Which Involves Linking Every Procedure or Service Code Reported on the Claim

question 25

Multiple Choice

Which involves linking every procedure or service code reported on the claim to a condition code that justifies the necessity of performing that procedure or service?

• A) claims adjudication
• B) diagnosis coding
• C) medical necessity
• D) reimbursement processing

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Definitions:

Limited Liability

A legal structure that limits the financial liability of the owners to the amount they invested in the company, protecting personal assets from business debts and obligations.

Franchises

A business model that allows individuals to operate their own outlets using the branding, products, and operational knowledge of an established company.

Franchisees

Individuals or entities that acquire the rights to operate a business under a franchisor's brand and system.

Franchisors

Companies or individuals that grant licenses to third parties to conduct business under their trademark and business model.