Matching
Match the following:
Premises:
Billing for procedures or services that were NOT necessary
The notice that alerts a Medicare beneficiary that a service may NOT be medically necessary and is, therefore, NOT covered
The practice of billing the parts of a bundled procedure as separate procedures
Reporting items or services that are NOT actually documented in the medical record but that the coder believes were performed
The codes used to report vision and hearing services
Two codes that could NOT have both reasonably been performed during a single patient encounter
Intentional acts of deception used to take advantage of another person or entity
The two-character code used with all levels of HCPCS codes to provide additional detail on services reported on Medicare claims
The use of a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided
The codes found in the Current Procedural Terminology (CPT) code book
Responses:
abuse
assumption coding
HCPCS Level II codes
advance beneficiary notice
HCPCS Level I codes
unbundling
mutually exclusive
HCPCS modifier
fraud
upcoding
Correct Answer:
Premises:
Responses:
Billing for procedures or services that were NOT necessary
The notice that alerts a Medicare beneficiary that a service may NOT be medically necessary and is, therefore, NOT covered
The practice of billing the parts of a bundled procedure as separate procedures
Reporting items or services that are NOT actually documented in the medical record but that the coder believes were performed
The codes used to report vision and hearing services
Two codes that could NOT have both reasonably been performed during a single patient encounter
Intentional acts of deception used to take advantage of another person or entity
The two-character code used with all levels of HCPCS codes to provide additional detail on services reported on Medicare claims
The use of a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided
The codes found in the Current Procedural Terminology (CPT) code book
Premises:
Billing for procedures or services that were NOT necessary
The notice that alerts a Medicare beneficiary that a service may NOT be medically necessary and is, therefore, NOT covered
The practice of billing the parts of a bundled procedure as separate procedures
Reporting items or services that are NOT actually documented in the medical record but that the coder believes were performed
The codes used to report vision and hearing services
Two codes that could NOT have both reasonably been performed during a single patient encounter
Intentional acts of deception used to take advantage of another person or entity
The two-character code used with all levels of HCPCS codes to provide additional detail on services reported on Medicare claims
The use of a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided
The codes found in the Current Procedural Terminology (CPT) code book
Responses:
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