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 most common disbursement is for...
Referrals
Pre-certification.
Office supplies.
Form W-4.


2. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
CPC
Petty cash
Third party payer
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.


3. An act of deception used to take advantage of another person or entity is called...
If the diagnosis makes you ask 'How did that happen?'
HCPCS Level II codes
Fraud.
If the diagnosis makes you ask 'How did that happen?'


4. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
False
460-519
Based on the patient's reported income from the previous month.
Payer


5. 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
Fair Debt Collection Practice Act
Up to $500 -000 - or 1% of the practice's net worth
60
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.


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

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7. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
False
HCPCS
Third-party
Open-book


8. Some insurers will not pay a claim unless it is filed within ________ of the date of service
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
False
Up to $500 -000 - or 1% of the practice's net worth
6 months


9. 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...
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Check your explanation of benefits form
Referrals
Fair Debt Collection Practice Act


10. If an employee earns $8 per hour and works 35 hours per week - the gross earnings are...
Payer
Age analysis.
Fraud.
$280.


11. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
Form W-4.
[ ]
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
HCPCS Level II codes


12. 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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13. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
HCPCS Level II codes
Includes
Fraud.
Third-party


14. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
False
True
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
V01-V83


15. 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.
Voucher
Fair Debt Collection Practices Act
[ ]
False


16. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
The code may not be used as the first code
CPC
$280.
False


17. 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.
True
Ask the physician to select a more specific code
Third-party
CPC


18. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Includes
CPC
Petty cash
Third party payer


19. A small fee that is collected at the time of service is called a(n) _______________.
Copayment
Statement of income and expense
Open-book
The code may not be used as the first code


20. The _______________ coding system has two levels and is used for coding services for Medicare patients
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
HCPCS
460-519
Fair Debt Collection Practices Act


21. 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
Truth in Lending Act
Check your explanation of benefits form
Damages


22. Money paid for intentionally breaking the law is called _______________ _______________.
Punitive damages
Disclosure
V01-V83
HCPCS Level II codes


23. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Voucher
Resources
Fair Debt Collection Practices Act
False


24. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
True
Third-party
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Up to $500 -000 - or 1% of the practice's net worth


25. The _______________-_______________ _______________ is the health plan that pays for medical services
Third party payer
V01-V83
Check your explanation of benefits form
Inaccurate and/or incorrect billing


26. 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
Statement of income and expense
Office supplies.


27. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Office supplies.
Truth in Lending Act
Traveler's
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.


28. In order to be considered negotiable - a check must be signed by the _______________.
Check your explanation of benefits form
Payee
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Payer


29. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
[ ]
$280.
Ask the physician to select a more specific code
Fair Debt Collection Practices Act


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

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31. National codes issued by CMS that cover many supplies and durable medical equipment are...
Pre-certification.
HCPCS Level II codes
Pre-certification.
V01-V83


32. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Petty cash
Damages
Fair Debt Collection Practices Act
Check your explanation of benefits form


33. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
[ ]
$280.
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Form W-4.


34. Money paid for intentionally breaking the law is called _______________ _______________.
Payer
Punitive damages
False
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay


35. The payment system used by Medicare is based on...
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
True
Resources
Punitive damages


36. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
Inaccurate and/or incorrect billing
Statement of income and expense
Form W-4.
Disclosure


37. Most practices try to reduce expenses by...
Includes
Fraud.
Traveler's
Controlling accounts payable


38. The Relative Value Unit System was created to...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
False
Age analysis
False


39. 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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40. 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
Liability
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Fraud.
Referrals


41. Some insurers will not pay a claim unless it is filed within ________ of the date of service
6 months
Fair Debt Collection Practices Act
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Includes


42. 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.
False
Open-book
Open-book
Petty cash


43. 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
( )
Fair Debt Collection Practices Act
Age analysis.


44. Eligibility for Medicaid is...

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45. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
( )
Fraud.
True
Disclosure


46. Eligibility for Medicaid is...

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47. Money paid as compensation as result of a lawsuit is called _______________.
( )
Third party payer
Damages
Liability


48. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
Disclosure
HCPCS Level II codes
Payee
Age analysis.


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


50. Which of the following types of insurance covers injuries that are caused by the insured or that occurred on the insured's property?
Based on the patient's reported income from the previous month.
False
Liability
Pre-certification.