HCPCS level II modifiers are attached to any CPT and/or HCPCS level II codes to __________ performed by providers.
a. clarify services and procedures
b. guarantee payment for services
c. justify the procedure
d. validate codes submitted on claims
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Q. 2) The category Commercial payers includes private health information and
A. Medicare/Medicaid.
B. employer-based group health insurers.
C. TriCare.
D. Blue Cross Blue Shield.
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Q. 3) HCPCS level II C codes identify items that may qualify for __________ under the hospital outpatient prospective payment system.
a. medical review coverage
b. professional health care services
c. transitional pass-through payments
d. unlisted procedures and services
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Q. 4) A three-digit code that describes a classification of a product or service provided to a patient is a
A. ICD-10-CM code.
B. CPT code.
C. HCPCS Level II code.
D. Revenue code.
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Q. 5) HCPCS level II temporary codes are maintained by the __________ and other members of the HCPCS National Panel, independent of permanent national codes.
a. CMS
b. DHS
c. PDAC
d. MAC
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Q. 6) There are seven criteria for high-quality clinical documentation. All of these elements are
included EXCEPT
A. precise.
B. complete.
C. consistent.
D. covered (by third-party payer).
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Q. 7) When claims are to be submitted to one of the four regional DME MACs, DMEPOS dealers that have coding questions should check with the __________, which is responsible for providing suppliers and manufacturers with assistance in determining HCPCS codes to be used.
a. Centers for Medicare and Medicaid Services
b. Department of Health and Human Services
c. Medicare Administrative Contractor
d. Medicare Pricing, Data Analysis and Coding Contractor
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Q. 8) A patient is being cared for in her home by a qualified agency participating in Medicare. The
data-entry software used to conduct all patient assessments is known as
A. HHRG.
B. RBRVS.
C. HAVEN.
D. IRVEN.
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Q. 9) HCPCS level II __________ codes are reported when a DMEPOS dealer submits a claim for
a product or service for which there is no existing HCPCS level II code.
a. miscellaneous
b. permanent
c. temporary
d. unlisted
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Q. 10) APCs are groups of services that the OPPS will reimburse. Which one of the following services is
not included in APCs?
A. radiation therapy
B. preventive services
C. screening exams
D. organ transplantation
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