Hospital billing/ UB-40 chp 12 Flashcards

7086969215	How many diagnosis can be listed in the UB-04 claim Form?	10	0
7090142927	What is listed on a Charge Description Master?	Procedure code, procedure description, service description, revenue code and charge amounts	1
7090149108	What are revenue codes?	The 3 digit code representing a specific accommodation ancillary service or billing calculation related to that service, identifies the hospital department that provided services	2
7090164888	What is Ambulatory Surgical Unit?	A department in a hospital that performs outpatient services for patients, day surgeries, minor procedures	3
7090172836	Define Cost Outlier	a case that cannot be assigned an appropriate DRG because of a rare condition, long length of stay or unique or unusual combination of diagnosis and surgeries	4
7090185687	What is the software program that allows a facility to calculate its Diagnosis Related Group (DRG) payment group?	grouper	5
7090187975	Who maintains the Ambulatory Payment Classification (APC) list?	CMS Centers of Medicare and Medicaid Services	6
7090191377	Ambulatory Payment Classification (APC) system bases payment on	procedures	7
7090194884	What is Prospective Payment System?	pay before service is rendered	8
7090200886	How often is a patient control number (PCN) assigned to a patient in the hospital?	with each admission and listed on a UB-04 claim form	9
7090202670	Define comorbidity	one or more diseases that presents in addition to the primary disease	10
7090210879	What are the different types of facilities that would use UB-04 claim form?	inpatient care, hospice	11
7090216178	Majority of hospital reimbursement comes from??	insurance companies	12
7090217813	When will a hospital bill for patient services?	when a patient is discharged, after discharge papers are signed by physician	13
7090226480	What is the method of reimbursement that pays hospitals a fixed rate per day for all services?	The Per Diem type	14
7090228744	What does OPPS stand for?	Outpatient Prospective Payment System	15
7090230742	Diagnosis Related Group (DRG) system is a type of?	Prospective payment system	16
7090239388	What physician is primarily responsible for patient's care while in the hospital?	attending physician	17
7090243424	Referring to Diagnosis Relayed Group (DRG) what does CC used to indicate?	complications or comorbidity	18
7090272000	If the time that the patient was admitted to the hospital is unknown, which code would be used, on form locator 13?	99	19