If Providers Submit a Claim for a Simple Procedure When

question 36

Multiple Choice

If providers submit a claim for a simple procedure when in fact a more complicated procedure was documented in the medical record, ____ may occur.

• A) no payment
• B) underpayment
• C) overpayment
• D) denial of claim
• E) recovery audit

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Definitions:

Vascular Disease

Disorders of the blood vessels including arteries, veins, and capillaries that can lead to major health problems such as stroke or heart attack.

Thiamine

A vitamin (B1) essential for glucose metabolism and the functioning of the nervous system, deficiency of which can lead to neurological and cardiovascular disorders.

Neurocognitive Disorder

A general term that describes decreased mental function due to a medical disease other than a psychiatric illness.

Alcohol

A mind-altering compound frequently present in drinks such as beer, wine, and hard liquors, renowned for its ability to intoxicate.