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Exam 12: Hospital Medical Billing

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Question 1

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A preexisting condition that, because of its effect on the principal diagnosis, results in more intensive therapy or a longer stay is a(n): A)chronic condition. B)complication. C)comorbidity. D)exacerbation.

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comorbidity.

Question 2

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When using a FOUR-digit Medicare "type of bill" code in form locator 4, the frequency is represented by the: A)first digit. B)second digit. C)third digit. D)fourth digit.

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Question 3

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When using a FOUR-digit Medicare "type of bill" code in form locator 4, the bill classification (type of care) is represented by the: A)first digit. B)second digit. C)third digit. D)fourth digit.

The admission and discharge hour codes on the UB-04 form are based on military time.

The method of reimbursement that establishes the rate of payment to a hospital before services are rendered is: A)capitation. B)fee for service. C)per diem. D)prospective payment system.

When referring to Diagnosis Related Groups (DRGs), the abbreviation CC is used to indicate: A)chief complaint. B)closed case. C)chronic condition. D)complications or comorbidities.

The number of form locators on the UB-04 claim form is: A)33. B)62. C)81. D)94.

Which of the following codes would be entered to report that the patient is female in form locator 11 on the UB-04? A)1 B)2 C)M D)F

If the time that a patient was admitted to the hospital is unknown, which code would be entered in form locator 13? A)It would be left blank. B)It would be noted as "unknown." C)Code 00 D)Code 99

A code that describes an accident or mishap responsible for the patient's admission to the hospital is known as a(n): A)condition code. B)occurrence code. C)value code. D)revenue code.

Revenue codes on the UB-04 claim form identify services and benefit days for Medicare patients.

The majority of hospital reimbursement comes from insurance companies.

What are the four sections of the UB-04 claim form?

It is the responsibility of the __________ physician to determine the principal diagnosis for his or her patient.

What is meant by inpatient care?

OPPS stands for: A)Outpatient Payment for Preventive Services. B)Outpatient Prospective Payment System. C)Optimal Payment for Procedures and Services. D)Other Payments for Procedures and Services.

In form locator 17 on the UB-04 claim form, the codes for "Left against medical advice or discontinued care," "Expired (or did not recover)," and "Admitted as an inpatient to this hospital" represent: A)admission source codes. B)discharge status codes. C)admission type codes. D)condition codes.

The volume of ICD-9 codes that is used to code hospital services and procedures is: A)Volume 3. B)Volume 2. C)Volume 1. D)Version 5010.

On form locator 67 of the UB-04 form, the principal diagnosis code is: A)optional. B)required. C)not applicable. D)not required.

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