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 _______________ coding system has two levels and is used for coding services for Medicare patients
Pre-certification.
HCPCS
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
If the diagnosis makes you ask 'How did that happen?'

2. A health-care provider who practices under false qualifications/credentials is guilty of...
False
Fraud.
Payer
Traveler's

3. Prison sentences are possible consequences of...
Controlling accounts payable
Punitive damages
Inaccurate and/or incorrect billing
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.

4. 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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5. 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
[ ]
Age analysis
( )

6. Prison sentences are possible consequences of...
( )
Fraud.
Inaccurate and/or incorrect billing
HCPCS Level II codes

7. The Relative Value Unit System was created to...
Check your explanation of benefits form
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Controlling accounts payable
Age analysis

8. If an employee earns $8 per hour and works 35 hours per week - the gross earnings are...
False
$280.
Based on the patient's reported income from the previous month.
Form W-4.

9. 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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10. National codes issued by CMS that cover many supplies and durable medical equipment are...
Punitive damages
Resources
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
HCPCS Level II codes

11. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Fair Debt Collection Practice Act
Fraud.
6 months
Includes

12. A small fee that is collected at the time of service is called a(n) _______________.
Copayment
Capitated rate
Pre-certification.
Fraud.

13. Money paid as compensation as result of a lawsuit is called _______________.
Damages
Based on the patient's reported income from the previous month.
Office supplies.
Up to $500 -000 - or 1% of the practice's net worth

14. Money paid for intentionally breaking the law is called _______________ _______________.
HCPCS Level II codes
False
Voucher
Punitive damages

15. Some insurers will not pay a claim unless it is filed within ________ of the date of service
60
6 months
Petty cash
True

16. Money paid for intentionally breaking the law is called _______________ _______________.
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
[ ]
Punitive damages
False

17. The ______________ is paid to the provider even if the patient receives no care
Office supplies.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Liability
Capitated rate

18. 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
Disclosure
False
Referrals

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

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20. The determination of the amount of money paid by a third-party payer for a procedure is...
Fair Debt Collection Practices Act
Liability
True
Pre-certification.

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.
Petty cash
Form W-4.
If the diagnosis makes you ask 'How did that happen?'
Punitive damages

22. Which of the following is also called Public Law 95-109?
Fair Debt Collection Practice Act
Traveler's
Liability
Includes

23. Money paid as compensation as result of a lawsuit is called _______________.
Fraud.
Punitive damages
Damages
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay

24. 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.
Damages
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
False
( )

25. Which of the following ICD-9-CM conventions indicates that the entries following it refine the content of a preceding entry?
Traveler's
False
Ask the physician to select a more specific code
Includes

26. Which of the following requires creditors to provide applicants with accurate and complete credit costs and terms?
Fraud.
Up to $500 -000 - or 1% of the practice's net worth
Fraud.
Truth in Lending Act

27. Which of the following should be a factor when selecting an outside collection agency?
[ ]
V01-V83
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
$280.

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
Truth in Lending Act
$280.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
60

29. 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
V01-V83
Punitive damages
Open-book

30. The payment system used by Medicare is based on...
Voucher
Choose an agency after a patient fails to respond to the final collection letter or has twice broken a promise to pay
Resources
False

31. 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
Inaccurate and/or incorrect billing
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Fraud.

32. Expenses such as routine eye examinations or dental care that are not covered by an insurance company are called exclusions.
False
$280.
Age analysis
True

33. The Relative Value Unit System was created to...
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
Fraud.
The code may not be used as the first code
Copayment

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

35. Which of the following is mandated for hourly employees by the Fair Labor Standards Act?
Fair Debt Collection Practice Act
Damages
Time and a half for all hours worked beyond the normal 8 hours in a regular workday
True

36. The American Academy of Professional Coders offers the ____ credential - also requiring coursework and on-the-job experience.
CPC
Up to $500 -000 - or 1% of the practice's net worth
Open-book
True

37. The number of dependents an employee is claiming is found on the
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.
Form W-4.
Payee

38. The most common disbursement is for...
Office supplies.
Fair Debt Collection Practices Act
Open-book
Ask the physician to select a more specific code

39. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
( )
460-519
Form W-4.
Ask the physician to select a more specific code

40. The _______________-_______________ _______________ is the health plan that pays for medical services
Disclosure
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
CPC
Third party payer

41. 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
Age analysis.
Punitive damages
False

42. 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...
Age analysis
Age analysis.
Denied as a billing error because the treatment was not medically necessary based on the diagnosis.
Pre-certification.

43. Which of the following demonstrates the practice's profitability by illustrating the practice's total income and expenses?
Statement of income and expense
6 months
Controlling accounts payable
Office supplies.

44. Forgiveness or waiver of copayments by the provider due to the patient's inability to pay is a universally acceptable practice
True
( )
Determine practice expense relative value units for all Medicare Physician Fee Schedule services
False

45. 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
Age analysis
Pre-certification.
Third party payer

46. In order to be considered negotiable - a check must be signed by the _______________.
Truth in Lending Act
Disclosure
Payer
False

47. Which ICD-9-CM convention is used around nonessential or supplementary terms that do not affect the code?
Punitive damages
Disclosure
( )
Check your explanation of benefits form

48. 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
V01-V83
Office supplies.
Referrals
True

49. The payment system used by Medicare is based on...
False
False
Resources
Truth in Lending Act

50. Where will you locate the ICD code for a complete radiologic examination of the nasal bones?
Voucher
CPC
460-519
Capitated rate