Lesson 5 Flashcards
How many diagnoses can be listed on the UB-04 claim form?
10
What is listed on a Charge Description Master?
Procedure codes, procedure or description, charge
What are revenue codes
Codes that identify the department that supplied the seevices
What is a ambulatory surgical unit
A department in a hospital that provides outpatient surgery seevices
Define Cost Outliner
A case that cannot be assigned a appropriate Diagnosis Related Group because of an atypical situation
What is the software program that allows a facility to calculate its diagnosis related group payment group?
Grouper
Who maintains the ambulatory payment classification list
Centers for medicare and medicaid seevices
Ambulatory payment classification system bases payment on
Procedures
What is prospective payment system
A method of reimbursement that establishes the rate of payment to a hospital before services are rendered
How often is a patient control number assigned to a patient in the hospital?
At each admission
Define comorbidity
A preexisting condition that because of its effect on the principle diagnosis, results in more intensive therapy or a longer stay
What are types of facilities that would use UB-04 claim form
Hospitals, rehabilitation centers, outpatient surgical centers, skilled nursing facilities
Majority of a hospital reimbursement comes from
Insurance companies
When will a hospital bill for patient services
After the discharge paperwork is completed and signed by the physician
What is the method of reimbursement that pays hospitals a foxed rate per day for all services
Per diem
What does OPPS stand for
Out patient prospective payment system
Diagnosis related group system is a type of
Prospective payment system
What physician is primarily responsible for patient’s care while in the hospital?
Attending physician
Referring to diagnosis related group, what does CC used to indicate?
Complications & comorbidities
If the time that the patient was admitted to the hospital os unknown, which code would be used (on form locater 13)
99
