Author Question: The __________________________ was developed by Medicare in an effort to control quality and cost ... (Read 16 times)

asd123 · **on:** Jul 7, 2018

The ___________________ _______ was developed by Medicare in an effort to control quality and cost and minimize preventable complications.

Fill in the blank(s) with correct word

Question 2

The importance of billing codes and reimbursement for services cannot be overstated. Which of the following responses are true regarding accurate code input and claims processing? Select all that apply.

1. CPT codes were grouped into services by the first digit followed by four more digits that further described the procedure.
2. The number 9 is reserved for visits related to evaluation and management procedures.
3. The CPT code 99211 is an office visit and used for injections.
4. Two digit modifiers are used to further distinguish services and procedures altering the billing process.
5. Inaccurate code input will delay claims processing.

Carissamariew · **Reply #1 on:** Jul 7, 2018

Answer to Question 1

Do Not Pay list
Rationale : In an effort to control the quality and cost of health care, Medicare developed a Do Not Pay list for preventable complications.
Global Rationale:

Cognitive Level: Understanding
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Caring
Learning Outcome:

Answer to Question 2

1,2,3,4,5
Rationale: CPT codes were grouped into services by the first digit followed by four more digits that further described the procedure. The number 9 is reserved for visits related to evaluation and management procedures. Thus, the CPT code 99211 is an office visit for less than 10 minutes and is often used when the patient only sees a nurse for an injection, blood pressure check, or some other simple procedure, which does not involve direct contact with the physician. Incorrect use of codes and modifiers delay claim processing.