Which of the following is not a potential reason for downcoding?
A. The insurance carrier does not cover the services included on the claim.
B. The coding system used by the insurer does not match that used by the provider.
C. A workers' compensation carrier converts a CPT code to the lowest-paying code in the system.
D. The payer discovers that documentation does not back up the level of code used.
E. The provider uses a HCPCS code the insurer does not recognize.
A. The insurance carrier does not cover the services included on the claim.
The medical office would generally know before sending the claim whether the insurer covers the specified services.
You might also like to view...
What is the leading cause of death for women between the ages of 35 and 45?
A) Sepsis due to endometriosis B) Uterine rupture C) Breast cancer D) Uterine cancer
Which cells of the body are more sensitive than others to deprivation of glucose and oxygen?
A) Lung and liver cells B) Heart and lung cells C) Brain and heart cells D) Liver and pancreas cells
Which of the following has the highest level of retention associated with it?
A. Sight B. Sight and hearing C. Talking D. Doing Hint: Review page 164 of Fire Service Personnel Management, 3rd Edition.
Mechanical tattooing is defined as:
a. a form of body art in which dye is injected under the skin. b. a type of self-mutilation requiring psychiatric follow-up for the patient. c. the introduction of foreign debris such as dirt, gunpowder, or small rocks into the skin. d. multiple punctures made by a nail gun.