Question 1

MAAC ________________________________________

Accepted Answer

Maximum Actual Allowable Charge

Question 2

CMS handles the daily operation of the Medicare program through the use of ____ ____ ____, formerly Fiscal Intermediaries.

Accepted Answer

A) Medical Adjustment Contractor 
B) Medicare Administrative Cooperative 
C) Medicare Administrative Contractors 
D) Medical Administrative Contractors 
A) Medical Adjustment Contractor 
B) Medicare Administrative Cooperative 
C) Medicare Administrative Contractors 
D) Medical Administrative Contractors C

Question 3

What edition of the Federal Register would outpatient facilities be especially interested in?

Accepted Answer

A) October 
B) November or December 
C) January 
D) July 
A) October 
B) November or December 
C) January 
D) July B

Question 4

Medicare Part B pays for:

Accepted Answer

A) durable medical equipment 
B) hospital/facility care 
C) physician services and durable medical equipment 
D) hospital/facility care and durable medical equipment 
A) durable medical equipment 
B) hospital/facility care 
C) physician services and durable medical equipment 
D) hospital/facility care and durable medical equipment

Question 5

The conversion factor (CF) is a national dollar amount that is applied to all services paid on the basis of the ____________________.

Accepted Answer

MFS
mfs
Medicare Fee

Question 6

What are the three items that the Medicare beneficiaries are responsible for paying before Medicare will begin to pay for services?

Accepted Answer

A) personal care items 
B) deductibles, drug costs, personal care items 
C) premiums 
D) deductibles, premiums, and coinsurance 
A) personal care items 
B) deductibles, drug costs, personal care items 
C) premiums 
D) deductibles, premiums, and coinsurance

Question 7

This program is also known as Medicare Advantage.

Accepted Answer

A) Part A 
B) Part B 
C) Part C 
D) Part D 
A) Part A 
B) Part B 
C) Part C 
D) Part D

Question 8

Which of the following is NOT a stated goal of the Physician Payment Reform?

Accepted Answer

A) decrease Medicare expenditures 
B) assure quality health care at a reasonable cost 
C) limit provider liabilities 
D) redistribute physician payment more equitably 
A) decrease Medicare expenditures 
B) assure quality health care at a reasonable cost 
C) limit provider liabilities 
D) redistribute physician payment more equitably

Question 9

Match the Medicare part(s) with the coverage.
-Physician visits

Accepted Answer

A)  Part A 
B)  Part D 
C)  Part B 
A)  Part A 
B)  Part D 
C)  Part B

Question 10

Medicare pays for what percentage of covered charges?

Accepted Answer

A) 70% 
B) 75% 
C) 80% 
D) 85% 
A) 70% 
B) 75% 
C) 80% 
D) 85%

Question 11

OIG ________________________________________

Accepted Answer

Office of

Question 12

CMS ________________________________________

Accepted Answer

Centers fo

Question 13

List the three goals of the Physician Payment Reform.

Accepted Answer

(in any order) decrease Medica

Question 14

The __________ __________ is a national dollar amount that is applied to all services paid on the basis of the MFS.

Accepted Answer

The answer of The __________ __________ is a national dollar...

Question 15

The Medicare program was established in:

Accepted Answer

A) 1955 
B) 1960 
C) 1965 
D) 1970 
A) 1955 
B) 1960 
C) 1965 
D) 1970

Question 16

Who handles the day-to-day operation of the Medicare program for the CMS?

Accepted Answer

A) HCFA 
B) peer review organization 
C) MACs 
D) IPPS 
A) HCFA 
B) peer review organization 
C) MACs 
D) IPPS

Question 17

In the role as a medical coder, it is your responsibility to ensure that you code ____________________ and ____________________ to optimize reimbursement for services provided. (Separate your answers with a comma and a space.)

Accepted Answer

accurately

Question 18

For endoscopic procedures, Medicare allows the full value of the highest valued endoscopy, plus the difference between the next highest endoscopy and the ____________________ endoscopy.

Accepted Answer

The answer of For endoscopic procedures, Medicare allows the full...

Question 19

Match the Medicare part(s) with the coverage.
-Automatic coverage when age 65

Accepted Answer

A)  Part A 
B)  Part D 
C)  Part B 
A)  Part A 
B)  Part D 
C)  Part B

Question 20

Nationally, unit values have been assigned for each service by Medicare (CPT and HCPCS) and determined on the basis of the resources necessary for the physician's performance of the service.

Accepted Answer

A) True 
 B)False

Exam 1: Reimbursement, Hipaa, and Compliance

MAAC ________________________________________

CMS handles the daily operation of the Medicare program through the use of ____ ____ ____, formerly Fiscal Intermediaries.

What edition of the Federal Register would outpatient facilities be especially interested in?

Medicare Part B pays for:

The conversion factor (CF) is a national dollar amount that is applied to all services paid on the basis of the ____________________.

What are the three items that the Medicare beneficiaries are responsible for paying before Medicare will begin to pay for services?

This program is also known as Medicare Advantage.

Which of the following is NOT a stated goal of the Physician Payment Reform?

Match the Medicare part(s) with the coverage. -Physician visits

Medicare pays for what percentage of covered charges?

OIG ________________________________________

CMS ________________________________________

List the three goals of the Physician Payment Reform.

The __________ __________ is a national dollar amount that is applied to all services paid on the basis of the MFS.

The Medicare program was established in:

Who handles the day-to-day operation of the Medicare program for the CMS?

In the role as a medical coder, it is your responsibility to ensure that you code ____________________ and ____________________ to optimize reimbursement for services provided. (Separate your answers with a comma and a space.)

For endoscopic procedures, Medicare allows the full value of the highest valued endoscopy, plus the difference between the next highest endoscopy and the ____________________ endoscopy.

Match the Medicare part(s) with the coverage. -Automatic coverage when age 65

Nationally, unit values have been assigned for each service by Medicare (CPT and HCPCS) and determined on the basis of the resources necessary for the physician's performance of the service.

An Overview of ICD-10-CM

ICD-10-CM Outpatient Coding and Reporting Guidelines

Using ICD-10-CM

Introduction to CPT

Introduction to Level II National Codes HCPSC

Modifiers

Evaluation and Management EM Services

Anesthesia

Surgery Guidelines and General Surgery

Extension 1: Chapter-Specific Guidelines: ICD-10-CM Chapters 1-10

Musculoskeletal System

Integumentary System

Respiratory System

Extension 2: Chapter-Specific Guidelines: ICD-10-CM Chapters 11-14

Cardiovascular System

Hemic, Lymphatic, Mediastinum, and Diaphragm

Digestive System

Urinary and Male Genital Systems

Reproductive, Intersex Surgery, Female Genital System, and Maternity Care and Delivery

Extension 3: Chapter-Specific Guidelines : ICD-10-CM Chapters 15-21

Endocrine and Nervous Systems

Eye, Ocular Adnexa, Auditory, and Operating Microscope

Radiology Section

Pathology/Laboratory Section

The Medicine Section

Inpatient Coding

Filters

CMS handles the daily operation of the Medicare program through the use of , formerly Fiscal Intermediaries.

The is a national dollar amount that is applied to all services paid on the basis of the MFS.

In the role as a medical coder, it is your responsibility to ensure that you code and to optimize reimbursement for services provided. (Separate your answers with a comma and a space.)