The two concepts that are used to determine if services provided under Medicare in hospital settings are appropriate as billed services are:
A) The correct ICD code and the correct CPT code.
B) Medical necessity and the correct CPT code.
C) Medical necessity and qualifying as skilled service.
D) Qualifying as skilled service and the correct ICD code.

Question

Quizplus · Accepted Answer

Medical necessity and the correct Current Procedural Terminology (CPT) code are essential to determine if services provided under Medicare in hospital settings are appropriate as billed. Medical necessity ensures that the services are needed for the diagnosis or treatment of a medical condition, while the correct CPT code accurately represents the specific services provided.

The Two Concepts That Are Used to Determine If Services