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Medical Coding And Billing Clinical

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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 process of classifying and reviewing past-due accounts from the first date of billing is...
Age analysis.
60
Liability
If the diagnosis makes you ask 'How did that happen?'

2. Some insurers will not pay a claim unless it is filed within ________ of the date of service
Third-party
Check your explanation of benefits form
Third-party
6 months

3. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
Third party payer
Statement of income and expense
6 months
Age analysis

4. The _______________ coding system has two levels and is used for coding services for Medicare patients
60
$280.
HCPCS
Payee

5. The ICD-9-CM convention code first underlying disease means...
Fair Debt Collection Practice Act
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.

6. Some insurers will not pay a claim unless it is filed within ________ of the date of service
Up to $500 -000 - or 1% of the practice's net worth
6 months
Fair Debt Collection Practice Act
CPC

7. The most appropriate response from a medical assistant when a patient calls the medical practice questioning why an insurance claim was rejected is...
Controlling accounts payable
Punitive damages
Age analysis.
Check your explanation of benefits form

8. 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.
True
Payee
Petty cash
False

9. The payment system used by Medicare is based on...
Includes
Inaccurate and/or incorrect billing
Resources
False

10. The determination of the amount of money paid by a third-party payer for a procedure is...
Capitated rate
Pre-certification.
Fair Debt Collection Practices Act
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay

11. The determination of the amount of money paid by a third-party payer for a procedure is...
Ask the physician to select a more specific code
False
HCPCS
Pre-certification.

12. 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?
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Fraud.
V01-V83
Referrals

13. 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
False
Third party payer

14. National codes issued by CMS that cover many supplies and durable medical equipment are...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
HCPCS Level II codes
Pre-certification.
Fraud.

15. Money paid as compensation as result of a lawsuit is called _______________.
Damages
Ask the physician to select a more specific code
[ ]
$280.

16. Eligibility for Medicaid is...

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

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18. An act of deception used to take advantage of another person or entity is called...
False
Controlling accounts payable
Fraud.
CPC

19. 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
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Payee
Third-party

20. The person to whom the check is written is the _______________.
HCPCS Level II codes
Payee
True
Third party payer

21. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
( )
Third-party
Includes
460-519

22. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
Disclosure
Resources
True
The code may not be used as the first code

23. 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.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Inaccurate and/or incorrect billing
False
Petty cash

24. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
True
6 months
Office supplies.
If the diagnosis makes you ask 'How did that happen?'

25. Money paid for intentionally breaking the law is called _______________ _______________.
Up to $500 -000 - or 1% of the practice's net worth
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Punitive damages
Referrals

26. Which of the following is mandated for hourly employees by the Fair Labor Standards Act?
Punitive damages
Payer
False
Time and a half for all hours worked beyond the normal 8 hours in a regular workday

27. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Age analysis.
Fraud.
Copayment
Truth in Lending Act

28. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
Check your explanation of benefits form
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
False
[ ]

29. The person to whom the check is written is the _______________.
Inaccurate and/or incorrect billing
Payee
Age analysis.
Third-party

30. 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
Capitated rate
[ ]
True

31. 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
False
Disclosure
( )
60

32. 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
False
60
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
$280.

33. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
Truth in Lending Act
If the diagnosis makes you ask 'How did that happen?'
CPC
Inaccurate and/or incorrect billing

34. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
Capitated rate
True
Capitated rate
Inaccurate and/or incorrect billing

35. The number of dependents an employee is claiming is found on the
Disclosure
6 months
$280.
Form W-4.

36. 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...
Petty cash
60
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Truth in Lending Act

37. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
False
The code may not be used as the first code
CPC
Statement of income and expense

38. The Relative Value Unit System was created to...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Inaccurate and/or incorrect billing
Liability
Fraud.

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

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40. Which of the following should be a factor when selecting an outside collection agency?
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
CPC
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
460-519

41. The most common disbursement is for...
Damages
Liability
Check your explanation of benefits form
Office supplies.

42. A health-care provider who practices under false qualifications/credentials is guilty of...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Check your explanation of benefits form
Fraud.
True

43. An employer identification number is required by law from every employer for federal tax accounting purposes
False
Controlling accounts payable
$280.
True

44. Which of the following should be a factor when selecting an outside collection agency?
True
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Based on the patient's reported income from the previous month.
Punitive damages

45. Prison sentences are possible consequences of...
Up to $500 -000 - or 1% of the practice's net worth
Form W-4.
Inaccurate and/or incorrect billing
Fair Debt Collection Practices Act

46. The _______________-_______________ _______________ is the health plan that pays for medical services
CPC
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Third party payer
Payer

47. 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...
Truth in Lending Act
Truth in Lending Act
False
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

48. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
Fraud.
If the diagnosis makes you ask 'How did that happen?'
False
HCPCS

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

50. 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
Includes
60
Open-book
Pre-certification.

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Medical Coding And Billing Clinical

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