Medical Insurance and Billing Unit 10 exam.docx

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1. There are two levels of codes associated with HCPCS, commonly referred to as HCPCS level I and II codes. TRUE 2. Durable medical equipment is defined by Medicare as equipment that can withstand repeated use, is primarily used to serve a medical purpose, is used in the hospital setting, and would not be used in the absence of illness or injury. TRUE 3. HCPCS is a reimbursement methodology or system, and it is important to understand that just because codes exist for certain products or services, coverage is not guaranteed. FALSE 4. HCPCS level II temporary codes are maintained by the AMA and other members of the HCPCS National Panel, independent of permanent level II codes. FALSE 5. HCPCS code modifiers accompany CPT and level II codes to provide additional information regarding the product or service identified. TRUE 6. G codes identify professional health care procedures and services that do not have codes identified in CPT. TRUE 7. DRGs are organized into mutually exclusive categories called major diagnostic categories (MDCs). TRUE 8. Paying according to a composite rate is a common form of Medicare payment, also known as unbundling. FALSE 9. A facility's case mix is a measure of the types of patients treated, and it reflects patients' utilization of varying levels of health care resources.
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