what form gives permission for the payer to send payment
directly to the provider
A) release of information C
B) informed consent
C) assignment of benefits
D) confirmation of receipt of privacy notice
which is a true statement for radiology orders in a medical
record
A) it is not necessary for the orders to be maintained in the
patients file, but they must be maintained by the facility
B) an order must be on file for the radiology report, but A
the actual image does not need to be on file
C) a written report does not have to be obtained to sup-
port the orders
D) orders should never be kept on file in the radiology
department; only the patient's record should be on file
which type of signature is not allowed according to the
medicare program integrity manual
A) illegible signature over a typed or printed name C
B) initials over a typed or printed name
C) stamped signatures
D) all of the above are not allowed
which E/M service does not require a chief complaint
A) preventative medicine services
B) A
C)
D)
,under HIPAA, what would be a policy requirement for
"minimum necessary"
A) anyone within the provider's oflce can have access to
PHI C
B) only the patient has access to PHI
C) only individuals whose job requires it may have access
to PHI
D) only the treating physician has access to PHI
which option requires a provider to certify it will continue
to operate existing compliance programs and report to
the OIG for a lesser period of time
A) B
corporate intergrity agreement (CIA)
B) certificate of compliance agreement (CCA)
C) condition of participation (CoP)
D) conditions for coverage (CfC)
what is the goal of the recovery audit contractor (RAC)
program
A) to identify and correct improper payment made on
claims of healthcare services provided to medicare ben-
eficiaries
B) A
addresses healthcare fraud and abuse issues identified
by the OIG
C) to establish quality standards on lab testing to ensure
accuracy and reliability of the patient's test results
D) to allow medicare administrative contractors (MACs) to
attempt collection of overpayment
medical review of claims submitted to medicare by Dr.
Mack contains lab work that was performed in his oflce.
,the claims report 82040, 82247, 82310, 82374, 82435,
82565, 82947, 84075, 84132, 84155, 84295, 84460,
84450, 84520 reported multiple claims for a comprehen-
sive metabolic lab panel (CPT code 80053).
which statement is true regarding this scenario
A) Dr. Mack is billing fro services not furnished which D
represents fraud
B) dr. mack reporting each lab test separately in the lab
panel is correct reporting
C) dr. mack is upcoming for the service provided which
represents abuse
D) dr. mack is unbundling codes for the service provided
which represents fraud
what is not a fundamental compliance element based on
the OIG compliance guidance documents
A) conducting ettective training and education
B) responding promptly to detected ottenses and devel- C
oping corrective action
C) an ettective computer program that provides a quality
improvement process
D) developing ettective lines of communication
a dermatologist reports an excision of a benign 2 cm
lesion (CPT 11402) on the left arm and also performs a
shave biopsy on the face (CPT 11102) on a suspicious
lesion. the provider reports both codes by appending
A
modifier 59 to the biopsy code.
according to the NCCI edits, these 2 codes are given a
CCM indicator of 1. this is an example of
, A) proper coding and billing practice
B) fraud
C) abuse
D) unbundling
a person in violation with FCA will be liable for the cost
of the civil action brought to recover any such penalty
as well as how many times for the damages the federal
government sustains because of the false claim
C
A) 10
B) 5
C) 3
D) 2
according to the radiology guidelines in the CPT code
book, what method of administering contrast is not con-
sidered as a study "with contrast" in the radiology codes
A) B
intrathecal injection
B) oral
C) intraairticular
D) all the above are considered as a study "with contrast"
according to CPT guidelines, what is a scenario that best
represents the correct use of modifier 78
A) a patient returning to the ED a second time in which
the ED physician performs an extensive anterior packing D
for hemostasis
B) patient had an open inguinal hernia repair 2 weeks
ago. he is in the doctor's oflce because the surgical
wound is bleeding. the physician was able to clean the
directly to the provider
A) release of information C
B) informed consent
C) assignment of benefits
D) confirmation of receipt of privacy notice
which is a true statement for radiology orders in a medical
record
A) it is not necessary for the orders to be maintained in the
patients file, but they must be maintained by the facility
B) an order must be on file for the radiology report, but A
the actual image does not need to be on file
C) a written report does not have to be obtained to sup-
port the orders
D) orders should never be kept on file in the radiology
department; only the patient's record should be on file
which type of signature is not allowed according to the
medicare program integrity manual
A) illegible signature over a typed or printed name C
B) initials over a typed or printed name
C) stamped signatures
D) all of the above are not allowed
which E/M service does not require a chief complaint
A) preventative medicine services
B) A
C)
D)
,under HIPAA, what would be a policy requirement for
"minimum necessary"
A) anyone within the provider's oflce can have access to
PHI C
B) only the patient has access to PHI
C) only individuals whose job requires it may have access
to PHI
D) only the treating physician has access to PHI
which option requires a provider to certify it will continue
to operate existing compliance programs and report to
the OIG for a lesser period of time
A) B
corporate intergrity agreement (CIA)
B) certificate of compliance agreement (CCA)
C) condition of participation (CoP)
D) conditions for coverage (CfC)
what is the goal of the recovery audit contractor (RAC)
program
A) to identify and correct improper payment made on
claims of healthcare services provided to medicare ben-
eficiaries
B) A
addresses healthcare fraud and abuse issues identified
by the OIG
C) to establish quality standards on lab testing to ensure
accuracy and reliability of the patient's test results
D) to allow medicare administrative contractors (MACs) to
attempt collection of overpayment
medical review of claims submitted to medicare by Dr.
Mack contains lab work that was performed in his oflce.
,the claims report 82040, 82247, 82310, 82374, 82435,
82565, 82947, 84075, 84132, 84155, 84295, 84460,
84450, 84520 reported multiple claims for a comprehen-
sive metabolic lab panel (CPT code 80053).
which statement is true regarding this scenario
A) Dr. Mack is billing fro services not furnished which D
represents fraud
B) dr. mack reporting each lab test separately in the lab
panel is correct reporting
C) dr. mack is upcoming for the service provided which
represents abuse
D) dr. mack is unbundling codes for the service provided
which represents fraud
what is not a fundamental compliance element based on
the OIG compliance guidance documents
A) conducting ettective training and education
B) responding promptly to detected ottenses and devel- C
oping corrective action
C) an ettective computer program that provides a quality
improvement process
D) developing ettective lines of communication
a dermatologist reports an excision of a benign 2 cm
lesion (CPT 11402) on the left arm and also performs a
shave biopsy on the face (CPT 11102) on a suspicious
lesion. the provider reports both codes by appending
A
modifier 59 to the biopsy code.
according to the NCCI edits, these 2 codes are given a
CCM indicator of 1. this is an example of
, A) proper coding and billing practice
B) fraud
C) abuse
D) unbundling
a person in violation with FCA will be liable for the cost
of the civil action brought to recover any such penalty
as well as how many times for the damages the federal
government sustains because of the false claim
C
A) 10
B) 5
C) 3
D) 2
according to the radiology guidelines in the CPT code
book, what method of administering contrast is not con-
sidered as a study "with contrast" in the radiology codes
A) B
intrathecal injection
B) oral
C) intraairticular
D) all the above are considered as a study "with contrast"
according to CPT guidelines, what is a scenario that best
represents the correct use of modifier 78
A) a patient returning to the ED a second time in which
the ED physician performs an extensive anterior packing D
for hemostasis
B) patient had an open inguinal hernia repair 2 weeks
ago. he is in the doctor's oflce because the surgical
wound is bleeding. the physician was able to clean the
