Medical Coding And Billing Clinical

Instructions:

• Answer 50 questions in 15 minutes.
• If you are not ready to take this test, you can study here.
• Match each statement with the correct term.
• Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. The _______________-_______________ _______________ is the health plan that pays for medical services
Fraud.
Third party payer
True
True


2. Most practices try to reduce expenses by...
Includes
Up to $500 -000 - or 1% of the practice's net worth
Based on the patient's reported income from the previous month.
Controlling accounts payable


3. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
Disclosure
Payer
[ ]
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.


4. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
( )
Payee
True
Determine practice expense relative value units for all Medicare Physician Fee Schedule services


5. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
False
Up to $500 -000 - or 1% of the practice's net worth
Voucher
( )


6. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Based on the patient's reported income from the previous month.
Fraud.
Inaccurate and/or incorrect billing
False


7. A(n) _______________ account uses the last date of payment or charge for each illness as the starting date for determining the time limit on that specific debt
Third party payer
460-519
Based on the patient's reported income from the previous month.
Open-book


8. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
CPC
Fair Debt Collection Practices Act
Damages
Petty cash


9. The most common disbursement is for...
Fraud.
Voucher
The code may not be used as the first code
Office supplies.


10. The _______________ coding system has two levels and is used for coding services for Medicare patients
If the diagnosis makes you ask 'How did that happen?'
Age analysis.
Fair Debt Collection Practices Act
HCPCS


11. The most common disbursement is for...
False
Fair Debt Collection Practices Act
Office supplies.
False


12. Which of the following types of insurance covers injuries that are caused by the insured or that occurred on the insured's property?
Truth in Lending Act
Controlling accounts payable
Liability
The code may not be used as the first code


13. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
True
( )
Voucher
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.


14. The Relative Value Unit System was created to...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
6 months
Ask the physician to select a more specific code
The code may not be used as the first code


15. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Third party payer
( )
True


16. Money paid for intentionally breaking the law is called _______________ _______________.
Punitive damages
If the diagnosis makes you ask 'How did that happen?'
False
V01-V83


17. Which of the following should be a factor when selecting an outside collection agency?
Copayment
True
Truth in Lending Act
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay


18. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
$280.
[ ]
Based on the patient's reported income from the previous month.
HCPCS


19. The ICD-9-CM convention code first underlying disease means...
Truth in Lending Act
The code may not be used as the first code
Referrals
Open-book


20. The determination of the amount of money paid by a third-party payer for a procedure is...
Truth in Lending Act
Pre-certification.
False
Traveler's


21. The process of classifying and reviewing past-due accounts by age from the first date of billing is called _______________ _______________.
Age analysis
Check your explanation of benefits form
Fair Debt Collection Practice Act
6 months


22. Eligibility for Medicaid is...

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23. You should not accept a(n) _______________-_______________ check that is made out to the patient rather than to the practice unless it is from a health insurance company.
Third-party
False
Inaccurate and/or incorrect billing
Open-book


24. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
HCPCS Level II codes
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
460-519
CPC


25. You should not accept a(n) _______________-_______________ check that is made out to the patient rather than to the practice unless it is from a health insurance company.
Third-party
CPC
Payer
Form W-4.


26. According to the Equal Credit Opportunity Act - how much will a practice have to pay if a credit applicant joins and wins a class action lawsuit against the practice?

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27. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
V01-V83
Ask the physician to select a more specific code
V01-V83
Traveler's


28. The most appropriate response from a medical assistant when a patient calls the medical practice questioning why an insurance claim was rejected is...
Check your explanation of benefits form
Punitive damages
Includes
True


29. An easy way to remember when an E code is required is...

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30. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
False
Based on the patient's reported income from the previous month.
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Traveler's


31. Most practices try to reduce expenses by...
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Controlling accounts payable
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
False


32. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
Includes
True
Copayment
Open-book


33. According to the Equal Credit Opportunity Act - how much will a practice have to pay if a credit applicant joins and wins a class action lawsuit against the practice?

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34. Usual and customary fees are converted to dollar amounts - which form the basis of the fee schedule that creates uniform payments adjusted for geographic differences.
False
The code may not be used as the first code
Fair Debt Collection Practices Act
Controlling accounts payable


35. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
False
Age analysis.
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Resources


36. The process of classifying and reviewing past-due accounts from the first date of billing is...
The code may not be used as the first code
Traveler's
Age analysis.
$280.


37. The most likely outcome of an insurance claim submitted with a diagnosis code of a sore throat and a treatment code indicating a cast for a broken leg would be...
Fraud.
Fair Debt Collection Practices Act
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Open-book


38. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Includes
Payer
Open-book
False


39. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Damages
Includes
False
Truth in Lending Act


40. The determination of the amount of money paid by a third-party payer for a procedure is...
Pre-certification.
Payer
Age analysis.
Includes


41. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Punitive damages
Inaccurate and/or incorrect billing
Voucher
460-519


42. An employer identification number is required by law from every employer for federal tax accounting purposes
Up to $500 -000 - or 1% of the practice's net worth
True
If the diagnosis makes you ask 'How did that happen?'
60


43. To avoid writing checks for small amounts - you may pay for small purchases using the _______________ _______________ fund - which is cash kept on hand in the office.
Controlling accounts payable
Capitated rate
True
Petty cash


44. he ICD code for a home visit for evaluation and management of an established patient is found in which of the following series of codes?
Statement of income and expense
6 months
[ ]
V01-V83


45. Some insurers will not pay a claim unless it is filed within ________ of the date of service
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Referrals
6 months
Office supplies.


46. Prison sentences are possible consequences of...
460-519
Third party payer
Inaccurate and/or incorrect billing
Fair Debt Collection Practices Act


47. What kind of checks are printed in $10 - $20 - $50 - and $100 denominations and must be purchased and signed at the bank?

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48. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
CPC
Capitated rate
Includes


49. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Payer
The code may not be used as the first code
Truth in Lending Act
Controlling accounts payable


50. The number of dependents an employee is claiming is found on the
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Controlling accounts payable
Truth in Lending Act
Form W-4.