CRCR study guide
Through which document does a hospital establish compliance standards ? -
answerCode of conduct
What is the purpose of the OIG work plan - answerIdentify acceptable compliance
programs in various provider settings.
If a Medicare patient is admitted on Friday what services fall within the three day DRG
window rule? - answerDiagnostic and clinically related non diagnostic charges provided
on the Tuesday, Wednesday, Thursday and Friday before admission.
What does a modifier allow a provider to do? - answerReport a specific circumstance
that affected a procedure or service without changing the code or it's definition.
If outpatient diagnostic services are provided within three days of the admission of a
Medicare beneficiary to an IPPS hospital, what must happen to these charges ? -
answerThey must be combined with the inpatient bill paid under the MS-DRG system
Why is the OIG pursuing the Medicare secondary payer initiative? - answerIt reviews
Medicare payments for beneficiaries who have other insurance and assessed the
effectiveness of procedures in preventing inappropriate Medicare payments for
beneficiaries with other insurance coverage.
What is a reoccurring or series registration? - answerOne registration record is created
for multiple days of service
What are nonemergency patients who come for service without prior notification to the
provider called ? - answerUnscheduled patients
Which of the following statements apply to the observation patient type ? - answerIt is
used to evaluate the need for an inpatient admission
Through which document does a hospital establish compliance standards ? -
answerCode of conduct
What is the purpose of the OIG work plan - answerIdentify acceptable compliance
programs in various provider settings.
If a Medicare patient is admitted on Friday what services fall within the three day DRG
window rule? - answerDiagnostic and clinically related non diagnostic charges provided
on the Tuesday, Wednesday, Thursday and Friday before admission.
What does a modifier allow a provider to do? - answerReport a specific circumstance
that affected a procedure or service without changing the code or it's definition.
If outpatient diagnostic services are provided within three days of the admission of a
Medicare beneficiary to an IPPS hospital, what must happen to these charges ? -
answerThey must be combined with the inpatient bill paid under the MS-DRG system
Why is the OIG pursuing the Medicare secondary payer initiative? - answerIt reviews
Medicare payments for beneficiaries who have other insurance and assessed the
effectiveness of procedures in preventing inappropriate Medicare payments for
beneficiaries with other insurance coverage.
What is a reoccurring or series registration? - answerOne registration record is created
for multiple days of service
What are nonemergency patients who come for service without prior notification to the
provider called ? - answerUnscheduled patients
Which of the following statements apply to the observation patient type ? - answerIt is
used to evaluate the need for an inpatient admission
