In each blank, try to type in the
word that is missing. If you've
typed in the correct word, the
blank will turn green.
If your not sure what answer should be entered, press the space bar and the next missing letter will be displayed. When you are all done, you should look back over all your answers and review the ones in red. These ones in red are the ones which you needed help on. Question: actions that are inconsistent with aaccepted, sound medical, business, or fiscal practicesAnswer: abuse Question: a legal newspaper published every business day by the National Archives and Administration (NARA)Answer: Register Question: an intentional deception or misrepresentation that someone makes, knowing it is , that could result in an unauthorized paymentAnswer: fraud Question: an organization that acontracts with CMS to process health care claims and perform program integrity for both Medicare Part A and Part BAnswer: Administrative Contractor (MAC) Question: two digit code attached to the main code; indicates that a procedure/service has been in some manner.Answer: modifier Question: unique identifier, previously called PAYERID, that will be assigned to third-party payers and is expected tohave 10 numberic , including a check digit in the tenth position.Answer: Health PlanID (PlanID) Question: unique identifier to be assigned to health care providers as an 8 or possibly 10-character alphanumeric , including a check digit in the last positionAnswer: Provider Identifier (NPI) Question: funds a provider or beneficiary has received in excess of amounts due and payable under Medicare and Medicaid statutes and .Answer: Question: document published by MC that contains new and changed policies and/or procedures that are to be into a specific CMS program manual.Answer: program Question: storage of documentation for an established period of time, usually mandated by federal and/or state law; its purpose is to ensure the availability of records for use by government and other third parties.Answer: record Question: submitting multiple CPT codes when one code should be Answer: unbundling Question: the major procedure or when reported with another code. The comprehensive code represents greater work, effort, and time than to the other code reported(also called column 1 codes)Answer: code Question: the lesser procedure or service when reported with another code. The component code is part of a major procedure or service and is represented by a lower work relative value unit (RVU) under the MC Dr.fee schedule as compared to the other code repoAnswer: component Question: procedures or services that could not be performed at the same session by the same provider on the same beneficiary.Answer: mutually codes Question: involves linking every procedure or service reported to the insurance company to a condition that the necessity for performing that procedure or serviceAnswer: necessity Question: pairs of CPT and/or HCPCS level II codes, whicha re not separately except under certain circumstances (e.g., reporting appropriate modifier).Answer: CCI Question: laws by legislative bodies. eg. federal Congress and state legislatures.Answer: statutes Question: an order of the court that requires a witness to appear at a particular time and to testify.Answer: Question: the assignment of an ICD-9-CM code that does not match patient record documentation for the of illegally increasing reimbursementAnswer: upcoding Question: CMS's HPMP replaced PEEP. The goal is to measure, monitor, and reduce the incidence of Medicare fee-for-service payment errors for short-term, care, inpatient PPS hospitalsAnswer: Hospital Payment Program (HPMP) |
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