dvice./of./another./provider
2. Which. / of. / the. / CPT. / codes. / should. / a. / billing. / and. / coding. / specialist. / use. / to. / indic
ate./total./prosthetic./specific./antigen./(PSA)./test?:./84153./Prostate./specific./antigen./(PSA);./Total
3. Which. / of. / the. / following. / coding. / manuals. / is. / use. / to. / identify. / products,. / suppli
es./and./services?:./HCPCS./Level./II
4. In. / which. / of. / the. / following. / scenarios. / is. / it. / appropriate. / to. / release. / a. / patient's
./psychiatric./records./without./the./patient's./consent?:./When./the./patient./is./being./investigate
d./by./the./police
5. A. / billing. / and. / coding. / specialist. / is. / reviewing. / a. / Medicare. / Part. / C. / denial. / for. / a.
/patient. / who. / was. / injured. / on. / the. / job.. / The. / Specialist. / should. / expect. / which. / of. /
the./following./to./be./the./reason./for./the./denial?:./Medicare./is./not./the./primary./insurance
6. Which./of./the./following./is./the./purpose./of./precertification?:./To./verify./coverage
7. Which. / of. / the. / following. / is. / entities. / outlines. / the. / minimum. / essential. / element
s. / of./a./comprehensive./program?:./Oflce./of./inspector./General./(OIG)
8. Which./of./the./following./is./the./process./of./sending./an./insurance./claim./through./
a./series./of./edits./for./final./determination?:./Adjudication
9. Two./providers./are./having./a./conversation./about./a./patient's./test./results./at./th
e. / nursing. / station.. / A. / different. / patient. / overhears. / them. / talking.. / This. / type. / of.
/privacy./exposure./is./known./as./which./of./the./following?:./Incidental./disclosure
10. Which./of./the./following./actions./by./a./billing./and./coding./specialist./prevents./
fraud?:./Performing./periodic./audits
11. A./billing./and./coding./specialist./is./preparing./a./claim./for./an./esophagectomy../
Which./of./the./following./types./of./service./is./being./provided?:./Removal
12. Which./of./the./following./is./the./purpose./of./a./claims./clearinghouse?:./To./identify.
/errors./that./will./prevent./a./claim./from./being./paid
13. A. / billing. / and. / coding. / specialist. / is. / preparing. / a. / claim
for. / a. / patient. / who. / had. / an. / Evaluation. / and. / Management. / (E/M). / visit. / for. / abdo
m-
inal./pain./that./resulted./in./the./decision./to./remove./the./appendix./immediately../
Which./of./the./following./modifiers./should./the./specialist./use./for./this./claim?
,-
24:. / Unrelated. / evaluation. / and. / management. / service. / by. / the. / same. / physician. /
or
, other. / qualified. / health. / care
professional. / during. / a. / postoperative . / period.
-
25:. / significant,. / separately. / identifiable. / evaluation. / and. / management. / service. / by./
the./same./physician./or./other./qualified./health./care./professional./on./the./same./d
ay./of./the./procedure./or./other./service.
-51:./Multiple./procedures
-57:./Decision./for./surgery:./-57:./Decision./for./surgery
14. An. / internal. / retrospective. / billing. / account. / audit. / prevents. / fraud. / and. / abuse. /
by./reviewing. / and. / comparing. / completed. / claim. / forms. / with. / which. / of. / the. / followin
g?-
:. / Documentation./from./patient./encounters
15. A. / billing. / and. / coding. / specialist. / is. / preparing. / a. / claim. / for. / a. / procedure. / that./t
ypically. / takes. / about. / 2. / hr.. / Due. / to. / complications,. / it. / took. / 4.5. / hr. / to. / complete./
the./procedure../Which./of./the./following./modifiers./should./the./specialist./use?:. / -
22:./Increased./procedural./services
16. Which. / of. / the. / following. / are. / included. / in. / the. / ICD-10-CM. / code. / set?
- Fracture./reduction
- Spiral./fracture
- Cast./application
- Walking./boot:./Spiral./fracture
17. In. / which. / of. / the. / following. / circumstance. / should. / a. / billing. / and. / coding. / specialist
./submit./a./claim./with./an./attachment./to./a./third-
party./payer?:./When./a./claim./contains./unlisted./procedure./codes
18. Which. / of. / the. / following. / describes. / the. / status. / of. / a. / claim. / that. / is. / in. / process. / a
nd./does. / not. / include. / required. / preauthorization. / for. / a. / service?:. / denied
19. A. / billing. / and. / coding. / specialist. / notices. / that. / there. / have. / recently. / been. / seve
ral./appeals. / for. / denials. / due. / to. / failure. / to. / obtain. / procedure. / preauthorization.. / Whi
ch. / of./the./following./actions./should./the./specialist./take?:./Schedule./an./oflce./training./sessio
n./about./procedures./that./require./preauthorization.
20. A. / billing. / and. / coding. / specialist. / is. / preparing. / a. / claim. / that. / includes. / a. / code
for./miscellaneous./supply../Which./of./the./following./actions./should./the./specialist./tak