Medical Billing Basics Flashcards

10924186041	chargemaster (charge description master [CDM])	document that contains a computer-generated list of procedures, services, and supplies with charges for each.	0
10924199982	Billing Procedures	Computer-generated statements. Encounter forms. Photocopied statements. Online billing statements	1
10924615362	What Items do chargemasters generally contain?	CPT/HCPCS Procedure Code Charge Description Revenue Code Charge Department Code Charge Code Charge Status	2
10924615363	Charge description master (CDM) or Chargemaster	is a large database that contains the price list for all services provided to its patients. Also used to collect information on all the goods and services provided to patients.	3
10924615364	CDM	Charge Description Master	4
10926984189	HCPCS	Healthcare Common Procedure Coding System ("hick picks")	5
10927010528	CPT	Current Procedural Terminology	6
10927426541	All chargemasters contain which item(s)? D	procedure code description charge all of the above	7
10927447265	The healthcare provider's comprehensive price list of all supplies, services, and equipment usage fees is referred to as the chargemaster or ___C__.	procedure codes provider schedule CDM master list	8
10927461314	The fees on the chargemaster __B___.	are always the same vary from provider to provider are set by the procedure code system do not include tax	9
10927480382	How often is the chargemaster or fee schedule updated? B	every day every year (at a minimum) every five years (at a minimum) never	10
10927570385	The CDM, may also be called	the service master price list charge list service item master,	11
10966144715	chargemaster committee	HIM Finance, & billing Technical and informations systems Management from all clinical departments	12
10966152130	plan for CDM Maintenance.	Purpose - Compliance Frequency - Update CDM & Codes, Risks- minimize violations Process - Line by line review of codes and charges Responsible Parties - Chargemaster committee	13
10974051653	Charge Description	The charge or item description identifies the procedure, service, product (including medications), or other items provided to a patient.	14
10974093706	Elements of a chargemaster	Descriptions : Charge Description Codes: Procedure, Service, or Product code, Revenue Code, Department code, Charge Code Charges: Charge, Charge Status	15
10974161362	Procedure, Service, or Product code	CPT or HCPCS Level II codes identify the specific procedure, service or product supplied to the patient	16
10974175947	Revenue code	Unique 4-digit number that represent descriptions and dollar amounts charged for hospital services provided to a patient.	17
10974188029	Department code	identifies the department that revenue should be allocated to foraccounting purposes.	18
10974211387	Charge code	Each item in the chargemaster is uniquely identified by a charge code assigned by the organization and may also be referred to as the charge description number or item code	19
10974242730	charge	simply the price or fee charged for the item.	20
10974251054	charge status	indicates active assignment of a charge and can be used for tracking when and how often an item has been charged.	21
15764575831	Hard coding	Use of the charge description master to code repetitive services.	22
15764587624	soft coding	Coders perform the coding on procedures that vary from patient to patient.	23
15765367570	Process for Coding/Billing for Healthcare Services Physicians and non	Diagnosis Codes - ICD-10-CM Procedure Codes - CPT® Supply Codes - HCPCS (if applicable) Billing - CMS-1500 form	24
15765471275	Coding/Billing for Outpatient Healthcare Institutions	Diagnosis Codes - ICD-10-CM Procedure Codes - CPT® (billing) Supply Codes - HCPCS (as appropriate) Billing - UB-04 form	25
15765527688	What procedure systems are used for outpatient hospital settings?	procedures are reported with CPT® and HCPCS codes in all outpatient hospital settings.	26
15765560732	What procedure system is used to report inpatient billing?	The new procedure system ICD-10-PCS is for hospital inpatient billing	27
15765629657	The Medicare Exception	Medicare requires all charges for same-day surgery to be billed on the CMS-1500. Coding/Billing for Medicare Patients for Outpatient Surgery Diagnosis Codes - ICD-10 Procedure Codes - CPT® (billing) Supply Codes - HCPCS (as appropriate) Billing - CMS-1500	28
15784783335	What are the four main parts to a superbill?	Provider information - includes name, degree, service location, and signature. Patient information - patient's name, DOB, and insurance information. Service information - date of service, CPT and ICD-10-CM codes, modifiers, time, units, quantity for drugs, and authorization information. Additional information - notes and comments.	29
15785264651	Coding and Billing by Service Provider		30
15784828719	Who Uses the UB-04?	Facilities	31
15784844488	Where are revenue codes required?	UB-04 for facilites	32
15784885236	What are the components for a Revenue code?	1) demographics, including payer information 2)fee for each service from the chargemaster 3)charge list, with description 4)correct diagnosis, procedure, and supply codes	33
15784988343	Who uses CMS 1500 and what is billed?	Physician's offices. Professional services and equipment and supply charges	34