Ch. 08 intro to CPT coding Questions with 100% Correct Answers| Verified | Latest Update 2024

Ch. 08 intro to CPT coding Questions with 100% Correct Answers| Verified | Latest Update 2024 To promote national correct coding methodologies and control the improper assignment of codes that result in inappropriate reimbursement of Medicare Part_________ claims, CMS implemented the NCCI. B The NCCI was initially developed for use by Medicare administrative contractors (MACs) that process Medicare Part B claims for physician office services; in August 2000, NCCI edits were added to the Outpatient Code ____________ for use by MACs to process Medicare Part B claims for outpatient hospital services. outpatient code editor The NCCI code pairs that should not be billed together because one service inherently includes the other are called column 1/column 2 edits, while the NCCI code pairs that, for clinical reasons, are unlikely to be performed on the same patient on the same day are called ___________ ________________ edits. mutually exclusive When a submitted claim for reimbursement is denied because of incorrect coding rather than medical necessity, the provider cannot submit an Advance Beneficiary Notice (ABN) or a Notice of Exclusions from Medicare ________ to seek payment from a Medicare beneficiary. benefits A 34-year-old male underwent upper gastrointestinal endoscopy, which included visualization of the esophagus, stomach, and duodenum. During endoscopy, brushings collected esophageal specimens and esophageal biopsy was performed. Upon review of CPT Surgery code descriptions for 43235 and 43239, the coder assigned 43239 only (because 43235 is considered a component of the total procedure, 43239). Reporting both codes would be considered ______________ unbundling