CRCR Study Guide Questions With Correct
Answers 2026 update
Effective compliance program - CORRECT ANSWER -1. Established compliance standards and
procedures.
2. Oversight of personnel by high level personnel.
3. Reasonable methods to achieve compliance with standards including monitoring systems and
hotlines
In what manner of case managers assist revenue cycle staff - CORRECT ANSWER -Providing
assistance with written appeals to health plans related to utilization and other care issues
What is charge master - CORRECT ANSWER -The charges master is primarily a list of
services/procedures , rooms accommodation, supplies, drugs , biologics
Level 1 HCPCS - CORRECT ANSWER -The approved American medical association cpt 4 codes
All cpt 4 codes are included with in hcpcs code listing
These five digit hcpcs codes are numeric
Level 2 HCPCS - CORRECT ANSWER -Cams developed codes for classifying supplies and non
physicians services such as durable medical equipment, ambulances services, surgical supplies .
Hint level 2 hcpcs code being with a -v followed by four numeric.
, Level three - CORRECT ANSWER -These contain codes assigned and maintained by the medic
her administrative contractors. These codes begin with the letter W through Z followed by four
numeric digits. These codes are not Calmund and are used basically to describe new procedures
not yet developed in level one and two.
Condition codes - CORRECT ANSWER -Are used by the provider, describe conditions or events
that apply to the. Being built on the claim. For example, if the reason for the patient visit is an
employment related, then condition 02 should be listed.
Occurrence codes - CORRECT ANSWER -Can provide additional information pertaining to the.
Being billed on the claim. For example, if the reason for the patients visit is due to an employer
related accident, occurrence code 04 with the specific of the accident would be listed.
Value codes - CORRECT ANSWER -Value codes in related dollar or unit amounts represent data
of a monetary nature that are necessary for processing of a clean. For example, a common code
is zero one which denotes the most common semi private room in a hospital. The code 01 and the
dollar amount will be listed in the value code section of the UB - 04.
What are claim edits? - CORRECT ANSWER -Rules developed to verify the accuracy and come
Platonist of a claim based on each health plan policies
Which statement is not a unique billing rule specific to providers? - CORRECT ANSWER -A
patient may be balance billed for whatever amount the non-contracting position charges above
the health plans reimbursement amount
Which of the following statements does not apply to the billing during COVID-19 public health
emergency - CORRECT ANSWER -Telemedicine claims are not payable if the patient conducts
the telemedicine visit from home
What is a sequential order for a silent PPO scheme - CORRECT ANSWER -Step one the patient's
claim is sent to the listed primary insurance carrier.
Answers 2026 update
Effective compliance program - CORRECT ANSWER -1. Established compliance standards and
procedures.
2. Oversight of personnel by high level personnel.
3. Reasonable methods to achieve compliance with standards including monitoring systems and
hotlines
In what manner of case managers assist revenue cycle staff - CORRECT ANSWER -Providing
assistance with written appeals to health plans related to utilization and other care issues
What is charge master - CORRECT ANSWER -The charges master is primarily a list of
services/procedures , rooms accommodation, supplies, drugs , biologics
Level 1 HCPCS - CORRECT ANSWER -The approved American medical association cpt 4 codes
All cpt 4 codes are included with in hcpcs code listing
These five digit hcpcs codes are numeric
Level 2 HCPCS - CORRECT ANSWER -Cams developed codes for classifying supplies and non
physicians services such as durable medical equipment, ambulances services, surgical supplies .
Hint level 2 hcpcs code being with a -v followed by four numeric.
, Level three - CORRECT ANSWER -These contain codes assigned and maintained by the medic
her administrative contractors. These codes begin with the letter W through Z followed by four
numeric digits. These codes are not Calmund and are used basically to describe new procedures
not yet developed in level one and two.
Condition codes - CORRECT ANSWER -Are used by the provider, describe conditions or events
that apply to the. Being built on the claim. For example, if the reason for the patient visit is an
employment related, then condition 02 should be listed.
Occurrence codes - CORRECT ANSWER -Can provide additional information pertaining to the.
Being billed on the claim. For example, if the reason for the patients visit is due to an employer
related accident, occurrence code 04 with the specific of the accident would be listed.
Value codes - CORRECT ANSWER -Value codes in related dollar or unit amounts represent data
of a monetary nature that are necessary for processing of a clean. For example, a common code
is zero one which denotes the most common semi private room in a hospital. The code 01 and the
dollar amount will be listed in the value code section of the UB - 04.
What are claim edits? - CORRECT ANSWER -Rules developed to verify the accuracy and come
Platonist of a claim based on each health plan policies
Which statement is not a unique billing rule specific to providers? - CORRECT ANSWER -A
patient may be balance billed for whatever amount the non-contracting position charges above
the health plans reimbursement amount
Which of the following statements does not apply to the billing during COVID-19 public health
emergency - CORRECT ANSWER -Telemedicine claims are not payable if the patient conducts
the telemedicine visit from home
What is a sequential order for a silent PPO scheme - CORRECT ANSWER -Step one the patient's
claim is sent to the listed primary insurance carrier.
