Author: Anonymous

To compare units of service with CPT® and HCPCS level II codes, CMS added which of the following to the NCCI program?   A.Medically utilized edits B.Medically undetermined edits C.Medically unlikely edits D.Medically unusual edits

Case 3 Surgical Specialists-Outpatient Surgery Preauthorization Form Date: 08/01/20XX Surgeon: Brian Surgery, MD Assistant Surgeon: John Smith, MD Surgeon NPI: 8908900989 Member Name: Doe Jane A Last First Middle Date of Birth: 06/07/1971            Insurance Carrier: Medical Insurance Specialists Policy Number: 589908765 Group Number: 97809 Date of Surgery: 8/15/20XX Facility Name: General Outpatient Hospital Surgical Center Facility NPI: 4567891923 Facility Address: 1234 Main Street, Here, TX Diagnosis: Old disruption of posterior cruciate ligament Diagnosis code: M23.50 Procedure: Arthroscopic posterior cruciate ligament repair Procedure code: 29889 Fee for Procedure: $2500.00 Contracted Fee: $2000.00 Type of Care (select one): ____ Inpatient ____ 23 Hour Observation X Outpatient Type of Anesthesia (select one): X General ____ Local Preauthorization Number: 2348995786 Insurance Paid Percentage: 70% of the allowable rate after $1500 deductible is met. Patient Responsibility: Patient has $700 deductible remaining that must be met. After deductible is met, patient pays 30% of the allowable rate.   49.Based on the information obtained during the preauthorization, how much is patient responsibility if the claim is paid?   A.$910.00 B.$1500.00 C.$1650.00 D.$1090.00

Medicare Part A is available to individuals under the age of 65 who have which of the following?     A.Diabetes mellitus type I or II B.Chronic kidney disease (CKD) C.End-stage renal disease (ESRD) and meet certain requirements D.Any chronic health condition

Presley owed Dr. Dillon $25,000 for professional services. Dr. Dillon orally assigned this claim to Ava, her adult daughter, as a wedding gift. Shortly thereafter, Dr. Dillon suffered substantial losses in the stock market, and assigned by a signed writing the same claim to her stockbroker, Saxton, in partial satisfaction of previous financial advances legally made by Saxton to Dr. Dillon in Dr. Dillon’s previous stock-market transactions. Without knowledge of either assignment, Presley subsequently paid Dr. Dillon the $25,000 then due, which Dr. Dillon promptly lost at a horse track, although she remains solvent.Assuming that Article 9 of the UCC does not apply to either of the assignments in this situation, which of the following is a correct statement of the parties’ rights and liabilities?

Collins, who has been in the painting and contracting business for 10 years and has a fine reputation, contracts to paint Faith’s barn. The barn is a standard red barn with a loft. The contract has no provision regarding assignment.If Collins assigns the contract to Pablo, a professional painter, and thereafter Pablo does not meet the contract specifications in painting the barn, Faith:

Valmart faxed the following signed message to Widget World, its long-time widget supplier: “Urgently need blue widgets. Ship immediately three gross at your current list price of $600.” Upon receipt of the fax, Widget World shipped three gross of red widgets to Valmart and faxed the following message: “Temporarily out of blue. In case red will help, we are shipping three gross at the same price. Hope you can use them.”Upon Valmart’s timely receipt of both the shipment and Widget World’s fax, which of the following best describes the rights and duties of Valmart and Widget World?

(Bonus up to 5 points): List and describe common chronic illnesses that affect older adults in late adulthood and explain their potential impact on daily life.

Define equity in law and explain the type of situation in which it becomes necessary.

Short Answer QuestionsProvide concise but complete responses to the following questions. Answers need not be more than five sentences.

Define ex post facto laws as articulated in Calder v. Bull (1798).