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. The determination of the amount of money paid by a third-party payer for a procedure is...
Form W-4.
Punitive damages
Pre-certification.
Voucher

2. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
CPC
Up to $500 -000 - or 1% of the practice's net worth
False
$280.

3. The ______________ is paid to the provider even if the patient receives no care
6 months
Capitated rate
Third-party
Age analysis

4. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Voucher
HCPCS Level II codes
Up to $500 -000 - or 1% of the practice's net worth

5. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
Voucher
True
Fraud.
CPC

6. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
Liability
False
Check your explanation of benefits form
Up to $500 -000 - or 1% of the practice's net worth

7. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
460-519
Based on the patient's reported income from the previous month.
Fair Debt Collection Practice Act
Fraud.

8. The ICD-9-CM convention code first underlying disease means...
Traveler's
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
The code may not be used as the first code
Capitated rate

9. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
( )
Fraud.
Damages
Check your explanation of benefits form

10. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
Age analysis.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
[ ]
Time and a half for all hours worked beyond the normal 8 hours in a regular workday

11. Which of the following is also called Public Law 95-109?
False
False
Fair Debt Collection Practice Act
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

12. Prison sentences are possible consequences of...
Includes
The code may not be used as the first code
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Inaccurate and/or incorrect billing

13. In order to be considered negotiable - a check must be signed by the _______________.
60
Payer
6 months
Age analysis

14. A health-care provider who practices under false qualifications/credentials is guilty of...
Up to $500 -000 - or 1% of the practice's net worth
Statement of income and expense
Fraud.
Age analysis

15. The payment system used by Medicare is based on...
Resources
460-519
CPC
Third party payer

16. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
6 months
Statement of income and expense
Fraud.
True

17. 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.
True
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
False
[ ]

18. 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
Age analysis.
The code may not be used as the first code
60
Fraud.

19. The person to whom the check is written is the _______________.
Disclosure
The code may not be used as the first code
Payee
Fraud.

20. The person to whom the check is written is the _______________.
False
If the diagnosis makes you ask 'How did that happen?'
Payee
Ask the physician to select a more specific code

21. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Check your explanation of benefits form
Fair Debt Collection Practices Act
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
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
Truth in Lending Act
Disclosure
V01-V83
Payee

23. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
Fraud.
460-519
[ ]
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

24. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Punitive damages
Includes
460-519
V01-V83

25. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Includes
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Payer
Age analysis.

26. The most appropriate response from a medical assistant when a patient calls the medical practice questioning why an insurance claim was rejected is...
Liability
The code may not be used as the first code
Check your explanation of benefits form
Fraud.

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

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28. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Third party payer
False
Truth in Lending Act
Copayment

29. 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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30. Which of the following is mandated for hourly employees by the Fair Labor Standards Act?
Truth in Lending Act
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Traveler's
Pre-certification.

31. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
Third-party
Form W-4.
( )
False

32. 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
Third party payer
Copayment
If the diagnosis makes you ask 'How did that happen?'

33. Which of the following should be a factor when selecting an outside collection agency?
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Check your explanation of benefits form
Punitive damages
Liability

34. Money paid for intentionally breaking the law is called _______________ _______________.
Third-party
Punitive damages
Petty cash
[ ]

35. Some insurers will not pay a claim unless it is filed within ________ of the date of service
Fraud.
Punitive damages
False
6 months

36. An employer identification number is required by law from every employer for federal tax accounting purposes
True
Liability
Voucher
Open-book

37. An employer identification number is required by law from every employer for federal tax accounting purposes
False
60
Copayment
True

38. The _______________-_______________ _______________ is the health plan that pays for medical services
Third party payer
[ ]
Petty cash
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

39. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
HCPCS
[ ]
Damages
Disclosure

40. The ICD-9-CM convention code first underlying disease means...
Fraud.
The code may not be used as the first code
True
Includes

41. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
Check your explanation of benefits form
Controlling accounts payable
False
Age analysis.

42. Which of the following types of insurance covers injuries that are caused by the insured or that occurred on the insured's property?
Third-party
Fraud.
False
Liability

43. Eligibility for Medicaid is...

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44. 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
True
60
$280.
Ask the physician to select a more specific code

45. Which of the following is also called Public Law 95-109?
Fraud.
Fair Debt Collection Practice Act
Open-book
60

46. The most common disbursement is for...
Petty cash
Liability
Office supplies.
False

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...
Form W-4.
Resources
Punitive damages
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

48. 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
Third-party
Fraud.
Age analysis

49. The number of dependents an employee is claiming is found on the
HCPCS Level II codes
Payee
Resources
Form W-4.

50. The process of classifying and reviewing past-due accounts from the first date of billing is...
$280.
Third-party
Age analysis.
Form W-4.