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...
$280.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Third party payer
Time and a half for all hours worked beyond the normal 8 hours in a regular workday

2. National codes issued by CMS that cover many supplies and durable medical equipment are...
Liability
HCPCS
HCPCS Level II codes
Traveler's

3. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
The code may not be used as the first code
HCPCS
Check your explanation of benefits form
[ ]

4. The _______________-_______________ _______________ is the health plan that pays for medical services
Capitated rate
True
Third party payer
The code may not be used as the first code

5. Some insurers will not pay a claim unless it is filed within ________ of the date of service
6 months
Inaccurate and/or incorrect billing
Capitated rate
Resources

6. 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...
True
Liability
Pre-certification.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

7. Prison sentences are possible consequences of...
Ask the physician to select a more specific code
Inaccurate and/or incorrect billing
Voucher
Liability

8. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
Statement of income and expense
True
60
False

9. The payment system used by Medicare is based on...
Age analysis.
Resources
Pre-certification.
CPC

10. The _______________ coding system has two levels and is used for coding services for Medicare patients
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
460-519
False
HCPCS

11. A small fee that is collected at the time of service is called a(n) _______________.
Payee
False
Copayment
HCPCS

12. If an employee earns $8 per hour and works 35 hours per week - the gross earnings are...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
$280.
6 months
Damages

13. The process of classifying and reviewing past-due accounts by age from the first date of billing is called _______________ _______________.
Age analysis
Voucher
Referrals
$280.

14. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Fraud.
Office supplies.
False
Fair Debt Collection Practices Act

15. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
Controlling accounts payable
Fair Debt Collection Practices Act
False
V01-V83

16. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
Statement of income and expense
Disclosure
Fair Debt Collection Practice Act
Resources

17. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
( )
460-519
True
$280.

18. In order to be considered negotiable - a check must be signed by the _______________.
False
Payer
Ask the physician to select a more specific code
Office supplies.

19. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
( )
False
Ask the physician to select a more specific code
The code may not be used as the first code

20. Which of the following prohibits harassment and false statements when attempting to collect from a patient?
Liability
Fair Debt Collection Practices Act
Open-book
[ ]

21. The _______________ coding system has two levels and is used for coding services for Medicare patients
60
Payee
HCPCS
Fair Debt Collection Practice Act

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.
60
Truth in Lending Act
False
Time and a half for all hours worked beyond the normal 8 hours in a regular workday

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

24. It is acceptable to threaten to send a patient's account to a collection agency even if you are not ready to do so
Ask the physician to select a more specific code
False
Open-book
Truth in Lending Act

25. Most practices try to reduce expenses by...
Disclosure
Controlling accounts payable
Statement of income and expense
Payer

26. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
6 months
True
Damages
Pre-certification.

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

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28. 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
Payer
Based on the patient's reported income from the previous month.
Third party payer

29. The _______________-_______________ _______________ is the health plan that pays for medical services
Third party payer
Damages
Petty cash
Payer

30. Which of the following should be a factor when selecting an outside collection agency?
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Controlling accounts payable
False
460-519

31. The person to whom the check is written is the _______________.
False
Payee
HCPCS Level II codes
Age analysis.

32. Eligibility for Medicaid is...

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33. The law requires all employers to withhold money from employees' net earnings to pay federal - state - and local income taxes
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
False
Form W-4.
Age analysis.

34. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
Voucher
Disclosure
True
Ask the physician to select a more specific code

35. A federal Truth in Lending statement - which is a written description of the agreed terms of payment - is also called a(n) _______________ statement
Disclosure
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Third-party
The code may not be used as the first code

36. An employer identification number is required by law from every employer for federal tax accounting purposes
Open-book
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
True

37. Money paid for intentionally breaking the law is called _______________ _______________.
Third-party
Capitated rate
Punitive damages
Inaccurate and/or incorrect billing

38. Most practices try to reduce expenses by...
Up to $500 -000 - or 1% of the practice's net worth
Controlling accounts payable
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Open-book

39. The number of dependents an employee is claiming is found on the
CPC
60
If the diagnosis makes you ask 'How did that happen?'
Form W-4.

40. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
True
Ask the physician to select a more specific code
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

41. Which of the following ICD-9-CM conventions is used around synonyms - alternative workings - or explanations?
[ ]
( )
Voucher
HCPCS

42. An act of deception used to take advantage of another person or entity is called...
Fraud.
If the diagnosis makes you ask 'How did that happen?'
Copayment
Resources

43. In order to be considered negotiable - a check must be signed by the _______________.
Fair Debt Collection Practices Act
Age analysis
( )
Payer

44. 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
Payee
Capitated rate
Referrals
( )

45. 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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46. 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.
6 months
Punitive damages
False
Third-party

47. Which of the following is also called Public Law 95-109?
Age analysis
Referrals
Fair Debt Collection Practice Act
False

48. The most common disbursement is for...
HCPCS Level II codes
Controlling accounts payable
( )
Office supplies.

49. Which of the following is also called Public Law 95-109?
Damages
True
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
Fair Debt Collection Practice Act

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
Statement of income and expense
$280.
HCPCS Level II codes
60