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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. 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
60
Check your explanation of benefits form
Referrals
Determine practice expense relative value units for all Medicare Physician Fee Schedule services

2. The _______________-_______________ _______________ is the health plan that pays for medical services
Age analysis.
Third party payer
Up to $500 -000 - or 1% of the practice's net worth
Disclosure

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

4. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
True
$280.
Up to $500 -000 - or 1% of the practice's net worth
Fair Debt Collection Practices Act

5. In order to be considered negotiable - a check must be signed by the _______________.
Payer
Fair Debt Collection Practices Act
Open-book
Statement of income and expense

6. 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.
Form W-4.
Third-party
Open-book
[ ]

7. 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...
Traveler's
If the diagnosis makes you ask 'How did that happen?'
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.

8. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
True
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Form W-4.
Resources

9. If an employee earns $8 per hour and works 35 hours per week - the gross earnings are...
Includes
Up to $500 -000 - or 1% of the practice's net worth
$280.
False

10. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Fraud.
Fair Debt Collection Practices Act
Includes
V01-V83

11. 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.
Disclosure
False
[ ]
Time and a half for all hours worked beyond the normal 8 hours in a regular workday

12. The process of classifying and reviewing past-due accounts from the first date of billing is...
6 months
Age analysis.
60
CPC

13. The ______________ is paid to the provider even if the patient receives no care
460-519
Capitated rate
CPC
V01-V83

14. National codes issued by CMS that cover many supplies and durable medical equipment are...
HCPCS Level II codes
Damages
HCPCS
( )

15. Money paid for intentionally breaking the law is called _______________ _______________.
Punitive damages
Pre-certification.
HCPCS
False

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

17. 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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18. Most practices try to reduce expenses by...
Payer
Fair Debt Collection Practice Act
Fraud.
Controlling accounts payable

19. The payment system used by Medicare is based on...
Fair Debt Collection Practice Act
False
Resources
( )

20. 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
CPC
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Disclosure

21. An employer identification number is required by law from every employer for federal tax accounting purposes
Resources
True
Fair Debt Collection Practices Act
If the diagnosis makes you ask 'How did that happen?'

22. Money paid for intentionally breaking the law is called _______________ _______________.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Inaccurate and/or incorrect billing
HCPCS Level II codes
Punitive damages

23. 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
Punitive damages
False
Referrals
Payee

24. The Relative Value Unit System was created to...
HCPCS
Office supplies.
HCPCS
Determine practice expense relative value units for all Medicare Physician Fee Schedule services

25. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
Open-book
False
Truth in Lending Act
Office supplies.

26. In order to be considered negotiable - a check must be signed by the _______________.
Payer
False
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Capitated rate

27. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
[ ]
Controlling accounts payable
If the diagnosis makes you ask 'How did that happen?'
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

28. Prison sentences are possible consequences of...
Referrals
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Inaccurate and/or incorrect billing
Fair Debt Collection Practices Act

29. Some insurers will not pay a claim unless it is filed within ________ of the date of service
False
Age analysis
6 months
Truth in Lending Act

30. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Includes
Age analysis
HCPCS
Third party payer

31. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
Resources
Petty cash
If the diagnosis makes you ask 'How did that happen?'
Ask the physician to select a more specific code

32. A small fee that is collected at the time of service is called a(n) _______________.
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Copayment
Ask the physician to select a more specific code
Fair Debt Collection Practices Act

33. The most common disbursement is for...
Office supplies.
True
False
Payee

34. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
Inaccurate and/or incorrect billing
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Up to $500 -000 - or 1% of the practice's net worth
CPC

35. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Damages
False
HCPCS Level II codes
Damages

36. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
60
True
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Voucher

37. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
CPC
Payer
False
Controlling accounts payable

38. The most common disbursement is for...
Office supplies.
( )
Truth in Lending Act
False

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
Office supplies.
Payer
Up to $500 -000 - or 1% of the practice's net worth
60

40. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Voucher
Copayment
Open-book
Determine practice expense relative value units for all Medicare Physician Fee Schedule services

41. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Payer
Pre-certification.
Truth in Lending Act

42. 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?
True
V01-V83
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Determine practice expense relative value units for all Medicare Physician Fee Schedule services

43. Which of the following types of insurance covers injuries that are caused by the insured or that occurred on the insured's property?
Punitive damages
Liability
Age analysis
Traveler's

44. The most appropriate response from a medical assistant when a patient calls the medical practice questioning why an insurance claim was rejected is...
Resources
Check your explanation of benefits form
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Fraud.

45. The _______________ coding system has two levels and is used for coding services for Medicare patients
HCPCS
Office supplies.
The code may not be used as the first code
Resources

46. Money paid as compensation as result of a lawsuit is called _______________.
False
Age analysis.
Damages
Includes

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

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48. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Check your explanation of benefits form
Ask the physician to select a more specific code
HCPCS Level II codes

49. The determination of the amount of money paid by a third-party payer for a procedure is...
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Payer
Referrals
Pre-certification.

50. 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.
Petty cash
Disclosure
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Ask the physician to select a more specific code

Can you answer 50 questions in 15 minutes?

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Medical Coding And Billing Clinical

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