This means that the service or procedure is reasonable and necessary for the diagnosis or treatment of illness or injury consistent with generally accepted standards of care.
A) peer review
B) optimization
C) benchmarking
D) medical necessity
Correct Answer:
Verified
Q318: The MS-DRG (Medicare Severity-Diagnosis-Related Group) system was
Q319: A PEG procedure would most likely be
Q320: The standard claim from used by hospitals
Q321: If the Medicare nonPAR approved payment amount
Q322: The case-mix index (CMI) for the top
Q324: These are assigned to every HCPCS/CPT code
Q325: The first step is
A) cases are differentiated
Q326: The third step is
A) cases are differentiated
Q327: Based on this patient volume, the MS-DRG
Q328: The second step is
A) cases are differentiated
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