The universal claim form used for hospital billing of private and government payers is the:
UB-82.
UB-92.
UB-04.
CMS-1500.
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Q. 2) The prospective payment system (PPS) is NOT widely used as a reimbursement method for inpatient care.
Indicate whether this statement is true or false.
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Q. 3) If a physician examines the system directly related to the problem plus two to nine additional systems, the review of systems (ROS) would be considered:
problem pertinent.
extended.
complete.
none of the above.
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Q. 4) To consider time as the key factor in determining the level of evaluation and management (E/M) services, the counseling and/or coordination of care must make up:
10 of the encounter.
25 of the encounter.
50 of the encounter.
75 of the encounter.
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Q. 5) The use of the CMS-1500 claim form is:
mandatory for all physician office claims.
mandatory for all Medicare claims but optional for private insurance carriers.
optional for all Medicare claims but mandatory for private insurance carriers.
optional for all physician office claims.
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Q. 6) Time is considered the controlling factor for determining the level of evaluation and management (E/M) service if counseling with the patient or family members constitutes at least 50 of the encounter.
Indicate whether this statement is true or false.
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Q. 7) A case that involves a unique combination of diagnoses and procedures that result in higher-than-usual costs is designated as a cost outlier.
Indicate whether this statement is true or false.
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Q. 8) For a patient whose condition permits adequate time to schedule the service, the admission type code would be reported as:
emergency.
urgent.
elective.
trauma.
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Q. 9) An examination that involves one or more organ systems or body areas is called a:
general multisystem exam.
general organ system exam.
single organ system exam.
multibody-area exam.
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Q. 10) A physician's review of laboratory reports and previous medical records would impact the level of medical __________ .
Fill in the blank with correct word.