EVIT Midterm Exam: Questions With Solutions (Pass!)
The international classification of diseases, 9th revision, clinical
modification(ICD-9-CM) will remain in use in the United States until October 1
of what year? Right Ans - 2015
Who publishes Current Procedural Terminology (CTP)? Right Ans - AMA
(American Medical Association)
As a result of the Medicare Modernization Act of 2004, new, revised, and
deleted codes must be implemented every year on which date? Right Ans -
Jan 1
Which level of the Healthcare Common Procedural Coding System (HCPCS)
includes National Codes? Right Ans - Level 2
The national codes are approved and maintained jointly by all but which of
the following organizations? Right Ans - National Hospital Association
(NHA)
Which HCPCS Level II codes are temporary codes for procedures, services, and
supplies? Right Ans - G codes
A ________ is used to inform third-party payers that circumstances for a
particular code has been altered Right Ans - Modifer
The evaluation and management (E/M) section codes are divided into ____
categories of provider services Right Ans - 17
services performed in the office are generally marked on a patients encounter
form by the what? Right Ans - Provider
when coding, the primary reason for the office visit is listed first, and other
reasons are listed in what order? Right Ans - Order of importance
when coding, you isolate the main term from the provider's statement and
then look it up in the what? Right Ans - Index
, ICD codes are descriptive of what? Right Ans - Presenting disease or
condition
When implemented, the US will be the only nation using the ICD-10 code
system Right Ans - False
Assigning CPT procedural codes that do not match patient documentation for
the purpose or increasing reimbursement is known as? Right Ans -
Upcoding
When records are reviewed by third-party payers, if a procedure is not
documented, it ? Right Ans - Didn't happen
Blue Cross was originally set up to pay for ? Right Ans - Hospital Expenses
In a(n) _____ plan, patients are able to see specialists without having to obtain
referrals from another physcian Right Ans - Indemnity
Because a primary care physician (PCP) in a HMO makes referrals and
approves additional care if needed, he or she is known as the ___________.
Right Ans - Gatekeeper
If the patient had a primary and secondary insurance on a 80/20 coinsurance
which of the following is the primary insurance responsible for? Right Ans
- 80
Part ___ of medicare is for payment of medical expenses such as office visits
and x-ray and laboratory services. Right Ans - B
Part ____ of medicare was created to provide coverage for both generic and
brand name drugs Right Ans - D
The only practitioners that can currently bill Medicare with the hard copy
CMS-1500s are businesses with what? Right Ans - Less than 10 full time
employees including phyicians
Medicare pays for ____ of the approved medical bill amount once the
deductible is satisfied Right Ans - 80%
The international classification of diseases, 9th revision, clinical
modification(ICD-9-CM) will remain in use in the United States until October 1
of what year? Right Ans - 2015
Who publishes Current Procedural Terminology (CTP)? Right Ans - AMA
(American Medical Association)
As a result of the Medicare Modernization Act of 2004, new, revised, and
deleted codes must be implemented every year on which date? Right Ans -
Jan 1
Which level of the Healthcare Common Procedural Coding System (HCPCS)
includes National Codes? Right Ans - Level 2
The national codes are approved and maintained jointly by all but which of
the following organizations? Right Ans - National Hospital Association
(NHA)
Which HCPCS Level II codes are temporary codes for procedures, services, and
supplies? Right Ans - G codes
A ________ is used to inform third-party payers that circumstances for a
particular code has been altered Right Ans - Modifer
The evaluation and management (E/M) section codes are divided into ____
categories of provider services Right Ans - 17
services performed in the office are generally marked on a patients encounter
form by the what? Right Ans - Provider
when coding, the primary reason for the office visit is listed first, and other
reasons are listed in what order? Right Ans - Order of importance
when coding, you isolate the main term from the provider's statement and
then look it up in the what? Right Ans - Index
, ICD codes are descriptive of what? Right Ans - Presenting disease or
condition
When implemented, the US will be the only nation using the ICD-10 code
system Right Ans - False
Assigning CPT procedural codes that do not match patient documentation for
the purpose or increasing reimbursement is known as? Right Ans -
Upcoding
When records are reviewed by third-party payers, if a procedure is not
documented, it ? Right Ans - Didn't happen
Blue Cross was originally set up to pay for ? Right Ans - Hospital Expenses
In a(n) _____ plan, patients are able to see specialists without having to obtain
referrals from another physcian Right Ans - Indemnity
Because a primary care physician (PCP) in a HMO makes referrals and
approves additional care if needed, he or she is known as the ___________.
Right Ans - Gatekeeper
If the patient had a primary and secondary insurance on a 80/20 coinsurance
which of the following is the primary insurance responsible for? Right Ans
- 80
Part ___ of medicare is for payment of medical expenses such as office visits
and x-ray and laboratory services. Right Ans - B
Part ____ of medicare was created to provide coverage for both generic and
brand name drugs Right Ans - D
The only practitioners that can currently bill Medicare with the hard copy
CMS-1500s are businesses with what? Right Ans - Less than 10 full time
employees including phyicians
Medicare pays for ____ of the approved medical bill amount once the
deductible is satisfied Right Ans - 80%
