Medicare Claim Codes Overview
5 Questions
6 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

Match the following code types with their primary usage:

C codes = Valid only on Medicare claims for hospital outpatient prospective payment system G codes = For professional component of services not found in CPT H codes = Identify mental health services for state Medicaid agencies K codes = Used when no permanent national codes exist for the product

Match the following codes with their descriptions:

S codes = For private insurers to identify drugs and services T codes = For state Medicaid agencies when there are no permanent national codes L codes = For drugs and medical equipment not identifiable in Level II codes C codes = Specific to hospital outpatient prospective payment system claims

Match the code types to the corresponding healthcare components:

G codes = Professional services not listed in CPT H codes = Alcohol and drug treatment services S codes = Medicaid services not reimbursable under Medicare L codes = Medical equipment billing claims

Match the following code types with the insurer requirements:

<p>K codes = Used when no permanent national codes exist C codes = Only valid on Medicare claims T codes = Can be used for private insurers but not Medicare S codes = Identified for drugs covered by private insurers</p> Signup and view all the answers

Match the following code types with their specific usages:

<p>L codes = For services requiring no CPT codes C codes = Hospital outpatient prospective payment system G codes = Services in professional medicine not listed in CPT H codes = Mental health service identification for Medicaid</p> Signup and view all the answers

Study Notes

Codes Used for Medicare Claims

  • C codes: Valid only for Medicare claims and used specifically for the hospital outpatient prospective payment system.

Codes Used for Professional Services and Procedures

  • G codes: Used for professional services and procedures not found in the CPT.

Codes Used for Drugs, Medical Equipment, and Services

  • L codes: Used for drugs, medical equipment, and services that do not have CPT codes and are not identifiable in Level II codes but are needed to process a billing claim.

Codes Used When No Permanent National Codes Exist

  • K codes: Used when no permanent national codes exist for the product or supply.

Codes Used for Private Insurers

  • S codes: Used by private insurers to identify drugs, services, supplies, and procedures. They are also used by Medicaid program but are not reimbursable under Medicare.

Codes Used for State Medicaid Agencies

  • H codes: Used by state Medicaid agencies to identify mental health services (alcohol and drug treatment).
  • T codes: Used by state Medicaid agencies when there are not permanent national codes. While they can be used for private insurers, they are not valid for Medicare.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Description

This quiz explores the various codes used for Medicare and other healthcare services. It covers specific codes like C, G, L, K, S, and H codes, highlighting their uses and significance in billing claims. Test your knowledge of these important coding systems!

More Like This

CVS Medicare Part B Flashcards
14 questions
Medicare Chapter 9 Flashcards
29 questions
Codes de posologie Médicale
18 questions

Codes de posologie Médicale

WellRegardedVanadium avatar
WellRegardedVanadium
Use Quizgecko on...
Browser
Browser