CPAT Prep Hospital And Clinic Billing Pfs
Preparation for Hospital/ Clinic portion of CPAT.
- 1.The uniform billing form is also known as the UB-04.
- A.
True
- B.
False
- 2.The UB-04 contains how many data elements?
- A.
78
- B.
81
- C.
92
- 3.Conditons codes are found in which field locators?
- A.
39-41
- B.
66-74
- C.
18-28
- D.
31-34
- 4.Revenue codes are found in which fields:
- A.
42-49
- B.
31-34
- C.
66-74
- D.
18-28
- 5.Occurrence codes are found in which fields:
- A.
18-28
- B.
31-34
- C.
39-41
- D.
42-49
- 6.A UB04 code that identifies a specific accommodation, ancillary service or billing calculation:
- A.
Condition code
- B.
Occurrence code
- C.
Value code
- D.
Revenue code
- 7.A UB-04 code which identifies the condition(s) relating to the bill that may affect payer processing:
- A.
Condition code
- B.
Occurrence code
- C.
Value code
- D.
Revenue code
- 8.A UB04 code used to identify values of monetary nature:
- A.
Condition code
- B.
Occurrence code
- C.
Value code
- D.
Revenue code
- 9.A UB04 code used which identifies the specific date defining a significant event relating to the bill that my affect payment processing:
- A.
Condition code
- B.
Occurrence code
- C.
Value code
- 10.The type of bill code is how many digits:
- A.
2
- B.
3
- C.
4
- D.
5
- 11.The type of bill code is found in what form locator:
- A.
5
- B.
6
- C.
2
- D.
4
- 12.The first digit in the type of bill indicates:
- A.
Frequency
- B.
Type of facility
- C.
Bill classification
- D.
None of the above
- 13.The third digit in the type of bill indicates:
- A.
Frequency
- B.
Type of facility
- C.
Bill classification
- D.
None of the above
- 14.Type of bill code 131 indicates:
- A.
Skilled Nursing, Outpatient, Interim –first claim
- B.
Hospital, outpatient, nonpayment zero claims
- C.
Hospital, inpatient, admit through discharge claim
- D.
Hospital, outpatient, admit through discharge claim
- 15.Type of bill code 227, the third digit 7 indicates:
- A.
Final claim for a home health PPS episode
- B.
Interim-last claim
- C.
Replacement of prior claim
- D.
Late charge only
- 16.Type of bill code 333, the second digit 3 indicates:
- A.
Outpatient
- B.
Inpatient Part B
- C.
Swing bed
- D.
Inpatient Part A
- 17.Hospital, Swing bed, Interim-first claim:
- A.
251
- B.
182
- C.
145
- D.
262
- 18.CWF is the acronym for:
- A.
Common Working Field
- B.
Constant Working File
- C.
Conditional Working File
- D.
Common Working File
- 19.The CWF contains all of the following except:
- A.
Part A and B deductible information
- B.
Date of birth
- C.
Date of service
- D.
Benefit periods and days remaining in the current benefit period
- 20.MSP is the acronym for:
- A.
Medicaid secondary payer
- B.
Medicare seasonal payer
- C.
Miscellaneous secondary payer
- D.
Medicare secondary payer
- 21.A claim that contains complete and necessary information but the information is illogical or incorrect is:
- A.
Clean claim
- B.
Incomplete claim
- C.
Invalid claim
- D.
None of the above
- 22.A clean claim is one which:
- A.
If investigated does not require contact with the provider
- B.
Will pass all front end edits
- C.
Is processed electronically
- D.
All of the above
- 23.The Medicare Part A deductible for days 1 through 60 is:
- A.
$1000
- B.
$1132
- C.
$1200
- D.
$1500
- 24.The Medicare Part A Lifetime Reserve 91 through 150 days:
- A.
$275 per day
- B.
$350 per day
- C.
$550 per day
- D.
$1100 per spell of illness
- 25.Blood deductible for Medicare Part A and Part B is:
- A.
1 pint per year
- B.
2 pints per year
- C.
3 pints per year
- D.
4 pints per year
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