Certified Inpatient Coding (CIC) Practice Exam

Which statement regarding Hospital Part A Coverage and Payment for blood transfusions is false?

1. Non-physician services are always covered under hospital services

2. Medically necessary blood transfusions are covered under Medicare Part A

3. The DRG payment covers blood and blood services

4. Costs for collecting autologous blood are recorded appropriately

The correct answer is: The DRG payment covers blood and blood services

The statement indicating that “the DRG payment covers blood and blood services” is false because Diagnosis-Related Group (DRG) payments do not specifically include additional payments for blood products or blood services. Instead, Medicare covers blood transfusions separately under Part A, as long as they are deemed medically necessary. While the DRG payment encompasses a wide array of hospital services based on the diagnosis and treatment provided, it typically does not account for the costs associated with blood and blood service supplies. In contrast, the other statements reflect correct information regarding Medicare coverage. Non-physician services being covered under hospital services aligns with the understanding that various necessary services, such as laboratory tests or blood services, are included in the overall hospital charges. Medicare Part A indeed covers medically necessary blood transfusions, reinforcing that these life-saving procedures are essential healthcare services. Lastly, costs for collecting autologous blood, which refers to blood donated by a patient for their own transfusion, are indeed recorded correctly in billing procedures, ensuring that the financial aspects of patient care are accurately managed.