CCA EXAM PREP Domain # 2
Reimbursement methodologies ACTUAL
QUESTIONS AND CORRECT ANSWERS
Code assignment - CORRECT ANSWERS 2nd step in reimbursement process
Documentation - medical/ financial record - CORRECT ANSWERS 1st step in
reimbursement process
Claim preparation - CORRECT ANSWERS 3rd step in reimbursement process
Claim to payer(s) - CORRECT ANSWERS 4th step in reimbursement process
Claim review - CORRECT ANSWERS 5th step in reimbursement process
Claim resolution - CORRECT ANSWERS 6th step in reimbursement process
1. Coding for physicians
2. Coding for facilities - CORRECT ANSWERS What are the 2 types of outpatient coding
situations
Demographic information - CORRECT ANSWERS What does medical biller use as
foundation for determining who should receive bills and who has responsibility for payment?
Front office during pre-regristration - CORRECT ANSWERS When is demographic
information collected
,Charge Description Master - CORRECT ANSWERS CDM stands for
Charge Description Master - CORRECT ANSWERS List of all supplies, services,
equipment, usage fees for patient care
Soft Coding - CORRECT ANSWERS Coders perform the coding on procedures that vary
from patient to patient.
Hard coding - CORRECT ANSWERS Done by CDM. Automatically assigns codes based
on a unique identifier number of routine services
Charge Master Contents - CORRECT ANSWERS - CPT/HCPCS procedure code
- Charge descripition
- Revenue Code
- Charge
- Department code
- Charge Code
- Charge Status
Fee/ Charge - CORRECT ANSWERS Price established and assigned to a unit of medical/
other service in facility
Annually - CORRECT ANSWERS How often is Chargemaster updated
, Routine services - CORRECT ANSWERS What does chargemaster code by using the
service identifier
Charge / item description - CORRECT ANSWERS Identifies procedure, service, product
(incl. meds), other items provided to patient
Procedure, service, product code - CORRECT ANSWERS CPT/ HCPCS level II codes
identify specific _____ supplied to patient. Not all ____ have corresponding CPT/ HCPCS II
codes.
Revenue code - CORRECT ANSWERS Unique 4-digit number that represents
descriptions and dollar amounts charges for hospital services provided to patient. Must
accompany valid procedure codes to be accepted
Revenue Code - CORRECT ANSWERS Used to identify location in facility where
procedure was performed. Must accompany valid procedure codes to be accepted
CMS and The National Uniform Billing Committee - CORRECT ANSWERS Revenue
codes are updated by___
Department code - CORRECT ANSWERS Identifies department that revenue should be
allocated to for accounting purposes.
Charge Code/ Charge description/ item code - CORRECT ANSWERS Each item in
chargemaster is uniquely identified by a ____ assigned by organization.
Charge status - CORRECT ANSWERS Active assignment of charge and can be used for
tracking when and how often an item has been charged.
Reimbursement methodologies ACTUAL
QUESTIONS AND CORRECT ANSWERS
Code assignment - CORRECT ANSWERS 2nd step in reimbursement process
Documentation - medical/ financial record - CORRECT ANSWERS 1st step in
reimbursement process
Claim preparation - CORRECT ANSWERS 3rd step in reimbursement process
Claim to payer(s) - CORRECT ANSWERS 4th step in reimbursement process
Claim review - CORRECT ANSWERS 5th step in reimbursement process
Claim resolution - CORRECT ANSWERS 6th step in reimbursement process
1. Coding for physicians
2. Coding for facilities - CORRECT ANSWERS What are the 2 types of outpatient coding
situations
Demographic information - CORRECT ANSWERS What does medical biller use as
foundation for determining who should receive bills and who has responsibility for payment?
Front office during pre-regristration - CORRECT ANSWERS When is demographic
information collected
,Charge Description Master - CORRECT ANSWERS CDM stands for
Charge Description Master - CORRECT ANSWERS List of all supplies, services,
equipment, usage fees for patient care
Soft Coding - CORRECT ANSWERS Coders perform the coding on procedures that vary
from patient to patient.
Hard coding - CORRECT ANSWERS Done by CDM. Automatically assigns codes based
on a unique identifier number of routine services
Charge Master Contents - CORRECT ANSWERS - CPT/HCPCS procedure code
- Charge descripition
- Revenue Code
- Charge
- Department code
- Charge Code
- Charge Status
Fee/ Charge - CORRECT ANSWERS Price established and assigned to a unit of medical/
other service in facility
Annually - CORRECT ANSWERS How often is Chargemaster updated
, Routine services - CORRECT ANSWERS What does chargemaster code by using the
service identifier
Charge / item description - CORRECT ANSWERS Identifies procedure, service, product
(incl. meds), other items provided to patient
Procedure, service, product code - CORRECT ANSWERS CPT/ HCPCS level II codes
identify specific _____ supplied to patient. Not all ____ have corresponding CPT/ HCPCS II
codes.
Revenue code - CORRECT ANSWERS Unique 4-digit number that represents
descriptions and dollar amounts charges for hospital services provided to patient. Must
accompany valid procedure codes to be accepted
Revenue Code - CORRECT ANSWERS Used to identify location in facility where
procedure was performed. Must accompany valid procedure codes to be accepted
CMS and The National Uniform Billing Committee - CORRECT ANSWERS Revenue
codes are updated by___
Department code - CORRECT ANSWERS Identifies department that revenue should be
allocated to for accounting purposes.
Charge Code/ Charge description/ item code - CORRECT ANSWERS Each item in
chargemaster is uniquely identified by a ____ assigned by organization.
Charge status - CORRECT ANSWERS Active assignment of charge and can be used for
tracking when and how often an item has been charged.
