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Domain 2 Exam Questions with
Detailed Verified Answers
Question:Under ASC PPSs, bilateral procedures are reimbursed at _______ of
the payment rate for their group.
Ans: 150%
Question: Use the following table to answer the question.
HCPCSCode Charge Service CodeItem Service DescriptionGeneral Ledger
KeyMedicareMedicaidChargesRevenue CodeActivity Date49683105CT scan;
head; w/out contrast and with
contrast37047070470500.0003511/1/201949683106CT scan; soft tissue neck;
with contrast37049170491675.0003511/1/2019
This data is used because it provides a uniform system of identifying
procedures, services, or supplies. Multiple columns can be available for various
financial classes.
Ans: HCPCS/CPT code
Question: This is the amount collected by the facility for the services it bills.
Ans: reimbursement
Question: Which of the following could influence a facility's case mix?
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Ans: all answers apply
changes in DRG weights
accuracy of coding
changes in the services offered by a facility
Question: Based on CMS's DRG system, other systems have been developed
for payment purposes. The one that classifies the non-Medicare population,
such as HIV patients, neonates, and pediatric patients, is known as
Ans: APR-DRGs.
Question: Coinsurance payments are paid by the _______ and determined by
a specified percentage.
Ans: patient (insured)
Question: Use the following case scenario to answer the question.
A patient with Medicare is seen in the physician's office.The total charge for
this office visit is $250.00.The patient has previously paid his deductible under
Medicare Part B.The PAR Medicare fee schedule amount for this service is
$200.00.The non-PAR Medicare fee schedule amount for this service is
$190.00.
If this physician is a nonparticipating physician who does NOT accept
assignment for this claim, the total amount of the patient's financial liability
(out-of-pocket expense) is
Domain 2 Exam Questions with
Detailed Verified Answers
Question:Under ASC PPSs, bilateral procedures are reimbursed at _______ of
the payment rate for their group.
Ans: 150%
Question: Use the following table to answer the question.
HCPCSCode Charge Service CodeItem Service DescriptionGeneral Ledger
KeyMedicareMedicaidChargesRevenue CodeActivity Date49683105CT scan;
head; w/out contrast and with
contrast37047070470500.0003511/1/201949683106CT scan; soft tissue neck;
with contrast37049170491675.0003511/1/2019
This data is used because it provides a uniform system of identifying
procedures, services, or supplies. Multiple columns can be available for various
financial classes.
Ans: HCPCS/CPT code
Question: This is the amount collected by the facility for the services it bills.
Ans: reimbursement
Question: Which of the following could influence a facility's case mix?
, Page | 2
Ans: all answers apply
changes in DRG weights
accuracy of coding
changes in the services offered by a facility
Question: Based on CMS's DRG system, other systems have been developed
for payment purposes. The one that classifies the non-Medicare population,
such as HIV patients, neonates, and pediatric patients, is known as
Ans: APR-DRGs.
Question: Coinsurance payments are paid by the _______ and determined by
a specified percentage.
Ans: patient (insured)
Question: Use the following case scenario to answer the question.
A patient with Medicare is seen in the physician's office.The total charge for
this office visit is $250.00.The patient has previously paid his deductible under
Medicare Part B.The PAR Medicare fee schedule amount for this service is
$200.00.The non-PAR Medicare fee schedule amount for this service is
$190.00.
If this physician is a nonparticipating physician who does NOT accept
assignment for this claim, the total amount of the patient's financial liability
(out-of-pocket expense) is
