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 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.
Payee
CPC
HCPCS

2. 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
Capitated rate
460-519
V01-V83
Open-book

3. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Voucher
Third party payer
False
HCPCS Level II codes

4. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Office supplies.
Copayment
Truth in Lending Act
Time and a half for all hours worked beyond the normal 8 hours in a regular workday

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

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.
Third-party
Pre-certification.
Statement of income and expense
Inaccurate and/or incorrect billing

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
[ ]
Referrals

8. The process of classifying and reviewing past-due accounts from the first date of billing is...
Third party payer
( )
$280.
Age analysis.

9. Which of the following is mandated for hourly employees by the Fair Labor Standards Act?
Payer
460-519
Up to $500 -000 - or 1% of the practice's net worth
Time and a half for all hours worked beyond the normal 8 hours in a regular workday

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

11. Most practices try to reduce expenses by...
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Controlling accounts payable
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

12. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
6 months
Statement of income and expense
Office supplies.
If the diagnosis makes you ask 'How did that happen?'

13. Money paid for intentionally breaking the law is called _______________ _______________.
Third party payer
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Punitive damages
Up to $500 -000 - or 1% of the practice's net worth

14. 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.
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Open-book
False
Statement of income and expense

15. Eligibility for Medicaid is...

16. 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
Age analysis
Capitated rate
HCPCS Level II codes
Referrals

17. The determination of the amount of money paid by a third-party payer for a procedure is...
V01-V83
Pre-certification.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Voucher

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

19. 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.
60
[ ]
Up to $500 -000 - or 1% of the practice's net worth

20. A health-care provider who practices under false qualifications/credentials is guilty of...
If the diagnosis makes you ask 'How did that happen?'
Fraud.
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay

21. Money paid as compensation as result of a lawsuit is called _______________.
Damages
Ask the physician to select a more specific code
Up to $500 -000 - or 1% of the practice's net worth
V01-V83

22. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
Referrals
CPC
True
False

23. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Fair Debt Collection Practices Act
HCPCS Level II codes
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
False

24. Prison sentences are possible consequences of...
Copayment
Traveler's
Inaccurate and/or incorrect billing
Pre-certification.

25. When looking up an ICD-9-CM code - you see the notation NOS. What should you do?
Referrals
False
Referrals
Ask the physician to select a more specific code

26. 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?

27. 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
60
False
HCPCS
Open-book

28. The ICD-9-CM convention code first underlying disease means...
$280.
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.
V01-V83

29. The most common disbursement is for...
Office supplies.
Controlling accounts payable
460-519
Open-book

30. The person to whom the check is written is the _______________.
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
( )
Payee
False

31. Which of the following is also called Public Law 95-109?
Payee
60
Fair Debt Collection Practice Act
Copayment

32. Money paid as compensation as result of a lawsuit is called _______________.
Up to $500 -000 - or 1% of the practice's net worth
Damages
Voucher
Office supplies.

33. If an employee earns $8 per hour and works 35 hours per week - the gross earnings are...
Up to $500 -000 - or 1% of the practice's net worth
Check your explanation of benefits form
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
$280.

34. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
( )
6 months
Traveler's
Based on the patient's reported income from the previous month.

35. The number of dependents an employee is claiming is found on the
Fraud.
Form W-4.
Traveler's
False

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

37. 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
Based on the patient's reported income from the previous month.

38. In order to be considered negotiable - a check must be signed by the _______________.
Payee
Referrals
Payer
Up to $500 -000 - or 1% of the practice's net worth

39. The ______________ is paid to the provider even if the patient receives no care
Payer
460-519
Traveler's
Capitated rate

40. The process of classifying and reviewing past-due accounts by age from the first date of billing is called _______________ _______________.
Payer
Voucher
Age analysis
Copayment

41. Some insurers will not pay a claim unless it is filed within ________ of the date of service
6 months
Payer
True
460-519

42. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
Based on the patient's reported income from the previous month.
6 months
Up to $500 -000 - or 1% of the practice's net worth
460-519

43. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
True
False
Inaccurate and/or incorrect billing
Fair Debt Collection Practices Act

44. Money paid for intentionally breaking the law is called _______________ _______________.
460-519
True
Check your explanation of benefits form
Punitive damages

45. The payment system used by Medicare is based on...
Resources
Based on the patient's reported income from the previous month.
Payee
True

46. A small fee that is collected at the time of service is called a(n) _______________.
Statement of income and expense
( )
Copayment
False

47. 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
6 months
Traveler's
Resources

48. Which of the following types of insurance covers injuries that are caused by the insured or that occurred on the insured's property?
Disclosure
HCPCS Level II codes
Liability
Open-book

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

50. 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
Liability
False
Statement of income and expense