Nha - Certified Billing And Coding Specialist (Cbcs) Study Guide

NHA - CERTIFIED BILLING AND CODING
SPECIALIST (CBCS) STUDY GUIDE



Theoosymboloo"O"ooinootheooCurrentooProceduralooTerminologyooreferenceooisoousedootoo
oindicateoowhat?oo-ooans--Reinstatedoooroorecycledoocode


InootheooanesthesiaoosectionooofootheooCPToomanual,oowhatooareooconsideredooqualifying
oocircumstances?oo-ooans--Add-onoocodes


AsooofooApriloo1,oo2014oowhatooisootheoomaximumoonumberooofoodiagnosesoothatoocanoob
eooreportedooonootheooCMS-1500ooclaimooformoobeforeooaoofurtherooclaimooisoorequired?
oo-ooans--12


WhatooisooconsideredooproperoosupportiveoodocumentationooforooreportingooCPTooandooI
CDoocodesooforoosurgicalooprocedures?oo-ooans--Operativeooreport

Whatooactionooshouldoobeootakenoofirstoowhenooreviewingooaoodelinquentooclaim?oo-
ooans--Verifyootheooageooofootheooaccount


Aooclaimoocanoobeoodeniedoooroorejectedooforoowhichooofootheoofollowingooreasons?oo-
ooans--Blockoo24Doocontainsootheoodiagnosisoocode


Aoocoroner'sooautopsyooisoocomprisedooofoowhatooexaminations?oo-ooans--
GrossooExamination

MedigapoocoverageooisooofferedootoooMedicareoobeneficiariesoobyoowhom?oo-ooans--
Privateoothird-partyoopayers

WhatoopartooofooMedicareoocoversooprescriptions?oo-ooans--PartooC

Whatooplaneoodividesootheoobodyoointoooleftooandooright?oo-ooans--Sagittal

WhereoocanoounlistedoocodesoobeoofoundooinootheooCPToomanual?oo-ooans--
Guidelinesoopriorootoooeachoosection

Ambulatoryoosurgeryoocenters,oohomeoohealthoocare,ooandoohospiceooorganizationsoouse
oowhichooformootooosubmitooclaims?oo-ooans--UB-04ooClaimooForm

, WhatoocolorooformatooisooacceptableooonootheooCMS-1500ooclaimooform?oo-ooans--Red

Whoooisooresponsibleootooopayootheoodeductible?oo-ooans--Patient

Aoopatient'soohealthooplanooisooreferredootoooasootheoo"payerooofoolastooresort."ooWhatooiso
otheoonameooofoothatoohealthooplan?oo-ooans--Medicaid


InformedooConsentoo-ooans--
Providersooexplainoomedicaloooroodiagnosticooprocedures,oosurgicaloointerventions,ooando
otheoobenefitsooandoorisksooinvolved,oogivingoopatientsooanooopportunityootoooaskooquestio
nsoobeforeoomedicaloointerventionooisooprovided.

ImpliedooConsentoo-ooans--
Aoopatientoopresentsooforootreatment,oosuchooasooextendingooanooarmootoooallowooaooveni
punctureootooobeooperformed.

Clearinghouseoo-ooans--
Agencyoothatooconvertsooclaimsoointooostandardizedooelectronicooformat,oolooksooforooerr
ors,ooandooformatsoothemooaccordingootoooHIPAAooandooinsuranceoostandards.

IndividuallyooIdentifiableoo-ooans--
Documentsoothatooidentifyootheoopersonooorooprovideooenoughooinformationoosooothatooth
eoopersonoocanoobeooidentified.

De-identifiedooInformationoo-ooans--
Informationoothatoodoesoonotooidentifyooanooindividualoobecauseoouniqueooandoopersonalo
ocharacteristicsoohaveoobeenooremoved.


Consentoo-ooans--Aoopatient'soopermissionooevidencedoobyoosignature.

Authorizationsoo-ooans--
Permissionoograntedoobyootheoopatientooorootheoopatient'soorepresentativeootoooreleaseooi
nformationooforooreasonsoootheroothanootreatment,oopayment,oooroohealthoocareoooperatio
ns.

Reimbursementoo-ooans--Paymentooforooservicesoorenderedoofromooaoothird-partyoopayer.

Auditingoo-ooans--Reviewooofooclaimsooforooaccuracyooandoocompleteness.

Fraudoo-ooans--
Makingoofalseoostatementsooofoorepresentationsooofoomaterialoofactsootoooobtainoosomeoo
benefitoooroopaymentooforoowhichoonoooentitlementoowouldoootherwiseooexist.