Use the following case scenario to answer the question. A patient with Medicare is seen in the physician’s office. The total charge for this office visit is $250.00. The patient has previously paid his deductible under Medicare Part B. The PAR Medicare fee schedule amount for this service is $200.00. The non-PAR Medicare fee schedule amount for this service is $190.00. If this physician is a participating physician who accepts assignment for this claim, the total amount the physician will receive is
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The following services are excluded under the Hospital Outpa…
The following services are excluded under the Hospital Outpatient Prospective Payment System (OPPS) Ambulatory Payment Classification (APC) methodology.
Some services are performed by a non-physician practitioner…
Some services are performed by a non-physician practitioner (such as a physician assistant). These services are an integral yet incidental component of a physician’s treatment. A physician must have personally performed an initial visit and must remain actively involved in the continuing care. Medicare requires direct supervision for these services to be billed. This is called
In CPT, Category III codes include codes
In CPT, Category III codes include codes
The standard claim form used by hospitals to request reimbur…
The standard claim form used by hospitals to request reimbursement for inpatient and outpatient procedures performed or services provided is called the
The patient was diagnosed with anterior spinal artery compre…
The patient was diagnosed with anterior spinal artery compression syndrome affecting T10–T12. The correct diagnosis code to report this condition is: M89.168 Other physeal arrest of lower leg M47.012 Anterior spinal artery compression syndromes, cervical region M89.164 Complete physeal arrest, right distal tibia M47.014 Anterior spinal artery compression syndromes, thoracic region
According to the American Medical Association, medical decis…
According to the American Medical Association, medical decision making is measured by all of the following except the
The provider performed an esophageal transplantation using a…
The provider performed an esophageal transplantation using a section from a cadaver donor. The ICD-10-PCS code to report is:
A physician performed an outpatient surgical procedure on th…
A physician performed an outpatient surgical procedure on the eye orbit of a patient with Medicare. Upon searching the CPT codes and consulting with the physician, the coder is unable to find a code for the procedure. The coder should assign
Which describes the portal system discussed in the endocrine…
Which describes the portal system discussed in the endocrine chapter?