MBC10 Lesson 5 Study Guide: Hospital Billing/UB-04 Ch. 12 Flashcards
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| 8883847477 | How many diagnosis can be listed on the UB-04 claim form? | Ten | 0 | |
| 8883884344 | What is listed on a Charge Description Master? | All services and items provided to the patient, hospital charges. | 1 | |
| 8883888226 | What are revenue codes? | They describe the specific accommodation and/or ancillary charges. | 2 | |
| 8883898866 | What is an Ambulatory Surgical Unit? | A designated center where outpatient services are offered to patients. | 3 | |
| 8883912614 | Define Cost Outlier | A case that cannot be assigned an appropriate DRG because of an atypical situation. | 4 | |
| 8883925531 | What is the software program that allows a facility to calculate its Diagnosis Related Group (DRG) payment group? | Grouper | 5 | |
| 8883930866 | Who maintains the Ambulatory Payment Classification (APC) list? | The CMS | 6 | |
| 8883938582 | Ambulatory Payment Classification (APC) system bases payment on ______ | Procedures | 7 | |
| 8883942781 | What is a Prospective Payment System? | Established payment rates to hospitals prospectively, before services are rendered. | 8 | |
| 8883955153 | How often is a patient control number (PCN) assigned to a patient in the hospital? | Each hospital admission. | 9 | |
| 8883958771 | Define comorbidity | One or more diseases that presents in addition to the primary disease or disorder. | 10 | |
| 8883977602 | What 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 | |
| 8884094532 | Majority of hospital reimbursement comes from _____ | Insurance companies | 12 | |
| 8884113027 | When will a hospital bill for patient services? | After the patient is discharged. | 13 | |
| 8884123615 | What is the method of reimbursement that pays hospitals a fixed rate per day for all services? | Per Diem type | 14 | |
| 8884126833 | What does OPPS stand for? | Outpatient Prospective Payment System | 15 | |
| 8884135083 | Diagnosis Related Group (DRG) system is a type of _____ | Prospective Payment System | 16 | |
| 8884148649 | What physician is primarily responsible for patient's care while in the hospital? | An attending physician | 17 | |
| 8884154962 | Referring to Diagnosis Related Group, what is CC used to indicate? | Complications or Comorbidities | 18 | |
| 8884162919 | If the time that the patient was admitted to the hospital is unknown, which code would be used? | Code 99 | 19 |