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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 ______.

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

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 (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