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...
Disclosure
Third-party
Copayment
Pre-certification.

2. A health-care provider who practices under false qualifications/credentials is guilty of...
Petty cash
Payer
Fraud.
[ ]

3. The process of classifying and reviewing past-due accounts from the first date of billing is...
True
Copayment
Pre-certification.
Age analysis.

4. An act of deception used to take advantage of another person or entity is called...
460-519
Disclosure
HCPCS
Fraud.

5. The payment system used by Medicare is based on...
Age analysis
Resources
False
Traveler's

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.
Ask the physician to select a more specific code
Third-party
Fraud.
False

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

8. 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
Open-book
Liability
Inaccurate and/or incorrect billing

9. The process of classifying and reviewing past-due accounts by age from the first date of billing is called _______________ _______________.
Capitated rate
6 months
Age analysis
Age analysis.

10. The process of classifying and reviewing past-due accounts from the first date of billing is...
Age analysis.
HCPCS Level II codes
Controlling accounts payable
Check your explanation of benefits form

11. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
Disclosure
True
60
Pre-certification.

12. The most appropriate response from a medical assistant when a patient calls the medical practice questioning why an insurance claim was rejected is...
Payer
Check your explanation of benefits form
False
Fair Debt Collection Practice Act

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

14. The ______________ is paid to the provider even if the patient receives no care
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Capitated rate
Up to $500 -000 - or 1% of the practice's net worth
Pre-certification.

15. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Voucher
Age analysis
Pre-certification.
True

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
True
Disclosure
False
Liability

17. An employer identification number is required by law from every employer for federal tax accounting purposes
True
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Controlling accounts payable
6 months

18. 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.
Copayment
( )
6 months
Petty cash

19. The Relative Value Unit System was created to...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
60
False
Controlling accounts payable

20. Eligibility for Medicaid is...

21. 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...
Payee
Third-party
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Check your explanation of benefits form

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

23. The number of dependents an employee is claiming is found on the
Based on the patient's reported income from the previous month.
Form W-4.
Pre-certification.
Truth in Lending Act

24. Which of the following should be a factor when selecting an outside collection agency?
HCPCS Level II codes
True
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
6 months

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

26. Most practices try to reduce expenses by...
Office supplies.
Controlling accounts payable
Damages
Liability

27. National codes issued by CMS that cover many supplies and durable medical equipment are...
HCPCS Level II codes
Voucher
Capitated rate
Damages

28. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
Office supplies.
Payee
460-519
Age analysis

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?

30. 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
Age analysis
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Age analysis.

31. 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.
Ask the physician to select a more specific code
Third-party
Inaccurate and/or incorrect billing
Referrals

32. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
Statement of income and expense
Inaccurate and/or incorrect billing
Age analysis
False

33. The _______________ coding system has two levels and is used for coding services for Medicare patients
HCPCS
$280.
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
True

34. 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.
Payer
Fair Debt Collection Practices Act
False
Fraud.

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

36. The process of classifying and reviewing past-due accounts by age from the first date of billing is called _______________ _______________.
Age analysis
Statement of income and expense
Liability
CPC

37. The most appropriate response from a medical assistant when a patient calls the medical practice questioning why an insurance claim was rejected is...
Age analysis
Check your explanation of benefits form
Fraud.
Fraud.

38. The _______________ coding system has two levels and is used for coding services for Medicare patients
True
Damages
HCPCS
Inaccurate and/or incorrect billing

39. 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
Third-party
Fraud.
Payee

40. The person to whom the check is written is the _______________.
Copayment
Fraud.
Pre-certification.
Payee

41. Which of the following is also called Public Law 95-109?
Based on the patient's reported income from the previous month.
Fair Debt Collection Practice Act
Payer
Fraud.

42. 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
Truth in Lending Act
Open-book
Controlling accounts payable
False

43. A health-care provider who practices under false qualifications/credentials is guilty of...
60
Fraud.
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Payee

44. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
CPC
False
Petty cash
Damages

45. The ______________ is paid to the provider even if the patient receives no care
Statement of income and expense
Capitated rate
HCPCS Level II codes
Liability

46. What kind of checks are printed in $10 - $20 - $50 - and $100 denominations and must be purchased and signed at the bank?

47. The ICD-9-CM convention code first underlying disease means...
Based on the patient's reported income from the previous month.
Age analysis
The code may not be used as the first code
Petty cash

48. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
( )
Open-book
Referrals
False

49. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
Age analysis
Capitated rate
Inaccurate and/or incorrect billing
Ask the physician to select a more specific code

50. Eligibility for Medicaid is...