MENU
Dr. Leona Koenig removed the appendix of a plan member of the Helium health plan. In order to increase the level of reimbursement that she would receive from Helium, Dr. Koenig submitted to the health plan separate charges for the preoperative physical examination, the surgical procedure, and postoperative care. All of these charges should have been included in the code for the surgical procedure itself. Dr. Koenig's submission is a misuse of the coding system used by health plans and is an example of:
Suggested Answer: D
Get Premium AHM-530 Questions
as Interactive Web-Based Practice Test or PDF
Real Exam Format
Detailed Explanations
Instant Access
Get Your Practice Test
8 comments · newest first
LI
Lina
1 year ago
Nope, this is classic unbundling, no doubt about it.
NA
Nana
1 year ago
I thought upcoding was the bigger issue here?
AN
Anglea
1 year ago
Wait, can you really get in trouble for that?
FI
Filiberto
1 year ago
Totally agree, she's trying to game the system.
SE
Selma
1 year ago
That's definitely unbundling.
LA
Lashanda
1 year ago
I'm a bit confused by this question. I'll need to review my notes on the Control process blade to make sure I have a solid understanding of its responsibilities.
FA
Fallon
1 year ago
Hmm, I'm a little confused by the wording on some of these options. I'll need to review the live migration process again to make sure I understand which steps are actually required here.
ST
Stevie
1 year ago
The question is asking for two characteristics, so I'll need to make sure I select the two most relevant options. Let me think this through step-by-step.