2022 Revenue Integrity Week

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Across
  1. 5. This government organization releases a Work Plan detailing upcoming audits.
  2. 8. A two-digit alphanumeric code added to a CPT or HCPCS code that provides additional information.
  3. 9. CMS’ primary audit programs are TPE, SMRC, and _____ Audits.
  4. 10. ICD-10-CM code Z28.39 should be assigned to indicate a lapsed _____ schedule status.
  5. 13. Current Procedural Terminology (CPT®) code 93798 is used to report physician or other qualified healthcare professional services for outpatient _____ rehabilitation, with continuous ECG monitoring (per session).
  6. 14. This diagnosis, an extreme complication of an infection, is one of the most common targets of denials.
  7. 16. The 2-_____ rule sets a benchmark for how many days of hospital-level care a physician expects a patient to need.
  8. 18. The “C” in CHRI stands for the this.
  9. 21. Modifier -CO is used to indicate _____ occupational therapy services furnished in whole or in part by an occupational therapy assistant.
  10. 22. Under the ____ day payment rule, certain outpatient services provided in a specific timeframe prior to inpatient admission are considered inpatient services and billed on the inpatient claim.
  11. 24. Modifier -JW is used to report ___ amounts that are discarded and not administered to the patient.
  12. 25. The _______ requires payers and providers to settle disputes about out-of-network bills through an arbitration process.
  13. 26. A Medically ____ Edit for a HCPCS/CPT code is the maximum units of service that, under typical circumstances, a provider can report for a single patient on a single date of service.
Down
  1. 1. This CMS reimbursement methodology applies to inpatient hospital services.
  2. 2. Place of service code 02 can be used to indicate this type of service.
  3. 3. ______ reconciliation is the process of ensuring that actual revenue matches planned revenue.
  4. 4. HCPCS code G2252 is used to report a brief _______ technology-based service, e.g., virtual check-in service.
  5. 6. The “E” in GFE stands for this.
  6. 7. The “A” in CAR-T stands for this.
  7. 11. Status indicator “C” indicates this type of procedure.
  8. 12. A _____ code is a unique code assigned to a specific drug, supply, or service.
  9. 15. Software that scans claims for errors.
  10. 17. New _____ Add On Payments provide additional payment to hospitals above the standard MS-DRG.
  11. 19. Condition code -G0 is reported when multiple medical visits occur on the same day in the same revenue center but are distinct and _____ visits.
  12. 20. There are two methods to calculate the substantive portion of a split/shared visit: performance of a key component and ____.
  13. 23. transparency rules require hospitals to post charges online in a machine-readable format.