Question 1

What document lists the year's planned projects for sampling types of billing to see if there are any problems?

Accepted Answer

A)  OIG fraud alert
B)  Federal Register
C)  Medical Carrier's Manual
D)  OIG work plan D

Question 2

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

Accepted Answer

A) True 
 B)False  False

Question 3

An example of an HCPCS Level II code is:

Accepted Answer

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

Question 4

An appliance, apparatus, or product intended for use in assisting or treating a patient is sometimes covered by insurance and is billed as:

Accepted Answer

A)  durable medical equipment (DM
E)  .
B)  pharmaceuticals.
C)  office supplies.
D)  surgical supplies.

Question 5

A progress note updates the patient's clinical course of treatment and itemizes all payment amounts due.

Accepted Answer

A) True 
 B)False

Question 6

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

Accepted Answer

The answer of Why is it important for coders to...

Question 7

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

Question 8

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.

Question 9

What is the primary duty of a medical coder?

Accepted Answer

The answer of What is the primary duty of a...

Question 10

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.

Question 11

An act of deception used to take advantage of another person or entity is __________ .

Accepted Answer

The answer of An act of deception used to take...

Question 12

How are Level II HCPCS codes used?

Accepted Answer

The answer of How are Level II HCPCS codes used?...

Question 13

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.

Question 14

HCPCS modifiers consist of:

Accepted Answer

A)  two digits.
B)  two letters.
C)  two letters or two numbers.
D)  two letters or one letter and one number.

Question 15

HCPCS Level II codes in the range J0120-J9999 would be used for:

Accepted Answer

A)  durable medical equipment (DM
E)  .
B)  dental procedures.
C)  diagnostic radiology services.
D)  drugs administered other than oral method.

Question 16

Level I HCPCS codes are also known as the:

Accepted Answer

A)  American Medical Association's CPT codes.
B)  Centers for Medicare and Medicaid Services (CMS)  diagnostic codes.
C)  Medicare local codes.
D)  National dental codes.

Question 17

The Current Procedural Terminology (CPT) codes are considered HCPCS Level I codes.

Accepted Answer

A) True 
 B)False

Question 18

Diagnostic and procedure codes should be appropriate for the patient's age, nationality, and condition.

Accepted Answer

A) True 
 B)False

Question 19

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

Accepted Answer

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

Question 20

An action that misuses money the government has allocated is considered:

Accepted Answer

A)  fraud.
B)  abuse.
C)  an error.
D)  a mistake.

Exam 9: Hcpcs and Coding Compliance

What document lists the year's planned projects for sampling types of billing to see if there are any problems?

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

An example of an HCPCS Level II code is:

An appliance, apparatus, or product intended for use in assisting or treating a patient is sometimes covered by insurance and is billed as:

A progress note updates the patient's clinical course of treatment and itemizes all payment amounts due.

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

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."

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

What is the primary duty of a medical coder?

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

An act of deception used to take advantage of another person or entity is __________ .

How are Level II HCPCS codes used?

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

HCPCS modifiers consist of:

HCPCS Level II codes in the range J0120-J9999 would be used for:

Level I HCPCS codes are also known as the:

The Current Procedural Terminology (CPT) codes are considered HCPCS Level I codes.

Diagnostic and procedure codes should be appropriate for the patient's age, nationality, and condition.

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

An action that misuses money the government has allocated is considered: