Ch 6 - AC #4
Dr. Ellen Zook, an allergist, is a participating provider with Phoenix Care and Medicare. She is a nonparticipating provider with Cirrus Health. Patients frequently receive allergy scratch testing, CPT code 95004, and are charged $470. In addition, Dr. Zook charges $65 for the average established patient office visit, CPT code 99213, and $70 for the average new patient office visit, CPT code 99203.
Harris Theodore is a new patient covered by Medicare. He has met his yearly deductible; his coinsurance is 80-20. Medicare’s allowed charge for 99213 is $52, for 99203 is $55, and for 95004 is $375. He was seen by Dr. Zook for an office visit and allergy scratch testing. What amount, if any, will be billed to Mr. Theodore for each procedure?
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Ch 6 - AC #1
Dr. Ellen Zook, an allergist, is a participating provider with Phoenix Care and Medicare. She is a nonparticipating provider with Cirrus Health. Patients frequently receive allergy scratch testing, CPT code 95004, and are charged $470. In addition, Dr. Zook charges $65 for the average established patient office visit, CPT code 99213, and $70 for the average new patient office visit, CPT code 99203.Harris Theodore is a new patient covered by Medicare. He has met his yearly deductible; his coinsurance is...
Ch 6 - AC #2
Dr. Ellen Zook, an allergist, is a participating provider with Phoenix Care and Medicare. She is a nonparticipating provider with Cirrus Health. Patients frequently receive allergy scratch testing, CPT code 95004, and are charged $470. In addition, Dr. Zook charges $65 for the average established patient office visit, CPT code 99213, and $70 for the average new patient office visit, CPT code 99203.Parminder Singh is an established patient also seen by Dr. Zook for an office visit and allergy scratch...
Ch 6 - AC #3
Dr. Ellen Zook, an allergist, is a participating provider with Phoenix Care and Medicare. She is a nonparticipating provider with Cirrus Health. Patients frequently receive allergy scratch testing, CPT code 95004, and are charged $470. In addition, Dr. Zook charges $65 for the average established patient office visit, CPT code 99213, and $70 for the average new patient office visit, CPT code 99203.Monica Salenski is a new patient covered by Cirrus Health. She was seen by Dr. Zook for an...
Dr. Ellen Zook, an allergist, is a participating provider with Phoenix Care and Medicare. She is...
Dr. Ellen Zook, an allergist, is a participating provider with Phoenix Care and Medicare. She is a nonparticipating provider with Cirrus Health. Patients frequently receive allergy scratch testing, CPT code 95004, and are charged $470. In addition, Dr. Zook charges $65 for the average established patient office visit, CPT code 99213, and $70 for the average new patient office visit, CPT code 99203, and $477 for 95004. Nils Hovik is an established patient and is covered by Phoenix Care through...
The Resource Based Relative Value Scale (RBRVS) is a prospective payment system established in 1992 by...
The Resource Based Relative Value Scale (RBRVS) is a
prospective payment system established in 1992 by the Centers for
Medicare and Medicaid Services (CMS) designed to improve and
stabilize the payments made to health care providers.
Application Assignment Instructions
Provide a response to the following questions:
1. What are the three types of RVU's?
2. Explain how CMS determines the national conversion factor
for the RBRVS system?
Using the following grid, respond to questions 3-5
below:
3. What is the...
Outpatient Insurance Coding - Applying Concepts Ch 1
1. The patient's health insurance plan has a $750 deductible for hospital visits, and then it covers 100 percent of hospital visit charges. The patient's first hospital visit this year had charges of $612. The patient was subsequently admitted to the hospital a second time this year, and the charges totaled $358. How much will the patient be billed for each visit? How much will the health insurance plan reimburse for each visit?2 A patient insured under an indemnity plan...
COUCO which a comprehensive and medical decision which a comprehensive on were performed and made until after the...
COUCO which a comprehensive and medical decision which a comprehensive on were performed and made until after the initial i a. True b. False 2.26. Select the appropriate E/M code for a new patient office visit in which a ce history and comprehensive physical examination were performed and medienensya making was of straightforward complexity. - 2.27. Select the appropriate E/M code for an established patient visit in which a con history and expanded problem-focused physical examination were perform medical decision...
Overview CPT modiners clanly services and procedures performed by providers. Although the CPT code and description...
Overview CPT modiners clanly services and procedures performed by providers. Although the CPT code and description remain unchanged, modifiers indicate that the description of the service or procedure performed has been altered. CPT modifiers are reported as two-digit numeric codes added to the five digit CPT code. (HCPCS level Il national modifiers are reported as two character alphabetical and alphanumeric codes added to the five-digit CPT or HCPCS level Il code.) Instructions Circle the most appropriate response 1. Dr. Marshall...
Instruc Instructions: Review each case study and select the correct ICD-10-CM diagnostic code. Please be aware that when...
Instruc Instructions: Review each case study and select the correct ICD-10-CM diagnostic code. Please be aware that when an answer consists of more than one code, there will be an answer blank for each cod tions: Review each case study and select the correct ICD-10-CM diagnostic code. Please be aware that when an answer consists of more than one code, there will be an answer blank for each code, NO hand writing and code all the cases Case 1 Office...
Instructions: Review each case study and select the correct ICD-10-CM diagnostic code.no hand writing and answer...
Instructions: Review each case study and select the correct ICD-10-CM diagnostic code.no hand writing and answer all the cases Case 1 Emergency Department Note This 9-year-old male patient was brought to the ER by his mother. His left external ear is warm to touch, and it appears red and swollen. He has had a fever of 100 for the past 2 days. Upon otoscopic exam, the middle and inner ear are reviewed with no findings. There is definitely cellulitis of...
The Resource Based Relative Value Scale (RBRVS) is a
prospective payment system established in 1992 by the Centers for
Medicare and Medicaid Services (CMS) designed to improve and
stabilize the payments made to health care providers.
Application Assignment Instructions
Provide a response to the following questions:
1. What are the three types of RVU's?
2. Explain how CMS determines the national conversion factor
for the RBRVS system?
Using the following grid, respond to questions 3-5
below:
3. What is the...
COUCO which a comprehensive and medical decision which a comprehensive on were performed and made until after the initial i a. True b. False 2.26. Select the appropriate E/M code for a new patient office visit in which a ce history and comprehensive physical examination were performed and medienensya making was of straightforward complexity. - 2.27. Select the appropriate E/M code for an established patient visit in which a con history and expanded problem-focused physical examination were perform medical decision...
Overview CPT modiners clanly services and procedures performed by providers. Although the CPT code and description remain unchanged, modifiers indicate that the description of the service or procedure performed has been altered. CPT modifiers are reported as two-digit numeric codes added to the five digit CPT code. (HCPCS level Il national modifiers are reported as two character alphabetical and alphanumeric codes added to the five-digit CPT or HCPCS level Il code.) Instructions Circle the most appropriate response 1. Dr. Marshall...
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