Test 2: Billing

Question 1

1 Billing Unit

Answer 1

Between 8 to 15 minutes, but less than 20 minutes (must be AT LEAST 8 min to bill)

Question 2

ICD codes

Answer 2

ICD codes report PRIMARILY the symptom and SECONDARILY the underlying cause

• correct coding promotes the distinct value of OT
• 9000 ICD codes are common in OT and PT

Question 3

Prospective Payment Systems (PPS)

Answer 3

Method of reimbursing in which payment is based on predetermined, fixed amount

• Part A: for Acute (up to 100 days) stays- minimum data set (MDS) section on the GG helps determine reimbursement
• Part B: for outpatient services- reimburses 80% of the bill

Question 4

Billing for splints

Answer 4

L-codes are used for hand splints and orthotics