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. Eligibility for Medicaid is...

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2. The Relative Value Unit System was created to...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Statement of income and expense
Based on the patient's reported income from the previous month.
Age analysis


3. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
Resources
If the diagnosis makes you ask 'How did that happen?'
Check your explanation of benefits form
Ask the physician to select a more specific code


4. Prison sentences are possible consequences of...
Inaccurate and/or incorrect billing
Fraud.
HCPCS Level II codes
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay


5. Money paid as compensation as result of a lawsuit is called _______________.
The code may not be used as the first code
Damages
Pre-certification.
False


6. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Third-party
If the diagnosis makes you ask 'How did that happen?'
Fair Debt Collection Practices Act
Age analysis.


7. 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
Fair Debt Collection Practice Act
$280.
Referrals
False


8. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
Ask the physician to select a more specific code
If the diagnosis makes you ask 'How did that happen?'
( )
False


9. The ICD-9-CM convention code first underlying disease means...
460-519
Office supplies.
False
The code may not be used as the first code


10. Some insurers will not pay a claim unless it is filed within ________ of the date of service
Inaccurate and/or incorrect billing
6 months
Form W-4.
The code may not be used as the first code


11. The _______________-_______________ _______________ is the health plan that pays for medical services
Punitive damages
[ ]
Third party payer
Truth in Lending Act


12. Money paid as compensation as result of a lawsuit is called _______________.
Payee
Third-party
Damages
Up to $500 -000 - or 1% of the practice's net worth


13. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
Referrals
False
460-519
Capitated rate


14. The payment system used by Medicare is based on...
Resources
Third-party
Ask the physician to select a more specific code
Time and a half for all hours worked beyond the normal 8 hours in a regular workday


15. Which of the following is also called Public Law 95-109?
True
Damages
460-519
Fair Debt Collection Practice Act


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

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17. The ______________ is paid to the provider even if the patient receives no care
Payee
True
Payer
Capitated rate


18. 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.
Age analysis
Third-party
Inaccurate and/or incorrect billing
$280.


19. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
Based on the patient's reported income from the previous month.
( )
V01-V83
Voucher


20. Money paid for intentionally breaking the law is called _______________ _______________.
Punitive damages
Traveler's
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Inaccurate and/or incorrect billing


21. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Check your explanation of benefits form
Voucher
6 months
Includes


22. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
CPC
Fair Debt Collection Practices Act
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Disclosure


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.
HCPCS
False
Third-party
Resources


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


25. National codes issued by CMS that cover many supplies and durable medical equipment are...
Liability
HCPCS Level II codes
V01-V83
Third-party


26. The process of classifying and reviewing past-due accounts by age from the first date of billing is called _______________ _______________.
Age analysis
Pre-certification.
False
Up to $500 -000 - or 1% of the practice's net worth


27. A health-care provider who practices under false qualifications/credentials is guilty of...
Fraud.
Age analysis.
False
HCPCS


28. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
The code may not be used as the first code
HCPCS Level II codes
Punitive damages
False


29. The process of classifying and reviewing past-due accounts from the first date of billing is...
True
Form W-4.
Age analysis
Age analysis.


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

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31. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
Referrals
Fair Debt Collection Practices Act
V01-V83
460-519


32. An act of deception used to take advantage of another person or entity is called...
False
Pre-certification.
Office supplies.
Fraud.


33. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
460-519
Open-book
Fair Debt Collection Practices Act
Age analysis


34. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
Capitated rate
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Payer
Ask the physician to select a more specific code


35. 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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36. 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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37. 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
Referrals
Fair Debt Collection Practice Act
Age analysis
Resources


38. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Up to $500 -000 - or 1% of the practice's net worth
Fraud.
False
Open-book


39. 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
Includes
[ ]
60
[ ]


40. In order to be considered negotiable - a check must be signed by the _______________.
Payer
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Form W-4.
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay


41. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
Age analysis.
( )
Petty cash
Statement of income and expense


42. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Capitated rate
Open-book
Voucher
Controlling accounts payable


43. The ______________ is paid to the provider even if the patient receives no care
[ ]
Capitated rate
Statement of income and expense
6 months


44. The most common disbursement is for...
Office supplies.
Third party payer
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
6 months


45. Prison sentences are possible consequences of...
Fraud.
Inaccurate and/or incorrect billing
[ ]
Age analysis.


46. In order to be considered negotiable - a check must be signed by the _______________.
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Payer
Copayment
Controlling accounts payable


47. A health-care provider who practices under false qualifications/credentials is guilty of...
60
Fraud.
Voucher
[ ]


48. The ICD-9-CM convention code first underlying disease means...
The code may not be used as the first code
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Age analysis
Referrals


49. The determination of the amount of money paid by a third-party payer for a procedure is...
HCPCS
Truth in Lending Act
Pre-certification.
Open-book


50. The number of dependents an employee is claiming is found on the
Third-party
Form W-4.
Controlling accounts payable
Punitive damages