CASE 13.3

QUESTIONS A AND B

The preceding RA has been received by a provider. A. LO 13.5 What is the patient coinsurance percentage required under plan R-1? B. LO 13.5 What is the patient coinsurance percentage required under plan PPO-3? C. L013.5 What is Gloria Ramirez's balance due for the two dates of service listed? D. L013.5 Kurt Jugal's first visit of the year is the encounter shown for DOS 2/16/2018. What is the patient's deductible under plan R-1? Read this information from a Medicare carrier and answer the questions that follow. E&M services rendered in a private residence are correctly billed with CPT codes 99341-99345(new patients) and CPT codes 99347-99350 (established patients), home services. These CPT codes are payable only in home settings, that is, place of service 12. National Government Services has seen many instances of providers billing outpatient/office codes in home settings. Home visits should not be reported with E&M codes 99201-99215, which represent office and outpatient services. A. LO 13.3 Based on Table 13.2, what claim adjustment reason code will result if this code is billed 99201 POS 12? LO 13 3 Which Remade Code would appear, N210 or N211? The preceding RA has been received by a provider. A. LO 13.5 What is the patient coinsurance percentage required under plan R-1? B. LO 13.5 What is the patient coinsurance percentage required under plan PPO-3? C. L013.5 What is Gloria Ramirez's balance due for the two dates of service listed? D. L013.5 Kurt Jugal's first visit of the year is the encounter shown for DOS 2/16/2018. What is the patient's deductible under plan R-1? Read this information from a Medicare carrier and answer the questions that follow. E&M services rendered in a private residence are correctly billed with CPT codes 99341-99345(new patients) and CPT codes 99347-99350 (established patients), home services. These CPT codes are payable only in home settings, that is, place of service 12. National Government Services has seen many instances of providers billing outpatient/office codes in home settings. Home visits should not be reported with E&M codes 99201-99215, which represent office and outpatient services. A. LO 13.3 Based on Table 13.2, what claim adjustment reason code will result if this code is billed 99201 POS 12? LO 13 3 Which Remade Code would appear, N210 or N211