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Registered Health Information Administrator (RHIA) Questions 371–375 (page: 76)

Under APCs, payment status indicator "C" means

This is a ten digit, intelligence-free, numeric identifier designed to replaced all previous provider legacy numbers. This number identifies the physician universally to all
payers. This number is issued to all HIPAA-covered entities. It is mandatory on the CMS- 1500 and UB-04 claim forms.

In the managed care industry, there are specific reimbursement concepts, such as "capitation." All of the following statements are true in regard to the concept of "capitation, " EXCEPT

When billing for the admitting physician for a patient that is admitted to the hospital as an inpatient, one must use a CPT Evaluation and Management code based upon the level of care provided. These are the codes to be selected from for initial hospital care.99221 Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components.
- a detailed or comprehensive history
- a detailed or comprehensive examination and
- medical decision making that is straightforward or of low complexity. 99222 Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components.
- a comprehensive history
- a comprehensive examination and
- medical decision making of moderate complexity
99223 Initial hospital care, per day, for the evaluation and management of a patient, which requires these 3 key components.
- a comprehensive history
- a comprehensive examination and
- medical decision making of high complexity
The following statement is true.

This document is published by the Office of Inspector General (OIG) every year. It details the OIG's focus for Medicare fraud and abuse for that year. It gives health care providers an indication of general and specific areas that are targeted for review. It can be found on the Internet on CMS' Web Site.