What is All Patient DiagnosisRelated Group (APDRG)?

• A.Adopted by Medicare in 2008 to reimburse hospitals for inpatient care provided to Medicare beneficiaries; expanded original DRG system (based on intensity of resources) to add two subclasses to each DRG that adjusts Medicare inpatient hospital reimbursement rates for severity of illness (SOI) (extent of physiological decompensation or organ system loss of function) and risk of mortality (ROM) (likelihood of dying); each subclass, in turn, is subdivided into four areas: (1) minor, (2) moderate, (3) major, (4) extreme.
• B.DRG system adapted for use by third-party payers to reimburse hospitals for inpatient care provided to nonMedicare beneficiaries (e.g. Blue Cross BlueShield, commercial health plans, TRICARE); DRG assignment is based on intensity of resources.

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What is the primary purpose of National Correct Coding Initiative (NCCI) edits?

• A.Increase claim approvals
• B.Identify unbundling and improper coding
• C.Replace CPT guidelines
• D.Set reimbursement rates

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What does it mean by graph?

• A.instrument for hearing
• B.process of recording
• C.instrument for reading
• D.instrument for speaking

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What does BS stand for?

• A.Beneficiary Standards
• B.Beneficiary Services
• C.Blue Shield
• D.Black Shield

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EMC

• A.Electronic Media Claim
• B.Exclusive provider organization
• C.Electronic Medical Record
• D.Explanation of Benefits

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