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MBC10 Lesson 5 Study Guide: Hospital Billing/UB-04 Ch. 12 Flashcards

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8883847477How many diagnosis can be listed on the UB-04 claim form?Ten0
8883884344What is listed on a Charge Description Master?All services and items provided to the patient, hospital charges.1
8883888226What are revenue codes?They describe the specific accommodation and/or ancillary charges.2
8883898866What is an Ambulatory Surgical Unit?A designated center where outpatient services are offered to patients.3
8883912614Define Cost OutlierA case that cannot be assigned an appropriate DRG because of an atypical situation.4
8883925531What is the software program that allows a facility to calculate its Diagnosis Related Group (DRG) payment group?Grouper5
8883930866Who maintains the Ambulatory Payment Classification (APC) list?The CMS6
8883938582Ambulatory Payment Classification (APC) system bases payment on ______Procedures7
8883942781What is a Prospective Payment System?Established payment rates to hospitals prospectively, before services are rendered.8
8883955153How often is a patient control number (PCN) assigned to a patient in the hospital?Each hospital admission.9
8883958771Define comorbidityOne or more diseases that presents in addition to the primary disease or disorder.10
8883977602What are the types of facilities that would use the UB-04 claim form?Inpatient care, hospice, skilled nursing facility, outpatient care, ASC, ASU, emergency care, and urgent care.11
8884094532Majority of hospital reimbursement comes from _____Insurance companies12
8884113027When will a hospital bill for patient services?After the patient is discharged.13
8884123615What is the method of reimbursement that pays hospitals a fixed rate per day for all services?Per Diem type14
8884126833What does OPPS stand for?Outpatient Prospective Payment System15
8884135083Diagnosis Related Group (DRG) system is a type of _____Prospective Payment System16
8884148649What physician is primarily responsible for patient's care while in the hospital?An attending physician17
8884154962Referring to Diagnosis Related Group, what is CC used to indicate?Complications or Comorbidities18
8884162919If the time that the patient was admitted to the hospital is unknown, which code would be used?Code 9919

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