acronym for:

    • Resource Based Related Value System

    • Resource Based Relative Value System

    • Resource Based Related Value Scale

    • Resource Based Relative Value Scale

    Correct Answer
    A. Resource Based Relative Value Scale
    Explanation
    RBRVS stands for Resource Based Relative Value Scale. This system is used to determine the reimbursement rates for medical services provided by physicians. It takes into account the resources required to perform each service, such as time, skill, and overhead costs. The relative value of each service is then calculated based on these factors, and payment rates are set accordingly. This system helps ensure that physicians are fairly compensated for their services based on the complexity and resources required for each procedure.

    Rate this question:

  • 48. 

    NCCI was introduced to do all of the following except:

    • Increase reimbursement

    • Identify codes that may be a potential for fraud and abuse

    • Establish standards of medical billing

    • Identify codes that are components of another code and should not be billed together.

    Correct Answer
    A. Increase reimbursement
    Explanation
    NCCI, or the National Correct Coding Initiative, was introduced to achieve multiple objectives, such as identifying codes that may be susceptible to fraud and abuse, establishing standards of medical billing, and identifying codes that should not be billed together. However, the purpose of NCCI does not include increasing reimbursement. Instead, it aims to promote accurate and appropriate coding practices to ensure proper reimbursement based on the services provided.

    Rate this question:

  • 49. 

    A UB04 code that identifies a specific accommodation, ancillary service or billing calculation:

    • Condition code

    • Occurrence code

    • Value code

    • Revenue code

    Correct Answer
    A. Revenue code
    Explanation
    A revenue code is a UB04 code that identifies a specific accommodation, ancillary service, or billing calculation. It is used to indicate the type of service or item provided to a patient, which helps in determining the appropriate billing and reimbursement. Revenue codes are essential for accurate and efficient medical billing and coding processes.

    Rate this question:

Quiz Review Timeline (Updated): Feb 19, 2024 +

Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Feb 19, 2024
    Quiz Edited by
    ProProfs Editorial Team
  • Nov 16, 2010
    Quiz Created by
    Brandy Cummins

Recent Quizzes

CPAT Billing Practice Exam of Doom II CPAT Billing Practice Exam of Doom II
CPAT AAHAM Final Practice Exam CPAT AAHAM Final Practice Exam
CPAT Prep Credit and Collections PFS CPAT Prep Credit and Collections PFS
Hospital and Clinic Billing! CPAT Trivia Quiz Hospital and Clinic Billing! CPAT Trivia Quiz
Certified Patient Account Technician Exam! Trivia Quiz Certified Patient Account Technician Exam! Trivia Quiz
CPAT PREP Formulas and formula definitions CPAT PREP Formulas and formula definitions
Back to Top Back to top
Advertisement
×

Wait!
Here's an interesting quiz for you.

We have other quizzes matching your interest.