Author: Anonymous

Match — Claim filing deadlineDOS = date of service

The PRIMARY purpose of the patient record is: [l1]

Typically the coinsurance for Medicare Part B services is:

Physician evaluates a patient with a past medical history of HTN and DM for right leg numbness; the right leg x-ray (performed in the physician’s office) was negative. The Physician formed a final diagnosis of right leg numbness. What diagnosis code(s) should be included in Box 21?

Polly Pockets has Medicare and AvMed. AvMed is primary and Medicare is secondary. Deductibles have been met. Polly was seen by his PCP who charged 100-. AvMed reimbursed 80% of the allowed amount. Medicare allowable for the visit is $100-. How much did Medicare pay the Physician?

All of the Medicare coverage scenarios are possible EXCEPT:

Captain and Tennille have 2 children, John Boy and Elizabeth. Both Captain and Tennille have insurance through their employers and both carry insurance on both children. Captains’s birthday is on Thanksgiving and Tennille was born on New Year’s Day. Tennille may be considered a “gold-digger” because Captain is 10 years her senior. Captain works for the Island Record Label and Tennille works for the Humane Society– they both have been employed with their respective companies since 2001. Since John Boy and Elizabeth both live with their natural, biological parents, which parent’s insurance would be considered primary?

What does “medical necessity” mean as it relates to submitting a claim for reimbursement?[l1]

The patient receives an annual well check-up. The physician charges 80- fee schedule. The Payer reimburses the physician at 90% of the $80- fee schedule. What does the Payer owe the physician?

The Resource-Based Relative Value Scale (RBRVS) is also known as