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. Some insurers will not pay a claim unless it is filed within ________ of the date of service
6 months
Fraud.
$280.
Up to $500 -000 - or 1% of the practice's net worth

2. Eligibility for Medicaid is...

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3. 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
CPC
HCPCS Level II codes
Referrals
Resources

4. The payment system used by Medicare is based on...
60
Payer
Payee
Resources

5. In order to be considered negotiable - a check must be signed by the _______________.
Payer
Voucher
Petty cash
Fraud.

6. 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?
Inaccurate and/or incorrect billing
Damages
CPC
V01-V83

7. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
Check your explanation of benefits form
Ask the physician to select a more specific code
False
Disclosure

8. The process of classifying and reviewing past-due accounts from the first date of billing is...
Based on the patient's reported income from the previous month.
Open-book
Age analysis.
Resources

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.
Fraud.
If the diagnosis makes you ask 'How did that happen?'
Pre-certification.

10. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
False
Truth in Lending Act
Statement of income and expense
Disclosure

11. An employer identification number is required by law from every employer for federal tax accounting purposes
False
V01-V83
True
Based on the patient's reported income from the previous month.

12. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Referrals
Truth in Lending Act
False
Check your explanation of benefits form

13. 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
Up to $500 -000 - or 1% of the practice's net worth
Open-book
Capitated rate
Payer

14. The number of dependents an employee is claiming is found on the
HCPCS
If the diagnosis makes you ask 'How did that happen?'
Form W-4.
CPC

15. A small fee that is collected at the time of service is called a(n) _______________.
Copayment
CPC
Inaccurate and/or incorrect billing
( )

16. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
HCPCS Level II codes
False
True
HCPCS Level II codes

17. A health-care provider who practices under false qualifications/credentials is guilty of...
Fraud.
Petty cash
Fair Debt Collection Practices Act
Fair Debt Collection Practices Act

18. The ______________ is paid to the provider even if the patient receives no care
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Capitated rate
[ ]
Voucher

19. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Disclosure
$280.
CPC
Includes

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

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21. Most practices try to reduce expenses by...
False
Controlling accounts payable
Fraud.
Determine practice expense relative value units for all Medicare Physician Fee Schedule services

22. 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.
Payee
Form W-4.
False
Includes

23. The ______________ is paid to the provider even if the patient receives no care
Up to $500 -000 - or 1% of the practice's net worth
Includes
True
Capitated rate

24. 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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25. The _______________-_______________ _______________ is the health plan that pays for medical services
Third party payer
Fraud.
460-519
Fair Debt Collection Practices Act

26. 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...
CPC
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Check your explanation of benefits form
Resources

27. The payment system used by Medicare is based on...
False
Resources
Copayment
Open-book

28. Most practices use checks from a standard checkbook - or they use _______________ checks - which are business checks with stubs attached
Voucher
The code may not be used as the first code
Pre-certification.
True

29. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
[ ]
HCPCS Level II codes
Statement of income and expense
Controlling accounts payable

30. Money paid as compensation as result of a lawsuit is called _______________.
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
False
Third party payer
Damages

31. The Relative Value Unit System was created to...
Resources
Capitated rate
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Up to $500 -000 - or 1% of the practice's net worth

32. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
Inaccurate and/or incorrect billing
Age analysis.
Statement of income and expense
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

33. 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
Inaccurate and/or incorrect billing
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.

34. 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
HCPCS
Includes
Voucher

35. The _______________ coding system has two levels and is used for coding services for Medicare patients
Disclosure
HCPCS
Copayment
Based on the patient's reported income from the previous month.

36. 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
False
Open-book
Fair Debt Collection Practices Act
Fraud.

37. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
( )
Fair Debt Collection Practices Act
HCPCS Level II codes

38. Which of the following is mandated for hourly employees by the Fair Labor Standards Act?
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Liability
Copayment
Payer

39. The most appropriate response from a medical assistant when a patient calls the medical practice questioning why an insurance claim was rejected is...
Pre-certification.
False
Traveler's
Check your explanation of benefits form

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.
Fair Debt Collection Practice Act
Third-party
460-519
$280.

41. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Fair Debt Collection Practices Act
6 months
Fraud.
Age analysis.

42. 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
Office supplies.
Fraud.
Referrals
HCPCS Level II codes

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

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44. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
False
460-519
Age analysis
True

45. Which of the following should be a factor when selecting an outside collection agency?
Petty cash
Open-book
Age analysis.
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay

46. 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.
Fraud.
Petty cash
True
Damages

47. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
6 months
[ ]
Includes
False

48. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Petty cash
Disclosure
False
Up to $500 -000 - or 1% of the practice's net worth

49. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
False
Fair Debt Collection Practices Act
Fraud.
Ask the physician to select a more specific code

50. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
Copayment
False
Disclosure
Capitated rate