Blog

Use the following table to answer the question.   MS-DRG Description Number of Patients CMS Relative Weight 470 Major joint replacement or reattachment of lower extremity w/o MCC 2,750 1.9871 392 Esophagitis, gastroent & misc. digestive disorders w/o MCC 2,200 0.7121 194 Simple pneumonia & pleurisy w CC 1,150 1.0235 247 Perc cardiovasc proc 2 drug-eluting stent w/o MCC 900 2.1255 293 Heart failure & shock w/o CC/MCC 850 0.8765 313 Chest pain 650 0.5489 292 Heart failure & shock w CC 550 1.0134 690 Kidney & urinary tract infections w/o MCC 400 0.8000 192 Chronic obstructive pulmonary disease w/o CC/MCC 300 0.8145 871 Septicemia w/o MV 96+ hours w MCC 250 1.7484 Which individual MS-DRG has the highest reimbursement?

If a query is submitted to the provider, and the coder receives no response within 5 days to a week, the coder should:

The provider performed an open coronary bypass on two internal mammary arteries, one right, one left. Zooplastic tissue was used. The correct ICD-10-PCS code or codes reported are:

The Correct Coding Initiative (CCI) edits contain a listing of codes under two columns titled “comprehensive codes” and “component codes.” According to the CCI edits, when a provider bills Medicare for a procedure that appears in both columns for the same beneficiary on the same date of service,

HIPAA administrative simplification provisions require all of the following code sets to be used EXCEPT

The prospective payment system based on resource utilization groups (RUGs) is used for reimbursement to ____________________ for patients with Medicare.

CMS-identified “hospital-acquired conditions” mean that when a particular diagnosis is not “present on admission,” CMS determines it to be

According to CPT, in which of the following cases would an established E/M code be used?

Of the following, which is a hospital-acquired condition (HAC)?

Under ASC PPS, when multiple procedures are performed during the same surgical session, a payment reduction is applied. The procedure in the highest level group is reimbursed at _____, and all remaining procedures are reimbursed at ______.