Determining which of several diagnoses to report as the principal diagnosis when multiple diagnoses equally meet the criteria for selection as the principal diagnosis is called __________, and it is permitted under the inpatient prospective payment system
a. maximizing payment
b. optimizing reimbursement
c. unbundling procedures
d. upcoding diagnoses
b
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The __________ instruction requires the causal condition to be sequenced first if present
a. code, if applicable, any causal condition first b. in diseases classifiable elsewhere c. other and other specified codes d. use additional code
Assume the patient has already met his or her deductible and that the physician is anonparticipating Medicare provider but does accept assignment. The standard fee for the servicesprovided is $120.00 . Medicare's PAR fee is $60.00 and Medicare's non-PAR fee is $57.00 . What isthe amount Medicare will pay the beneficiary on this claim?
A. $120.00 C. $57.00 B. $60.00 D. $45.60
The membrane that directly lines the outside of the lung is:
visceral peritoneum parietal pleura visceral pleura parietal peritoneum
Which of the following is NOT an essential goals of health planning?
A. Improving the organization of health services B. Speeding the development and diffusion of needed new health services C. Encouraging duplication of services D. Improving coordination to facilitate the communication among all clinicians in the continuum of care