Question 1

What is the primary duty of a medical coder?

Accepted Answer

The primary duty of a medical

Question 2

Healthcare payers base their decision to pay or deny claims on the:

Accepted Answer

A)  diagnosis codes only. 
B)  procedure codes only. 
C)  diagnosis and procedure codes. 
D)  neatness of the claim. 
A)  diagnosis codes only. 
B)  procedure codes only. 
C)  diagnosis and procedure codes. 
D)  neatness of the claim.

Question 3

Each year a specific area of billing is audited for billing and coding accuracy by the Office of ________.

Accepted Answer

The answer of Each year a specific area of billing...

Question 4

The federal government will protect and reward people involved in qui tam, or whistle-blower, cases to identify Medicare fraud.

Accepted Answer

A) True 
 B)False

Question 5

Medicare incentive payments are authorized over a 5-year period to physicians and hospitals that demonstrate meaningful use of certified EHR technology.

Accepted Answer

A) True 
 B)False

Question 6

When each reported service is connected to a diagnosis that supports the procedure as medically necessary, the claim is referred to as:

Accepted Answer

A)  accurate. 
B)  clean. 
C)  complete. 
D)  authorized. 
A)  accurate. 
B)  clean. 
C)  complete. 
D)  authorized.

Question 7

The written notification that must be signed by a patient with Medicare coverage to acknowledge that he or she understands that a service may NOT be considered medically necessary and therefore may not be paid by Medicare is a(n):

Accepted Answer

A)  advance beneficiary notice. 
B)  medical necessary authorization. 
C)  denial of payment notice. 
D)  liability for potential payment notice. 
A)  advance beneficiary notice. 
B)  medical necessary authorization. 
C)  denial of payment notice. 
D)  liability for potential payment notice.

Question 8

Match the following
-The practice of billing the parts of a bundled procedure as separate procedures

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 9

The Compliance Program Guidance suggests that a physician's office implement a plan that includes all of the following EXCEPT:

Accepted Answer

A)  conducting internal monitoring and auditing of claims. 
B)  developing open lines of communication. 
C)  conducting appropriate training and education of staff. 
D)  dismissing any employee who fails to understand the compliance plan. 
A)  conducting internal monitoring and auditing of claims. 
B)  developing open lines of communication. 
C)  conducting appropriate training and education of staff. 
D)  dismissing any employee who fails to understand the compliance plan.

Question 10

The HCPCS modifier GA indicates:

Accepted Answer

A)  a waiver of liability statement is on file. 
B)  an advance beneficiary notice has been signed by the patient. 
C)  the procedure billed may be denied by Medicare as "not medically necessary." 
D)  all of the above. 
A)  a waiver of liability statement is on file. 
B)  an advance beneficiary notice has been signed by the patient. 
C)  the procedure billed may be denied by Medicare as "not medically necessary." 
D)  all of the above.

Question 11

Medicare requires that all physician offices have a seven-part compliance plan in place.

Accepted Answer

A) True 
 B)False

Question 12

According to the NCCI, ________ code includes all the services that are described by ________ code.

Accepted Answer

The answer of According to the NCCI, ________ code includes...

Question 13

Code linkage refers to the connection between the:

Accepted Answer

A)  procedure and modifier. 
B)  diagnosis and procedure. 
C)  diagnosis and symptom. 
D)  HCPCS Level I and Level II codes. 
A)  procedure and modifier. 
B)  diagnosis and procedure. 
C)  diagnosis and symptom. 
D)  HCPCS Level I and Level II codes.

Question 14

Match the following
-The codes found in the Current Procedural Terminology (CPT) code book

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 15

Once a Medicare beneficiary signs the ________, he or she is legally responsible for the charges if Medicare denies payment for the service as "not medically necessary."

Accepted Answer

A)  ABN 
B)  GA 
C)  HIPAA release 
D)  CMS-1500 
A)  ABN 
B)  GA 
C)  HIPAA release 
D)  CMS-1500

Question 16

The Stark Law was enacted to govern the practice of:

Accepted Answer

A)  physician referrals to other providers such as physical and occupational therapists. 
B)  physician referrals of Medicare and Medicaid patients to facilities in which he or she has a financial interest. 
C)  medical office coding practices. 
D)  utilization of controlled substances in medical facilities. 
A)  physician referrals to other providers such as physical and occupational therapists. 
B)  physician referrals of Medicare and Medicaid patients to facilities in which he or she has a financial interest. 
C)  medical office coding practices. 
D)  utilization of controlled substances in medical facilities.

Question 17

What questions should a coder ask in checking a claim to make sure it is accurate and ready to submit?

Accepted Answer

Is the coded service billable? 
Are the

Question 18

When the services of two codes could NOT have both been reasonably done in a single encounter, the codes are considered ________.

Accepted Answer

The answer of When the services of two codes could...

Question 19

The Current Procedural Terminology codes are considered HCPCS Level________ codes.

Accepted Answer

The answer of The Current Procedural Terminology codes are considered...

Question 20

Codes that report various types of transportation services would be found in HCPCS Level I.

Accepted Answer

A) True 
 B)False

What is the primary duty of a medical coder?

Healthcare payers base their decision to pay or deny claims on the:

Each year a specific area of billing is audited for billing and coding accuracy by the Office of ________.

The federal government will protect and reward people involved in qui tam, or whistle-blower, cases to identify Medicare fraud.

Medicare incentive payments are authorized over a 5-year period to physicians and hospitals that demonstrate meaningful use of certified EHR technology.

When each reported service is connected to a diagnosis that supports the procedure as medically necessary, the claim is referred to as:

The written notification that must be signed by a patient with Medicare coverage to acknowledge that he or she understands that a service may NOT be considered medically necessary and therefore may not be paid by Medicare is a(n):

Match the following -The practice of billing the parts of a bundled procedure as separate procedures

The Compliance Program Guidance suggests that a physician's office implement a plan that includes all of the following EXCEPT:

The HCPCS modifier GA indicates:

Medicare requires that all physician offices have a seven-part compliance plan in place.

According to the NCCI, code includes all the services that are described by code.

Code linkage refers to the connection between the:

Match the following -The codes found in the Current Procedural Terminology (CPT) code book

Once a Medicare beneficiary signs the ________, he or she is legally responsible for the charges if Medicare denies payment for the service as "not medically necessary."

The Stark Law was enacted to govern the practice of:

What questions should a coder ask in checking a claim to make sure it is accurate and ready to submit?

When the services of two codes could NOT have both been reasonably done in a single encounter, the codes are considered ________.

The Current Procedural Terminology codes are considered HCPCS Level________ codes.

Codes that report various types of transportation services would be found in HCPCS Level I.

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

What is the primary duty of a medical coder?

Healthcare payers base their decision to pay or deny claims on the:

Each year a specific area of billing is audited for billing and coding accuracy by the Office of ________.

The federal government will protect and reward people involved in qui tam, or whistle-blower, cases to identify Medicare fraud.

Medicare incentive payments are authorized over a 5-year period to physicians and hospitals that demonstrate meaningful use of certified EHR technology.

When each reported service is connected to a diagnosis that supports the procedure as medically necessary, the claim is referred to as:

The written notification that must be signed by a patient with Medicare coverage to acknowledge that he or she understands that a service may NOT be considered medically necessary and therefore may not be paid by Medicare is a(n):

Match the following -The practice of billing the parts of a bundled procedure as separate procedures

The Compliance Program Guidance suggests that a physician's office implement a plan that includes all of the following EXCEPT:

The HCPCS modifier GA indicates:

Medicare requires that all physician offices have a seven-part compliance plan in place.

According to the NCCI, ________ code includes all the services that are described by ________ code.

Code linkage refers to the connection between the:

Match the following -The codes found in the Current Procedural Terminology (CPT) code book

Once a Medicare beneficiary signs the ________, he or she is legally responsible for the charges if Medicare denies payment for the service as "not medically necessary."

The Stark Law was enacted to govern the practice of:

What questions should a coder ask in checking a claim to make sure it is accurate and ready to submit?

When the services of two codes could NOT have both been reasonably done in a single encounter, the codes are considered ________.

The Current Procedural Terminology codes are considered HCPCS Level________ codes.

Codes that report various types of transportation services would be found in HCPCS Level I.

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

According to the NCCI, code includes all the services that are described by code.