Question 1

If the government recovers money from a suit, the whistleblower is entitled to what percent of the government's recovery?

Accepted Answer

A)  5-10% 
B)  10-20% 
C)  15-30% 
D)  40-50% 
A)  5-10% 
B)  10-20% 
C)  15-30% 
D)  40-50%

Question 2

What are four benefits of a compliance plan?

Accepted Answer

Benefits are speeding and optimizing pro

Question 3

The third-party payer or Medicare may pay the first listed code at the approved rate but reduce any following procedures by 75% or deny it as being part of the primary procedure.

Accepted Answer

A) True 
 B)False

Question 4

HCPCS Level II codes are assigned and maintained by individual state Medicare carriers.

Accepted Answer

A) True 
 B)False

Question 5

If a person pretends to be a physician and treats patients without a valid medical license, it is considered abuse.

Accepted Answer

A) True 
 B)False

Question 6

Match the following
-The two-character code used with all levels of HCPCS codes to provide additional detail on services reported on Medicare claims

Accepted Answer

A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice 
A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice

Question 7

Why is it important for coders to understand and abide by patient privacy regulations?

Accepted Answer

Coders must understand and abide by pati

Question 8

Benefits of a voluntary compliance plan include:

Accepted Answer

A)  minimizing billing mistakes. 
B)  reducing the chances that an audit will be conducted by the CMS or OIG. 
C)  avoiding conflicts with the self-referral and anti-kickback statutes. 
D)  all of the above. 
A)  minimizing billing mistakes. 
B)  reducing the chances that an audit will be conducted by the CMS or OIG. 
C)  avoiding conflicts with the self-referral and anti-kickback statutes. 
D)  all of the above.

Question 9

HCPCS is the acronym for Healthcare Coding Procedures in a Common System.

Accepted Answer

A) True 
 B)False

Question 10

An advisory opinion from the CMS or OIG is considered legal advice on any question regarding healthcare business.

Accepted Answer

A) True 
 B)False

Question 11

Coding ________ is part of the overall effort of medical practices and facilities to comply with regulations, including those related to the confidentiality of patients' personal and health information.

Accepted Answer

The answer of Coding ________ is part of the overall...

Question 12

HCPCS modifiers are required on all health insurance forms filed for private insurance patients.

Accepted Answer

A) True 
 B)False

Question 13

Abuse against Medicare is considered illegal because taxpayer dollars have been misspent.

Accepted Answer

A) True 
 B)False

Question 14

The best way to be sure that an intended action will NOT be subject to investigation as fraud is to:

Accepted Answer

A)  base the decision on past practices. 
B)  obtain an advisory opinion from the Office of Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS). 
C)  submit the claim, and request an explanation if denied. 
D)  get the advice of an attorney. 
A)  base the decision on past practices. 
B)  obtain an advisory opinion from the Office of Inspector General (OIG) and Centers for Medicare and Medicaid Services (CMS). 
C)  submit the claim, and request an explanation if denied. 
D)  get the advice of an attorney.

Question 15

Match the following
-The codes used to report vision and hearing services

Accepted Answer

A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice 
A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice

Question 16

The ________ required CMS to revalidate all existing 1.5 million Medicare suppliers and providers under new risk-based screening requirements.

Accepted Answer

Affordable

Question 17

Using a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided is referred to as:

Accepted Answer

A)  bundling. 
B)  unbundling. 
C)  upcoding. 
D)  downcoding. 
A)  bundling. 
B)  unbundling. 
C)  upcoding. 
D)  downcoding.

Question 18

The types of edits for National Correct Coding Initiative (NCCI) errors include all of the following EXCEPT:

Accepted Answer

A)  modifier indicators. 
B)  diagnostic and procedure code linkages. 
C)  mutually exclusive edits. 
D)  column I versus column II edits. 
A)  modifier indicators. 
B)  diagnostic and procedure code linkages. 
C)  mutually exclusive edits. 
D)  column I versus column II edits.

Question 19

Match the following
-Two codes that could NOT have both reasonably been performed during a single patient encounter

Accepted Answer

A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice 
A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice

Question 20

A coder who needs to find the code for prosthetic procedures would find it in the:

Accepted Answer

A)  Level I HCPCS code book. 
B)  Level II HCPCS code book. 
C)  Level III HCPCS code book. 
D)  This is not considered an HCPCS code. 
A)  Level I HCPCS code book. 
B)  Level II HCPCS code book. 
C)  Level III HCPCS code book. 
D)  This is not considered an HCPCS code.

If the government recovers money from a suit, the whistleblower is entitled to what percent of the government's recovery?

What are four benefits of a compliance plan?

The third-party payer or Medicare may pay the first listed code at the approved rate but reduce any following procedures by 75% or deny it as being part of the primary procedure.

HCPCS Level II codes are assigned and maintained by individual state Medicare carriers.

If a person pretends to be a physician and treats patients without a valid medical license, it is considered abuse.

Match the following -The two-character code used with all levels of HCPCS codes to provide additional detail on services reported on Medicare claims

Why is it important for coders to understand and abide by patient privacy regulations?

Benefits of a voluntary compliance plan include:

HCPCS is the acronym for Healthcare Coding Procedures in a Common System.

An advisory opinion from the CMS or OIG is considered legal advice on any question regarding healthcare business.

Coding ________ is part of the overall effort of medical practices and facilities to comply with regulations, including those related to the confidentiality of patients' personal and health information.

HCPCS modifiers are required on all health insurance forms filed for private insurance patients.

Abuse against Medicare is considered illegal because taxpayer dollars have been misspent.

The best way to be sure that an intended action will NOT be subject to investigation as fraud is to:

Match the following -The codes used to report vision and hearing services

The ________ required CMS to revalidate all existing 1.5 million Medicare suppliers and providers under new risk-based screening requirements.

Using a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided is referred to as:

The types of edits for National Correct Coding Initiative (NCCI) errors include all of the following EXCEPT:

Match the following -Two codes that could NOT have both reasonably been performed during a single patient encounter

A coder who needs to find the code for prosthetic procedures would find it in the:

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters

Exam 8: Hcpcs Coding and Compliance

If the government recovers money from a suit, the whistleblower is entitled to what percent of the government's recovery?

What are four benefits of a compliance plan?

The third-party payer or Medicare may pay the first listed code at the approved rate but reduce any following procedures by 75% or deny it as being part of the primary procedure.

HCPCS Level II codes are assigned and maintained by individual state Medicare carriers.

If a person pretends to be a physician and treats patients without a valid medical license, it is considered abuse.

Match the following -The two-character code used with all levels of HCPCS codes to provide additional detail on services reported on Medicare claims

Why is it important for coders to understand and abide by patient privacy regulations?

Benefits of a voluntary compliance plan include:

HCPCS is the acronym for Healthcare Coding Procedures in a Common System.

An advisory opinion from the CMS or OIG is considered legal advice on any question regarding healthcare business.

Coding ________ is part of the overall effort of medical practices and facilities to comply with regulations, including those related to the confidentiality of patients' personal and health information.

HCPCS modifiers are required on all health insurance forms filed for private insurance patients.

Abuse against Medicare is considered illegal because taxpayer dollars have been misspent.

The best way to be sure that an intended action will NOT be subject to investigation as fraud is to:

Match the following -The codes used to report vision and hearing services

The ________ required CMS to revalidate all existing 1.5 million Medicare suppliers and providers under new risk-based screening requirements.

Using a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided is referred to as:

The types of edits for National Correct Coding Initiative (NCCI) errors include all of the following EXCEPT:

Match the following -Two codes that could NOT have both reasonably been performed during a single patient encounter

A coder who needs to find the code for prosthetic procedures would find it in the:

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Auditing

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters