RCC Medicare & Payer-Specific Radiology Billing

Question 1

Medicare's facility fee schedule for outpatient radiology is governed by which system?

Accepted Answer

OPPS/APC

Answer

Outpatient hospital radiology services are paid under the Outpatient Prospective Payment System (OPPS) using Ambulatory Payment Classifications (APCs).

Question 2

Which Medicare form is used to submit outpatient hospital radiology claims?

Accepted Answer

CMS-1450 (UB-04)

Answer

Outpatient hospital claims, including radiology, are submitted on the CMS-1450 (UB-04) claim form.

Question 3

What is the Medicare global period for most radiology procedures?

Accepted Answer

0 days (XXX indicator)

Answer

Most radiology procedures carry the 'XXX' global period indicator, meaning the concept of global period does not apply.

Question 4

Medicare requires a written order for which imaging modality before services are rendered?

Accepted Answer

All advanced imaging under AUC program

Answer

The Appropriate Use Criteria (AUC) program requires ordering physicians to consult AUC for advanced diagnostic imaging including CT, MRI, and nuclear medicine.

Question 5

Which modifier signals that a service was performed in a Medicare-approved Ambulatory Surgery Center?

Accepted Answer

Modifier SG

Answer

Modifier SG is used by ASCs to indicate the facility fee for services performed in that setting.

RCC - Radiology Certified Coder Practice Test

RCC - Radiology Certified Coder Practice Test

RCC Medicare & Payer-Specific Radiology Billing