Which is the amount of time the office or outpatient care provider spends with the patient and/or family?
a. face-to-face time
b. unit/floor time
(
Q. 2) When a provider, knowingly or unknowingly, uses practices that are inconsistent with accepted
medical practice and that directly or indirectly result in unnecessary costs to the Medicare
program, this is called
A. fraud.
B. abuse.
C. unbundling.
D. hypercoding.
(
Q. 3) Which is considered when determining the number of diagnoses or management options for medical decision-making complexity? It includes a disease, condition, illness, injury, symptom, sign, finding, complaint, or other reason for the encounter, with or without a diagnosis being established at the time of the encounter.
a. chief complaint
b. history of present illness
c. nature of presenting problem
d. review of systems
(
Q. 4) ____ are errors in medical care that are clearly identifiable, preventable, and serious in their
consequences for patients.
A. Misadventures
B. Adverse preventable events
C. Never events or Sentinel events
D. Potential compensable events
(
Q. 5) When the physician makes arrangements with other providers or agencies for services to be provided to a patient, this is called __________ of care.
a. coordination
b. delivery
c. quality
d. transfer
(
Q. 6) This law prohibits a physician from referring Medicare patients to clinical laboratory services
where the doctor or a member of his family has a financial interest.
A. the False Claims Act
B. the Civil Monetary Penalties Act
C. the Federal Antikickback Statute
D. the Stark I Law
(
Q. 7) CPT defines counseling as it relates to evaluation and management coding as a(n) __________ concerning areas that involve diagnostic results, impressions, recommended diagnostic studies, and so on.
a. assessment that impacts patient care
b. discussion with a patient and/or family
c. order for further ancillary testing
d. way to guarantee quality patient care
(
Q. 8) The term used to indicate that the service or procedure is reasonable and necessary for the
diagnosis or treatment of illness or injury consistent with generally accepted standards of care is
A. appropriateness. C. benchmarking.
B. evidence-based medicine. D. medical necessity.
(
Q. 9) CPT medical decision making refers to the complexity of __________ as measured by the number of diagnoses or management options, amount and/or complexity of data to be reviewed, and risk of complications and/or morbidity or mortality.
a. assessing patient data in a group or single practice
b. completing a comprehensive history and physical examination
c. establishing a diagnosis and/or selecting a management option
d. ordering ancillary tests and interpreting their results
(
Q. 10) These are assigned to every HCPCS/CPT code under the Medicare hospital outpatient prospective
payment system to identify how the service or procedure described by the code would be paid.
A. geographic practice cost indices C. minimum data set
B. major diagnostic categories D. payment status indicator
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