Question 1

An example of an HCPCS Level II code is:

Accepted Answer

A)  99213. 
B)  250.00. 
C)  E849.0. 
D)  J0290. 
A)  99213. 
B)  250.00. 
C)  E849.0. 
D)  J0290.

Question 2

The legislation that prohibits submitting a fraudulent claim or making a false statement in connection with a claim is called the:

Accepted Answer

A)  Health Insurance Portability and Accountability Act. 
B)  Social Security Act. 
C)  Federal Civil False Claims Act. 
D)  American Civil Liberties Act. 
A)  Health Insurance Portability and Accountability Act. 
B)  Social Security Act. 
C)  Federal Civil False Claims Act. 
D)  American Civil Liberties Act.

Question 3

Services can be denied for all of the following reasons EXCEPT when:

Accepted Answer

A)  the patient has a physical examination within 6 months of becoming a Medicare Part B subscriber. 
B)  the procedure is considered experimental. 
C)  there is a cap on the number of services allowed. 
D)  the service was not performed at an appropriate location. 
A)  the patient has a physical examination within 6 months of becoming a Medicare Part B subscriber. 
B)  the procedure is considered experimental. 
C)  there is a cap on the number of services allowed. 
D)  the service was not performed at an appropriate location.

Question 4

Codes for drugs administered other than by oral method would be found in HCPCS Level II.

Accepted Answer

A) True 
 B)False

Question 5

The National Panel that maintains Level II HCPCS codes includes representatives from:

Accepted Answer

A)  Centers for Medicare and Medicaid Services (CMS). 
B)  Blue Cross/Blue Shield Association. 
C)  Health Insurance Association of America (HIA
A) . 
D)  all of the above. 
A)  Centers for Medicare and Medicaid Services (CMS). 
B)  Blue Cross/Blue Shield Association. 
C)  Health Insurance Association of America (HIA
A) . 
D)  all of the above.

Question 6

To bill for a procedure that was NOT medically necessary is considered:

Accepted Answer

A)  fraud. 
B)  abuse. 
C)  inaccurate. 
D)  incomplete. 
A)  fraud. 
B)  abuse. 
C)  inaccurate. 
D)  incomplete.

Question 7

In order for a medical practice to demonstrate that it is making good-faith efforts to prevent fraud and abuse, it should develop a(n) ________ plan.

Accepted Answer

The answer of In order for a medical practice to...

Question 8

To bill for a procedure that was NOT performed is considered:

Accepted Answer

A)  fraud. 
B)  abuse. 
C)  unbundling. 
D)  upcoding. 
A)  fraud. 
B)  abuse. 
C)  unbundling. 
D)  upcoding.

Question 9

Which organizations are represented on the HCPCS National Panel?

Accepted Answer

Representatives are from the B

Question 10

Match the following
-The use of a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided

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 11

For Medicare patients, to indicate that a procedure was performed on the left side of the body, the modifier LT should be used.

Accepted Answer

A) True 
 B)False

Question 12

Match the following
-The notice that alerts a Medicare beneficiary that a service may NOT be medically necessary and is, therefore, NOT covered

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 13

Compliance Program Guidance for Individual and Small Group Physician Practices can be found in the:

Accepted Answer

A)  Health Insurance Portability and Accountability Act (HIPA
A) . 
B)  Office of Inspector General's Fraud Alerts. 
C)  Federal Register. 
D)  National Correct Coding Initiative (NCCI). 
A)  Health Insurance Portability and Accountability Act (HIPA
A) . 
B)  Office of Inspector General's Fraud Alerts. 
C)  Federal Register. 
D)  National Correct Coding Initiative (NCCI).

Question 14

When two or more codes can be combined and billed as a single code, they are referred to as mutually exclusive.

Accepted Answer

A) True 
 B)False

Question 15

The Health Care Fraud Prevention and Enforcement Action Team (HEAT) is comprised of all the following EXCEPT:

Accepted Answer

A)  U.S. Department of Justice (DOJ). 
B)  Department of Health and Human Services (HSS). 
C)  Office of Inspector General (OIG). 
D)  Federal Bureau of Investigation (FBI). 
A)  U.S. Department of Justice (DOJ). 
B)  Department of Health and Human Services (HSS). 
C)  Office of Inspector General (OIG). 
D)  Federal Bureau of Investigation (FBI).

Question 16

State Medicaid agency codes are reported with what HCPCS code range?

Accepted Answer

A)  C1300-C9899 
B)  G0008-G9156 
C)  T1000-T5999 
D)  V2020-V2799 
A)  C1300-C9899 
B)  G0008-G9156 
C)  T1000-T5999 
D)  V2020-V2799

Question 17

HCPCS is organized by code number rather than by service or supply name.

Accepted Answer

A) True 
 B)False

Question 18

HCPCS Level II codes are updated annually by the:

Accepted Answer

A)  Centers for Medicare and Medicaid Services (CMS). 
B)  American Dental Association (AD
A) . 
C)  American Medical Association (AM
A) . 
D)  World Health Organization (WHO). 
A)  Centers for Medicare and Medicaid Services (CMS). 
B)  American Dental Association (AD
A) . 
C)  American Medical Association (AM
A) . 
D)  World Health Organization (WHO).

Question 19

What is an individual called who files a lawsuit on behalf of the federal government?

Accepted Answer

A)  plaintiff 
B)  informant 
C)  source 
D)  relator 
A)  plaintiff 
B)  informant 
C)  source 
D)  relator

Question 20

Durable medical equipment (DME) is billed using Level ________ HCPCS codes.

Accepted Answer

The answer of Durable medical equipment (DME) is billed using...

An example of an HCPCS Level II code is:

The legislation that prohibits submitting a fraudulent claim or making a false statement in connection with a claim is called the:

Services can be denied for all of the following reasons EXCEPT when:

Codes for drugs administered other than by oral method would be found in HCPCS Level II.

The National Panel that maintains Level II HCPCS codes includes representatives from:

To bill for a procedure that was NOT medically necessary is considered:

In order for a medical practice to demonstrate that it is making good-faith efforts to prevent fraud and abuse, it should develop a(n) ________ plan.

To bill for a procedure that was NOT performed is considered:

Which organizations are represented on the HCPCS National Panel?

Match the following -The use of a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided

For Medicare patients, to indicate that a procedure was performed on the left side of the body, the modifier LT should be used.

Match the following -The notice that alerts a Medicare beneficiary that a service may NOT be medically necessary and is, therefore, NOT covered

Compliance Program Guidance for Individual and Small Group Physician Practices can be found in the:

When two or more codes can be combined and billed as a single code, they are referred to as mutually exclusive.

The Health Care Fraud Prevention and Enforcement Action Team (HEAT) is comprised of all the following EXCEPT:

State Medicaid agency codes are reported with what HCPCS code range?

HCPCS is organized by code number rather than by service or supply name.

HCPCS Level II codes are updated annually by the:

What is an individual called who files a lawsuit on behalf of the federal government?

Durable medical equipment (DME) is billed using Level ________ HCPCS codes.

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

An example of an HCPCS Level II code is:

The legislation that prohibits submitting a fraudulent claim or making a false statement in connection with a claim is called the:

Services can be denied for all of the following reasons EXCEPT when:

Codes for drugs administered other than by oral method would be found in HCPCS Level II.

The National Panel that maintains Level II HCPCS codes includes representatives from:

To bill for a procedure that was NOT medically necessary is considered:

In order for a medical practice to demonstrate that it is making good-faith efforts to prevent fraud and abuse, it should develop a(n) ________ plan.

To bill for a procedure that was NOT performed is considered:

Which organizations are represented on the HCPCS National Panel?

Match the following -The use of a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided

For Medicare patients, to indicate that a procedure was performed on the left side of the body, the modifier LT should be used.

Match the following -The notice that alerts a Medicare beneficiary that a service may NOT be medically necessary and is, therefore, NOT covered

Compliance Program Guidance for Individual and Small Group Physician Practices can be found in the:

When two or more codes can be combined and billed as a single code, they are referred to as mutually exclusive.

The Health Care Fraud Prevention and Enforcement Action Team (HEAT) is comprised of all the following EXCEPT:

State Medicaid agency codes are reported with what HCPCS code range?

HCPCS is organized by code number rather than by service or supply name.

HCPCS Level II codes are updated annually by the:

What is an individual called who files a lawsuit on behalf of the federal government?

Durable medical equipment (DME) is billed using Level ________ HCPCS codes.

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