Test your basic knowledge |

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. 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.
V01-V83
Check your explanation of benefits form
Third-party
Form W-4.

2. The ICD-9-CM convention code first underlying disease means...
The code may not be used as the first code
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
V01-V83
If the diagnosis makes you ask 'How did that happen?'

3. If an employee earns $8 per hour and works 35 hours per week - the gross earnings are...
$280.
V01-V83
Damages
HCPCS

4. In order to be considered negotiable - a check must be signed by the _______________.
6 months
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Payer
Resources

5. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
Payee
460-519
Statement of income and expense
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

6. Which of the following is also called Public Law 95-109?
Fair Debt Collection Practice Act
Inaccurate and/or incorrect billing
V01-V83
Truth in Lending Act

7. 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.
460-519
Third-party
Resources
Punitive damages

8. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Includes
False
The code may not be used as the first code
Age analysis

9. Which of the following should be a factor when selecting an outside collection agency?
Copayment
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Controlling accounts payable
$280.

10. The ICD-9-CM convention code first underlying disease means...
The code may not be used as the first code
Liability
Inaccurate and/or incorrect billing
Pre-certification.

11. The most common disbursement is for...
HCPCS
Office supplies.
Third-party
Pre-certification.

12. 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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13. A health-care provider who practices under false qualifications/credentials is guilty of...
The code may not be used as the first code
False
Fraud.
False

14. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
Fraud.
60
[ ]
Third party payer

15. 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
True
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
60

16. The ______________ is paid to the provider even if the patient receives no care
The code may not be used as the first code
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Capitated rate
False

17. The determination of the amount of money paid by a third-party payer for a procedure is...
Check your explanation of benefits form
Pre-certification.
False
6 months

18. Most practices try to reduce expenses by...
Punitive damages
Liability
Controlling accounts payable
Resources

19. An employer identification number is required by law from every employer for federal tax accounting purposes
False
Check your explanation of benefits form
True
Determine practice expense relative value units for all Medicare Physician Fee Schedule services

20. Under a Medicare Managed Care Plan - the PCP provides treatment and manages the patient's medical care through _______________ to specialists when additional care is required
Age analysis.
HCPCS Level II codes
V01-V83
Referrals

21. The Relative Value Unit System was created to...
CPC
Ask the physician to select a more specific code
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
False

22. Eligibility for Medicaid is...

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23. The process of classifying and reviewing past-due accounts by age from the first date of billing is called _______________ _______________.
Payer
Ask the physician to select a more specific code
False
Age analysis

24. 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?
Fair Debt Collection Practice Act
Office supplies.
V01-V83
Pre-certification.

25. The determination of the amount of money paid by a third-party payer for a procedure is...
Referrals
Up to $500 -000 - or 1% of the practice's net worth
Based on the patient's reported income from the previous month.
Pre-certification.

26. The most common disbursement is for...
$280.
False
Office supplies.
Capitated rate

27. The payment system used by Medicare is based on...
False
Resources
Fraud.
Based on the patient's reported income from the previous month.

28. 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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29. The process of classifying and reviewing past-due accounts from the first date of billing is...
Age analysis.
Third party payer
60
Ask the physician to select a more specific code

30. 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
Pre-certification.
Disclosure
Capitated rate

31. 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
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Inaccurate and/or incorrect billing
HCPCS
Open-book

32. 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
The code may not be used as the first code
Up to $500 -000 - or 1% of the practice's net worth
Petty cash
Open-book

33. A small fee that is collected at the time of service is called a(n) _______________.
60
Referrals
Copayment
Punitive damages

34. A benefit period for Medicare begins the day a patient goes into the hospital and ends when that patient has not been hospitalized for ____ days
Payer
HCPCS Level II codes
( )
60

35. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Referrals
Truth in Lending Act
Voucher
HCPCS Level II codes

36. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
False
Disclosure
Voucher
Age analysis

37. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Fair Debt Collection Practices Act
False
Fair Debt Collection Practice Act
Truth in Lending Act

38. Eligibility for Medicaid is...

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39. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
Ask the physician to select a more specific code
Statement of income and expense
Disclosure
False

40. The number of dependents an employee is claiming is found on the
Office supplies.
[ ]
Fair Debt Collection Practices Act
Form W-4.

41. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
460-519
Up to $500 -000 - or 1% of the practice's net worth
Based on the patient's reported income from the previous month.
[ ]

42. The _______________-_______________ _______________ is the health plan that pays for medical services
The code may not be used as the first code
Third party payer
Payee
Ask the physician to select a more specific code

43. A health-care provider who practices under false qualifications/credentials is guilty of...
If the diagnosis makes you ask 'How did that happen?'
Fraud.
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Third-party

44. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Punitive damages
If the diagnosis makes you ask 'How did that happen?'
False

45. The ______________ is paid to the provider even if the patient receives no care
Fraud.
Controlling accounts payable
Traveler's
Capitated rate

46. Money paid as compensation as result of a lawsuit is called _______________.
Disclosure
Check your explanation of benefits form
Liability
Damages

47. Which of the following is mandated for hourly employees by the Fair Labor Standards Act?
Payee
Third party payer
Up to $500 -000 - or 1% of the practice's net worth
Time and a half for all hours worked beyond the normal 8 hours in a regular workday

48. 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...
Disclosure
Copayment
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Determine practice expense relative value units for all Medicare Physician Fee Schedule services

49. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
Capitated rate
True
Third party payer
CPC

50. The person to whom the check is written is the _______________.
If the diagnosis makes you ask 'How did that happen?'
Payee
Check your explanation of benefits form
Resources