A patient is admitted to the hospital with complaints of chest pain and coughing. After examination and testing, the patient is diagnosed with pneumonia. The patient has a sputum culture, which is negative for the presence of any bacterium. After the patient is discharged, an ICD-10-CM code is assigned that identifies the patient as having bacterial pneumonia. Submitting a specific pneumonia ICD-10-CM code is a practice encouraged by the facility to increase its reimbursement rate from Medicare. This practice is known as __________.
a. abuse
b. fraud
Question 2
Which legislation limited exclusions for preexisting medical conditions?
a. Balanced Budget Act
b. HIPAA
c. Stark I
d. TEFRA