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?

     

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    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