CO CO Business Operations & Practice Management 1 — Questions and Answers
Question 1: Under the ABC (American Board for Certification in Orthotics, Prosthetics and Pedorthics) credentialing system, how many continuing education units (CEUs) must a CO earn per five-year renewal cycle?
- 25 CEUs
- 50 CEUs (Correct answer)
- 75 CEUs
- 100 CEUs
Correct answer: 50 CEUs
ABC requires Certified Orthotists to complete 50 continuing education units (CEUs) per five-year certification renewal period.
Question 2: Which federal law governs the privacy of patient health information and applies directly to orthotic practices that transmit health information electronically?
- OSHA
- HIPAA (Correct answer)
- ADA
- ERISA
Correct answer: HIPAA
HIPAA (Health Insurance Portability and Accountability Act) mandates the protection and confidential handling of patient health information.
Question 3: What is a Certificate of Medical Necessity (CMN) in the context of Medicare billing for orthotic devices?
- A patient consent form
- A physician-signed document that establishes medical need for the ordered device (Correct answer)
- An insurance pre-authorization form
- A laboratory test result
Correct answer: A physician-signed document that establishes medical need for the ordered device
A CMN is a physician-signed document that certifies the medical necessity of an orthotic device for Medicare coverage and reimbursement.
Question 4: Which Medicare benefit category covers most custom orthotic devices for outpatients?
- Part A (Hospital Insurance)
- Part B (Medical Insurance) (Correct answer)
- Part C (Medicare Advantage)
- Part D (Prescription Drug)
Correct answer: Part B (Medical Insurance)
Medicare Part B covers durable medical equipment, including most custom orthotic devices, for outpatient beneficiaries.
Question 5: What does the term 'assignment' mean in Medicare orthotic billing?
- Assigning an ICD-10 diagnosis code to the claim
- The provider agrees to accept Medicare's approved amount as full payment (Correct answer)
- Transferring the claim to a secondary insurer
- Assigning a technician to fabricate the device
Correct answer: The provider agrees to accept Medicare's approved amount as full payment
Accepting assignment means the orthotist agrees that Medicare's approved amount is payment in full and cannot bill the patient above that amount.
Question 6: Which organization accredits orthotic and prosthetic patient care facilities in the United States?
- AOPA (American Orthotic and Prosthetic Association)
- ABC (American Board for Certification)
- BOC (Board of Certification/Accreditation)
- Both ABC and BOC (Correct answer)
Correct answer: Both ABC and BOC
Both ABC and BOC provide accreditation for orthotic and prosthetic patient care facilities in the United States.
CO CO Business Operations & Practice Management 1
Under the ABC (American Board for Certification in Orthotics, Prosthetics and Pedorthics) credentialing system, how many continuing education units (CEUs) must a CO earn per five-year renewal cycle?