CBCS Final Exam l Fully solved 2023

When a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CORRECT ANSWER CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the following is the amount of the adjustment? - CORRECT ANSWER $75 Which of the following suffixes refers to an abnormal condition? - CORRECT ANSWER -osis Which of the following entities contracts with Medicare to recoup money form inappropriately paid claims? - CORRECT ANSWER Recovery Audit Contractor Which of the following abbreviations is used to describe the reason a patient presents for an encounter at the office visit? - CORRECT ANSWER CC A patient comes in the office with an injury form work. Which box on line 1 of the CMS-1500 claim from should the billing and coding specialist check off to transmit the calm for payment? - CORRECT ANSWER FECA Which of the following physical status modifiers should the billing and coding specialist use to indicate a healthy patient who has no evidence of disease at the time of anesthesia administration? - CORRECT ANSWER P1 Which of the following practices does HIPPA Title II define as fraud? - CORRECT ANSWER Altering codes to increase payment A provider charges $30 for a treatment that has an allowed of $25. Which of the following statements regarding this $5 difference between the two amounts is correct? - CORRECT ANSWER The insurance payer pays the $5 if the provider is a participating provider. A patient who has coinsurance and has met their deductible has which of the following third-party payers? - CORRECT ANSWER Preferred provider organization(PPO) If a patient does not sign box 13 on the CMS-1500 form. Which of the following will receive payment? - CORRECT ANSWER Provider Which is the correct form? - CORRECT ANSWER Thomas Jr. Martin F A patient has a diagnosis of chest pain. The billing and coding specialist should link the diagnosis to the procedure in which of the following blocks on the CMS- 1500 form? - CORRECT ANSWER 24D A provider's office is being investigated for fraud. Which of the following processes will be reviewed first? - CORRECT ANSWER Compliance Plan Which of the following entities works with Centers for Medicare and Medicaid services to prevent overpayment? - CORRECT ANSWER Medicaid Integrity contractors