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


2. An employer identification number is required by law from every employer for federal tax accounting purposes
( )
True
Fraud.
Payee


3. The person to whom the check is written is the _______________.
Statement of income and expense
CPC
Punitive damages
Payee


4. 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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5. 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
Truth in Lending Act
Referrals
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Disclosure


6. The payment system used by Medicare is based on...
False
Resources
Capitated rate
CPC


7. 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.
Disclosure
Third-party
CPC
Liability


8. 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
V01-V83
60
Ask the physician to select a more specific code
Controlling accounts payable


9. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
Fraud.
Disclosure
( )
Includes


10. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
CPC
Third-party
Payee
False


11. The process of classifying and reviewing past-due accounts from the first date of billing is...
Age analysis.
6 months
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Fraud.


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. The ICD-9-CM convention code first underlying disease means...
True
Fair Debt Collection Practice Act
Age analysis.
The code may not be used as the first code


14. 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
Age analysis
Based on the patient's reported income from the previous month.
False


15. The number of dependents an employee is claiming is found on the
The code may not be used as the first code
Check your explanation of benefits form
Up to $500 -000 - or 1% of the practice's net worth
Form W-4.


16. 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.
Open-book
Pre-certification.
Capitated rate


17. The _______________-_______________ _______________ is the health plan that pays for medical services
Third party payer
True
Truth in Lending Act
Pre-certification.


18. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
Ask the physician to select a more specific code
Copayment
( )
Third party payer


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

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20. 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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21. 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
$280.
Traveler's
Petty cash


22. The ICD-9-CM convention code first underlying disease means...
Capitated rate
HCPCS
Check your explanation of benefits form
The code may not be used as the first code


23. Most practices try to reduce expenses by...
Resources
Controlling accounts payable
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Third party payer


24. The most common disbursement is for...
Petty cash
Fraud.
Office supplies.
Referrals


25. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Fair Debt Collection Practice Act
6 months
Truth in Lending Act
Third party payer


26. Which of the following should be a factor when selecting an outside collection agency?
Capitated rate
Includes
Payee
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay


27. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
Open-book
[ ]
Includes
Controlling accounts payable


28. A health-care provider who practices under false qualifications/credentials is guilty of...
Statement of income and expense
Fraud.
Age analysis
If the diagnosis makes you ask 'How did that happen?'


29. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Truth in Lending Act
Payer
If the diagnosis makes you ask 'How did that happen?'
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay


30. National codes issued by CMS that cover many supplies and durable medical equipment are...
False
460-519
HCPCS Level II codes
HCPCS


31. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
False
Age analysis.
Punitive damages
The code may not be used as the first code


32. Some insurers will not pay a claim unless it is filed within ________ of the date of service
Disclosure
Up to $500 -000 - or 1% of the practice's net worth
6 months
Fair Debt Collection Practices Act


33. Money paid for intentionally breaking the law is called _______________ _______________.
HCPCS Level II codes
[ ]
Capitated rate
Punitive damages


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

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35. A health-care provider who practices under false qualifications/credentials is guilty of...
Third party payer
[ ]
Open-book
Fraud.


36. In order to be considered negotiable - a check must be signed by the _______________.
Payer
Age analysis
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Fair Debt Collection Practices Act


37. Money paid as compensation as result of a lawsuit is called _______________.
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
False
Fraud.
Damages


38. Which of the following is mandated for hourly employees by the Fair Labor Standards Act?
Voucher
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Based on the patient's reported income from the previous month.
Statement of income and expense


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.
Age analysis.
Fraud.
Petty cash
Copayment


40. 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.
False
Third-party
Third party payer
Form W-4.


41. The payment system used by Medicare is based on...
Age analysis
Resources
True
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.


42. The person to whom the check is written is the _______________.
False
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Age analysis
Payee


43. 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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44. Prison sentences are possible consequences of...
Inaccurate and/or incorrect billing
Referrals
The code may not be used as the first code
Fraud.


45. 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.
6 months
Check your explanation of benefits form
Referrals


46. Money paid for intentionally breaking the law is called _______________ _______________.
Punitive damages
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Form W-4.
Damages


47. The ______________ is paid to the provider even if the patient receives no care
CPC
HCPCS Level II codes
HCPCS Level II codes
Capitated rate


48. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
[ ]
False
Traveler's
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.


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


50. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
Fair Debt Collection Practices Act
False
True
Fair Debt Collection Practices Act