1.)Which of the following is a patient-level adjustment for Inpatient Psychiatri
ID: 247638 • Letter: 1
Question
1.)Which of the following is a patient-level adjustment for Inpatient Psychiatric Facility Prospective Payment (IPF PPS) claims.
Age
Emergency
Rural Hospital
HIPPS
2.) What is the term for the average MS-DRG relative weight of all patients treated in a facility during a specified time period?
Case mix index
Outlier pool
Share
Mean qualifier
3.)The MS-DRG based payment received by an inpatient acute care hospital includes reimbursement for all of the following inpatient services except:
Medications
Physican services
Lab tests
Dressing and other supplies
4.)Which formula would you use to “wage adjust” the base payment rate for most health care providers in the U.S.?
(payment rate * non-labor portion % * WI) + (payment rate * labor portion %)
(payment rate * labor portion% * WI) + (payment rate * non-labor portion%)
(payment rate * WI)
(payment rate * non-labor portion% * WI) + (payment rate * labor portion% * COLA)
5.)Medicare inpatient medical (acute care) hospital reimbursement levels are based on:
CPT codes reported during the encounter
MS-DRG for the stay
Charges accumulated during the episode of care
Usual and customary charges reported during the encounter
6.)Which of the following is not a true statements about ICD-10 Coding system.
The United States was the first country to transition from ICD-9 to ICD-10
It will be very costly for the U.S. to transition from ICD-9 to ICD-10
ICD-10 allows for far greater specificity in coding than ICD-9
ICD-10 codes are maintained by the World Health Organization (WHO)
7.)What is not an RVU in the physician payment calculation?
Physician work (WORK)
physician practice expenses (PE)
malpractice (MP
Conversion Factor (CF)
8.)What is the control mechanism the government uses on Medicare payments to physicians to keep overall expenditures within spending targets.
Sustainable growth rate
Two midnight rule
Three midnight rule
Medical necessity
9.Payments to facilities are adjusted to reflect differences in labor expenses using this?
PE
CPI
GPCI
Wage index
10Which classification system is used to determine payments for hospital outpatient services?
IRVEN
HHRGs
RUGs
APCs
11.All of the following are an adjustment to a payment based on the relative needs of an individual patient except.
DRG
RVU
RUG
HHRG
12.The adjustment for skilled nursing (rehab) facility payments (the RUG) is constructed using:
ICD 9 codes
CPT codes
Minimum data set
OASIS
Explanation / Answer
1.Answer:Rural hopitals.All four has a adjustment for claiming. Among four rural hospitals have greater importance.
2.Answer: Case mix index.It gives the mean of the weight of patients treated in specific time period.outlier pool denotes the odd group,different set of groups.share denotes the payment adjustment in the( IPF PPS) and mean qualifier is not exist.
3.Answer: physician. All others resources gets claim.
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