MEDICAL BILLING AND CODING
(MBC1) ICD10 QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
The standard office visit fee for a procedure is $1400. Your physician is contracting with ABC insurance
and the fee schedule is $1275, what would the contractual adjustment be?
a) $125
b) $280
c) $1.020
d) $1.120 - ANSWER a) $125
If both parents have health insurance, the parent whose insurance is primary is the
a) Mother
b) Father
c) One who has had insurance the longest
d) One whose birthday is first in the year - ANSWER d) One whose birthday is first in the year
In ICD-10-CM, a placeholder character is used for codes requiring the seventh character extender. This
placeholder is represented as
a) A default code
b) An A
c) An X
d) An 1 - ANSWER c) An X
What does the prefix "hypo-" mean?
a) Large
b) Abnormal
c) Above Normal
d) Below Normal - ANSWER d) Below Normal
,If the doctor is a Participating Provider, what does this mean?
a) The payment goes to the patient and the doctor must bill the patient for any services rendered b) The
physician is a certified HIPAA doctor
c) The physician will accept the amount paid by the insurance company and will be responsible to write
off the non-allowed amount
d) The physician can charge what they feel is reasonable and customary for their geographical location
and will be paid 100% of their fee - ANSWER c) The physician will accept the amount paid by the
insurance company and will be responsible to write off the non-allowed amount
When a claim is "denied' by the insurance carrier. What is your next step?
a) Write off the charge because it cannot be billed to the patient
b) Investigate to see why it was denied and rebill with information to support payment
c) Appeal claim with State Insurance Commissioner
d) Give all appeals to your office administrator or physician for them to review before you write off any
charges - ANSWER b) Investigate to see why it was denied and rebill with information to support
payment
The radius is located in the:
a) Lower leg
b) Upper leg
c) Lower arm
d) Upper arm - ANSWER c) Lower arm
Which answer below is not covered under Medicare Part A?
a) Skilled Nursing Hospital services
b) Skilled Nursing Home services
c) Physician Office services
d) Hospice services - ANSWER c) Physician Office services
What is the definition of UCR?
a) Utilization management program that performs external utilization review services
, b) Pre-authorizations that are required for outpatient services
c) Amounts commonly charged for a service within a particular geographic region
d) An employer-managed healthcare plan - ANSWER c) Amounts commonly charged for a service within
a particular geographic region
What does COB mean?
a) Physicians coordinating with other providers or agencies to provide services to the patient
b) Prevents multiple insurance plans from paying benefits covered by other plans when the patient has
more than one policy
c) Allows employees to continue healthcare coverage beyond the benefit termination date
d) Supplemental plans designed to cover costs not paid by Medicare - ANSWER a) Physicians
coordinating with other providers or agencies to provide services to the patient
Are all non-covered benefits written off by the physician?
a) Yes, if you are contracted with the insurance company all non-covered benefits must be written off.
Billing patients for these would be considered fraud
b) Some non-covered services can be billed to the patient, such as cosmetic procedures, preventive
medicine, etc. The patient does not have a benefit for these services and the patient is responsible for
them
c) It depends on if the provider is participating or non-participating
d) Only if you are an out-of-network provider then you can bill the patient - ANSWER b) Some non-
covered services can be billed to the patient, such as cosmetic procedures, preventive medicine, etc. The
patient does not have a benefit for these services and the patient is responsible for them
The fluid part of the blood is called:
a) Red blood cells
b) White blood cells
c) Platelets
d) Plasma - ANSWER d) Plasma
NEC means not elsewhere coded.
a) True
(MBC1) ICD10 QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
The standard office visit fee for a procedure is $1400. Your physician is contracting with ABC insurance
and the fee schedule is $1275, what would the contractual adjustment be?
a) $125
b) $280
c) $1.020
d) $1.120 - ANSWER a) $125
If both parents have health insurance, the parent whose insurance is primary is the
a) Mother
b) Father
c) One who has had insurance the longest
d) One whose birthday is first in the year - ANSWER d) One whose birthday is first in the year
In ICD-10-CM, a placeholder character is used for codes requiring the seventh character extender. This
placeholder is represented as
a) A default code
b) An A
c) An X
d) An 1 - ANSWER c) An X
What does the prefix "hypo-" mean?
a) Large
b) Abnormal
c) Above Normal
d) Below Normal - ANSWER d) Below Normal
,If the doctor is a Participating Provider, what does this mean?
a) The payment goes to the patient and the doctor must bill the patient for any services rendered b) The
physician is a certified HIPAA doctor
c) The physician will accept the amount paid by the insurance company and will be responsible to write
off the non-allowed amount
d) The physician can charge what they feel is reasonable and customary for their geographical location
and will be paid 100% of their fee - ANSWER c) The physician will accept the amount paid by the
insurance company and will be responsible to write off the non-allowed amount
When a claim is "denied' by the insurance carrier. What is your next step?
a) Write off the charge because it cannot be billed to the patient
b) Investigate to see why it was denied and rebill with information to support payment
c) Appeal claim with State Insurance Commissioner
d) Give all appeals to your office administrator or physician for them to review before you write off any
charges - ANSWER b) Investigate to see why it was denied and rebill with information to support
payment
The radius is located in the:
a) Lower leg
b) Upper leg
c) Lower arm
d) Upper arm - ANSWER c) Lower arm
Which answer below is not covered under Medicare Part A?
a) Skilled Nursing Hospital services
b) Skilled Nursing Home services
c) Physician Office services
d) Hospice services - ANSWER c) Physician Office services
What is the definition of UCR?
a) Utilization management program that performs external utilization review services
, b) Pre-authorizations that are required for outpatient services
c) Amounts commonly charged for a service within a particular geographic region
d) An employer-managed healthcare plan - ANSWER c) Amounts commonly charged for a service within
a particular geographic region
What does COB mean?
a) Physicians coordinating with other providers or agencies to provide services to the patient
b) Prevents multiple insurance plans from paying benefits covered by other plans when the patient has
more than one policy
c) Allows employees to continue healthcare coverage beyond the benefit termination date
d) Supplemental plans designed to cover costs not paid by Medicare - ANSWER a) Physicians
coordinating with other providers or agencies to provide services to the patient
Are all non-covered benefits written off by the physician?
a) Yes, if you are contracted with the insurance company all non-covered benefits must be written off.
Billing patients for these would be considered fraud
b) Some non-covered services can be billed to the patient, such as cosmetic procedures, preventive
medicine, etc. The patient does not have a benefit for these services and the patient is responsible for
them
c) It depends on if the provider is participating or non-participating
d) Only if you are an out-of-network provider then you can bill the patient - ANSWER b) Some non-
covered services can be billed to the patient, such as cosmetic procedures, preventive medicine, etc. The
patient does not have a benefit for these services and the patient is responsible for them
The fluid part of the blood is called:
a) Red blood cells
b) White blood cells
c) Platelets
d) Plasma - ANSWER d) Plasma
NEC means not elsewhere coded.
a) True
