quiz week 2

Question 1

1. If a patient has Medicare and the fee schedule amount is $450 after the surgeon's charge of $1050, what is the patient's co-pay?

    

   80

    

   110

    

   90

    

   45

4 points  

Question 2

1. You are the CFO at a community hospital where there has been a reduction in revenue reported over the last three months. With whom might you consult to determine the cause? (choose all that apply)

    

   The former CFO.

    

   The payroll manager

    

   The controller

    

   The human resources officer

4 points  

Question 3

1. When you meet with the controller, he tells you the volume report did not show any issues. Where else might he check?

    

   A collections and accounts receivable analysis.

    

   The payroll totals for the year.

    

   The insurance payoffs.

    

   An employee absence report analysis.

4 points  

Question 4

1. While ICD-10 is the most recent coding source, ICD-9 was still used prior to October 2015 for __________.

    

   Patients born before 1960

    

   Coding older diseases

    

   Patient lists

    

   Billing

4 points  

Question 5

1. ________________ can best be described as weighing the probability of one disease versus another disease as the cause of the pateint's symptoms.

    

   Differential diagnosis

    

   Treatment diagnosis

    

   Disease causation

    

   Supplemental diagnosis

4 points  

Question 6

1. Which factors could contribute to the difficulties of being a CFO?

    

   Lower state and federal revenues.

    

     Reduced labor costs.

    

      Lower costs for regulatory compliance.

    

      Lower liability costs.

4 points  

Question 7

1. A self-pay patient with no insurance is billed:

    

   22% of actual cost due to new state healthcare guidelines

    

   Only after it is determined by a doctor that the patient is actually sick and in need of care

    

   With a 56% deduction due to new healthcare guidelines

    

   The full price

4 points  

Question 8

1.  When you ask the controller to look into federal reimbursements to see if he can find the cause of the reduction, how might he respond? (Select all that apply)

    

      Federal reimbursements are not part of the revenue cycle, the problem lies in revenue.

    

       Since federal reimbursements are part of the revenue cycle, we might find the problem there.

    

       The problem lies in revenue so it’s possible that charges are not being generated.

    

      The problem lies in revenue so there could be a problem in claims.

4 points  

Question 9

1. In 1922 interest grew in using classification to categorize not only causes of mortality, but also _____________.

    

   Causes of immortality

    

   Causes of morbidity

    

   Causes of disease pathology

    

   Causes of disease spread

4 points  

Question 10

1. The determination of medical _______ involves comparing the procedure being billed to the diagnosis submitted.

    

   Similarity

    

   Necessity

    

   Symptoms

    

   Urgency

4 points  

Question 11

1. A main cause for the spread and severity of the Black Death includes:

    

   Poor sanitation

    

   Large extended families living together

    

   Lack of medical knowledge

    

   Historical trend of resistance to medical treatment

4 points  

Question 12

1. Once a diagnosis has been made by the doctor, _________ can then be determined.

    

   Life-expectancy

    

   Disease pathology

    

   Disease causation

    

   The code

4 points  

Question 13

1. Florence Nightingale's work to improve sanitation reduced the mortality rate in her hospital from __________ in one year.

    

   43% to 5%

    

   62% to 5%

    

   33% to 2%

    

   60% to 2%

4 points  

Question 14

1. The first step toward a diagnosis is:

    

   Patient history

    

   Family morbidity rate

    

   Known genetic defects

    

   Cause of disease

4 points  

Question 15

1. CPT is part of HCPCS, known as _____________

    

   Level 3

    

   Level 1

    

   Level 4

    

   Level 5

4 points  

Question 16

1. Procedure coding encompasses a wide variety of services to patients, including:

    

   Gas expenses related to travel for care

    

   Pathology and diagnostic testing

    

   Reimbursement for time lost at work

    

   Self treatment

4 points  

Question 17

1. This form has space for 12 diagnosis codes and 6 procedure codes:

    

   CMS-1500

    

   CSM-1500

    

   CCM-1300

    

   HMHC-1250

4 points  

Question 18

1. Diagnosis can best be classified as the identification of a disease from its ____________.

    

   Location

    

   Pathology

    

   Symptoms

    

   Point of origin

4 points  

Question 19

1. When you provide the results of your analysis about the reduction in revenue problem to the CEO, what might you report? (Select all that apply)

    

   You were right about the bundling – the problem resides with the APC outpatient billing.

    

   We found that the claims included an APC code, but not the specific procedure code.

    

      All of the Medicare payments were exactly correct.

    

      We looked just at drugs as a snapshot and they are billing for the drug itself, but not for its administration.

4 points  

Question 20

1. Dr. William Farr is best known for is contribution to:

    

   Finding the cure for the Black Death

    

   Streamlining scientific method

    

   Refining the Cullen disease clarification

    

   Refining the classification of disease pathology

4 points  

Question 21

1. In the 1960s and 1970s the expansion of the CPT led to:

    

   Adoption of 5-digit codes in CPT-2

    

   Adopton of 5-digit codes in CPT-3

    

   Adoption of 3-digit codes in CPT-4

    

   Adoption of 4-digit codes in CPT-2

4 points  

Question 22

1. Select the two types of claim forms used by different types of providers.

    

   CMS-1500 and UB-04

    

   CSM-110 and UR-42

    

   C3P-0000 and R2-D2

    

   CMS-1200 and RD-92

4 points  

Question 23

1. An amendment to the ____________ in 1974 made the National Committee on Vital and Health Statistics a statutory body and required that there be an annual report to Congress on the health of the American people.

    

   Public Information Act

    

   National Healthcare Act

    

   Procedure Coding Act

    

   Public Health Act

4 points  

Question 24

1. The purpose of the ICD-10 is:

    

   To promote international comparability in the collection, classification, processing, and presentation of morbidity and mortality statistics

    

   To promote the advancement of medical science

    

   To promote international standards for the collection and dissemination of medical statistics

    

   To provide a clear and concise method for documenting disease and illness

4 points  

Question 25

1. The doctors review system is intended to:

    

   Make the patient aware of what is going on

    

   Convert symptoms into code

    

   Certify that the correct evaluations were made

    

   Identify symptoms you may have forgotten to mention