Question 1

There are two sets of criteria for assigning E&M codes-the 1995 and the 1997 guidelines.Explain each and discuss their differences.

Accepted Answer

The main difference in the two sets of g

Question 2

HCPCS National Codes used to report medical services,supplies,drugs,and durable medical equipment are Level ________ codes.

Accepted Answer

A)  I 
B)  II 
C)  III 
D)  IV 
A)  I 
B)  II 
C)  III 
D)  IV

Question 3

Current Procedural Terminology (CPT)was first developed and published by the _______________ in 1966.

Accepted Answer

American M

Question 4

To qualify for Emergency Department Services codes,the facility must be available for immediate emergency care 24 hours a day for patients not on "observation status."

Accepted Answer

A) True 
 B)False

Question 5

Contributing factors that affect the E/M coding level reported include all of the following,except:

Accepted Answer

A)  counseling. 
B)  coordination of care. 
C)  nature of presenting problem. 
D)  whether or not a modifier is used. 
A)  counseling. 
B)  coordination of care. 
C)  nature of presenting problem. 
D)  whether or not a modifier is used.

Question 6

Medicare has no specific requirements for reporting Part B physician office services.

Accepted Answer

A) True 
 B)False

Question 7

The CPT index is organized by ____________ listed alphabetically.

Accepted Answer

The answer of The CPT index is organized by ____________...

Question 8

List the two purposes National Correct Coding Initiative (NCCI)edits serve.

Accepted Answer

Ensure that the most comprehensive group

Question 9

The use of Category II codes is optional and is not to be used as a substitute for Category I codes.

Accepted Answer

A) True 
 B)False

Question 10

What must accompany the claim when a rarely used,unusual,variable,or new service is performed?

Accepted Answer

A)  A modifier 
B)  A special report 
C)  A special symbol 
D)  An EOB 
A)  A modifier 
B)  A special report 
C)  A special symbol 
D)  An EOB

Question 11

MATCHING
 
-Symbol denoting modifier-exempt codes

Accepted Answer

The answer of MATCHING
 
-Symbol denoting modifier-exempt codes
 ...

Question 12

The last of the three key components of E/M coding is medical decision making.

Accepted Answer

A) True 
 B)False

Question 13

The health insurance professional must determine three factors that would direct him or her to the proper category in the E/M coding section,which include all except the following.

Accepted Answer

A)  Place of service 
B)  Type of service 
C)  Time spent with patient 
D)  Patient status 
A)  Place of service 
B)  Type of service 
C)  Time spent with patient 
D)  Patient status

Question 14

The type of code that contains the full description of the procedure without additional explanation is the _____ code.

Accepted Answer

A)  stand-alone 
B)  indented 
C)  single 
D)  multiple 
A)  stand-alone 
B)  indented 
C)  single 
D)  multiple

Question 15

List and explain the four formatting classifications for codes appearing in the tabular section of CPT.

Accepted Answer

The CPT manual is composed of six chapte

Question 16

If Jane Smith schedules an appointment with Dr.Allen,and neither Dr.Allen nor any of his colleagues at Broadmoor Medical Clinic have treated her before,Jane's status would be:

Accepted Answer

A)  new patient. 
B)  traditional patient. 
C)  established patient. 
D)  customary patient. 
A)  new patient. 
B)  traditional patient. 
C)  established patient. 
D)  customary patient.

Question 17

Face-to-face time is the amount of time the physician spends during bedside care of the hospitalized patient.

Accepted Answer

A) True 
 B)False

Question 18

The time the healthcare provider spends in direct contact with a patient is called _____ time.

Accepted Answer

A)  face-to-face 
B)  unit/floor 
C)  counseling 
D)  treatment 
A)  face-to-face 
B)  unit/floor 
C)  counseling 
D)  treatment

Question 19

HIPAA has directed CMS to adopt uniform standards for coding systems to be used for reporting all healthcare transactions,thus eliminating Level II codes.

Accepted Answer

A) True 
 B)False

Question 20

What are the two major subcategories of nursing facilities?

Accepted Answer

A)  Initial/subsequent 
B)  Inpatient/outpatient 
C)  Critical/observation 
D)  Emergency/nonemergency 
A)  Initial/subsequent 
B)  Inpatient/outpatient 
C)  Critical/observation 
D)  Emergency/nonemergency

There are two sets of criteria for assigning E&M codes-the 1995 and the 1997 guidelines.Explain each and discuss their differences.

HCPCS National Codes used to report medical services,supplies,drugs,and durable medical equipment are Level ________ codes.

Current Procedural Terminology (CPT)was first developed and published by the _______________ in 1966.

To qualify for Emergency Department Services codes,the facility must be available for immediate emergency care 24 hours a day for patients not on "observation status."

Contributing factors that affect the E/M coding level reported include all of the following,except:

Medicare has no specific requirements for reporting Part B physician office services.

The CPT index is organized by ____________ listed alphabetically.

List the two purposes National Correct Coding Initiative (NCCI)edits serve.

The use of Category II codes is optional and is not to be used as a substitute for Category I codes.

What must accompany the claim when a rarely used,unusual,variable,or new service is performed?

MATCHING -Symbol denoting modifier-exempt codes

The last of the three key components of E/M coding is medical decision making.

The health insurance professional must determine three factors that would direct him or her to the proper category in the E/M coding section,which include all except the following.

The type of code that contains the full description of the procedure without additional explanation is the _____ code.

List and explain the four formatting classifications for codes appearing in the tabular section of CPT.

If Jane Smith schedules an appointment with Dr.Allen,and neither Dr.Allen nor any of his colleagues at Broadmoor Medical Clinic have treated her before,Jane's status would be:

Face-to-face time is the amount of time the physician spends during bedside care of the hospitalized patient.

The time the healthcare provider spends in direct contact with a patient is called _____ time.

HIPAA has directed CMS to adopt uniform standards for coding systems to be used for reporting all healthcare transactions,thus eliminating Level II codes.

What are the two major subcategories of nursing facilities?

The Origins of Health Insurance

Tools of the Trade: A Career as a Health (Medical)Insurance Professional

The Legal and Ethical Side of Medical Insurance

Types and Sources of Health Insurance

Claim Submission Methods

Traditional Fee For Service/Private Plans

Unraveling the Mysteries of Managed Care

Understanding Medicaid

Conquering Medicare’s Challenges

Military Carriers

Miscellaneous Carriers: Workers’ Compensation and Disability Insurance

Diagnostic Coding

The Patient

Keys to Successful Claims Management

The Role of Computers in Health Insurance

Reimbursement Procedures: Getting Paid

Hospital Billing and the UB-04

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Exam 13: Procedural, Evaluation and Management, and HCPCS Coding

There are two sets of criteria for assigning E&M codes-the 1995 and the 1997 guidelines.Explain each and discuss their differences.

HCPCS National Codes used to report medical services,supplies,drugs,and durable medical equipment are Level ________ codes.

Current Procedural Terminology (CPT)was first developed and published by the _______________ in 1966.

To qualify for Emergency Department Services codes,the facility must be available for immediate emergency care 24 hours a day for patients not on "observation status."

Contributing factors that affect the E/M coding level reported include all of the following,except:

Medicare has no specific requirements for reporting Part B physician office services.

The CPT index is organized by ____________ listed alphabetically.

List the two purposes National Correct Coding Initiative (NCCI)edits serve.

The use of Category II codes is optional and is not to be used as a substitute for Category I codes.

What must accompany the claim when a rarely used,unusual,variable,or new service is performed?

MATCHING -Symbol denoting modifier-exempt codes

The last of the three key components of E/M coding is medical decision making.

The health insurance professional must determine three factors that would direct him or her to the proper category in the E/M coding section,which include all except the following.

The type of code that contains the full description of the procedure without additional explanation is the _____ code.

List and explain the four formatting classifications for codes appearing in the tabular section of CPT.

If Jane Smith schedules an appointment with Dr.Allen,and neither Dr.Allen nor any of his colleagues at Broadmoor Medical Clinic have treated her before,Jane's status would be:

Face-to-face time is the amount of time the physician spends during bedside care of the hospitalized patient.

The time the healthcare provider spends in direct contact with a patient is called _____ time.

HIPAA has directed CMS to adopt uniform standards for coding systems to be used for reporting all healthcare transactions,thus eliminating Level II codes.

What are the two major subcategories of nursing facilities?

The Origins of Health Insurance

Tools of the Trade: A Career as a Health (Medical)Insurance Professional

The Legal and Ethical Side of Medical Insurance

Types and Sources of Health Insurance

Claim Submission Methods

Traditional Fee For Service/Private Plans

Unraveling the Mysteries of Managed Care

Understanding Medicaid

Conquering Medicare’s Challenges

Military Carriers

Miscellaneous Carriers: Workers’ Compensation and Disability Insurance

Diagnostic Coding

The Patient

Keys to Successful Claims Management

The Role of Computers in Health Insurance

Reimbursement Procedures: Getting Paid

Hospital Billing and the UB-04

Filters