MEDICAL BILLING & CODING: FINAL
EXAM STUDY GUIDE QUESTIONS AND
ANSWERS
birthday - Answer-The _____________ rule states if a husband and wife both have
insurance through their employers, the insurance policy of the policyholder whose
birthday occurs first in the calendar year is the primary payer for all dependents.
fee schedule - Answer-A medical office's ________ _________ are the fees charged
to most of their patients most of the time under typical conditions.
taxonomy code - Answer-The _______________________ is a 10-digit number that
represents the physician's medical specialty.
before - Answer-The ABN, or Advance Beneficiary Notice of Noncoverage, must be
verbally reviewed with the beneficiary or his or her representative and any questions
raised during that review must be answered ________________ it is signed.
Underpayment - Answer-______________________ can occur when healthcare
providers submit claims for a simple procedure, but the medical record reveals that a
more complicated procedure was actually performed.
every - Answer-You should contact Medicaid to verify patient's benefit eligibility
___________ time they are seen in the office.
80-20 - Answer-With an _____ - _____ coinsurance, your patient will be responsible
for 20% off the allowable charge; or 20% of $100, which is $20.
copayment - Answer-A _______________ is a small fee paid by the patient that is
collected at the time of the visit.
references - Answer-Companies have manuals for _______________ and
representatives of the insurance companies are available to answer
_______________ about a patient's coverage.
Medical - Answer-Unless the patient has a ___________ emergency, Medicaid often
requires authorization before services are performed.
A, B - Answer-Medicare part _____ is hospital insurance and Part ____ helps pay for
a wide range of procedures and supplies.
this date - Answer-The effective date of insurance coverage should always be
verified. Services performed before ___________________ may be excluded from
claims.
October 1, 2014 - Answer-Under HIPAA, the diagnosis code that must be used in the
United States started on _____________________.
, 3 to 7 - Answer-ICD-10-CM s a ______ to ______ character alphaneumeric
representation of a disease or condition.
category - Answer-A ____________ code in ICD-10-CM is three characters.
subcategory - Answer-A _______________ code in ICD-10-CM has four to five
characters.
final code - Answer-A ___________ in ICD-10-CM has six to seven characters.
disease, injuries - Answer-Part of ICD-10-CM list _____________ and
_____________ alphabetically with corresponding diagnosis codes.
tabular - Answer-The _________ list is made up of twenty-one chapters of disease
descriptions and their codes.
alphabetical index - Answer-The ICD-10-CM index to Disease and Injuries is known
as the __________________ ______________.
diagnostic - Answer-A ______________ statement is a physician's description of the
main reason for a patient's encounter.
alphabetical, tabular - Answer-When coding, the coder first locates the
description/code in the _______________ index and then verifies the proposed code
selection by turning to the ______________ index and studying the entries.
hyphen - Answer-The _____________ means that the coder will need to drill down
to select the right code.
main - Answer-Each __________ term appears in boldface type and identifies a
disease or condition.
default - Answer-Each main term appears in boldface type and is followed by its
_________ code.
RBRVS (Resource based Relative Value Scale) - Answer-Medigap is not a part of
Medicare's _______________________________________________.
Inferior - Answer-People who qualify for Medicaid assistance are in no way
_____________ to those with private insurance.
65, Military - Answer-TRICARE for Life enrollees who are aged ______ and older
can receive healthcare at a ____________ treatment facility
BlueCross, BlueShield - Answer-_____________________ and ________________
is a nationwide federation of nonprofit and for-profit service organization that provide
prepaid healthcare services to subscribers.
EXAM STUDY GUIDE QUESTIONS AND
ANSWERS
birthday - Answer-The _____________ rule states if a husband and wife both have
insurance through their employers, the insurance policy of the policyholder whose
birthday occurs first in the calendar year is the primary payer for all dependents.
fee schedule - Answer-A medical office's ________ _________ are the fees charged
to most of their patients most of the time under typical conditions.
taxonomy code - Answer-The _______________________ is a 10-digit number that
represents the physician's medical specialty.
before - Answer-The ABN, or Advance Beneficiary Notice of Noncoverage, must be
verbally reviewed with the beneficiary or his or her representative and any questions
raised during that review must be answered ________________ it is signed.
Underpayment - Answer-______________________ can occur when healthcare
providers submit claims for a simple procedure, but the medical record reveals that a
more complicated procedure was actually performed.
every - Answer-You should contact Medicaid to verify patient's benefit eligibility
___________ time they are seen in the office.
80-20 - Answer-With an _____ - _____ coinsurance, your patient will be responsible
for 20% off the allowable charge; or 20% of $100, which is $20.
copayment - Answer-A _______________ is a small fee paid by the patient that is
collected at the time of the visit.
references - Answer-Companies have manuals for _______________ and
representatives of the insurance companies are available to answer
_______________ about a patient's coverage.
Medical - Answer-Unless the patient has a ___________ emergency, Medicaid often
requires authorization before services are performed.
A, B - Answer-Medicare part _____ is hospital insurance and Part ____ helps pay for
a wide range of procedures and supplies.
this date - Answer-The effective date of insurance coverage should always be
verified. Services performed before ___________________ may be excluded from
claims.
October 1, 2014 - Answer-Under HIPAA, the diagnosis code that must be used in the
United States started on _____________________.
, 3 to 7 - Answer-ICD-10-CM s a ______ to ______ character alphaneumeric
representation of a disease or condition.
category - Answer-A ____________ code in ICD-10-CM is three characters.
subcategory - Answer-A _______________ code in ICD-10-CM has four to five
characters.
final code - Answer-A ___________ in ICD-10-CM has six to seven characters.
disease, injuries - Answer-Part of ICD-10-CM list _____________ and
_____________ alphabetically with corresponding diagnosis codes.
tabular - Answer-The _________ list is made up of twenty-one chapters of disease
descriptions and their codes.
alphabetical index - Answer-The ICD-10-CM index to Disease and Injuries is known
as the __________________ ______________.
diagnostic - Answer-A ______________ statement is a physician's description of the
main reason for a patient's encounter.
alphabetical, tabular - Answer-When coding, the coder first locates the
description/code in the _______________ index and then verifies the proposed code
selection by turning to the ______________ index and studying the entries.
hyphen - Answer-The _____________ means that the coder will need to drill down
to select the right code.
main - Answer-Each __________ term appears in boldface type and identifies a
disease or condition.
default - Answer-Each main term appears in boldface type and is followed by its
_________ code.
RBRVS (Resource based Relative Value Scale) - Answer-Medigap is not a part of
Medicare's _______________________________________________.
Inferior - Answer-People who qualify for Medicaid assistance are in no way
_____________ to those with private insurance.
65, Military - Answer-TRICARE for Life enrollees who are aged ______ and older
can receive healthcare at a ____________ treatment facility
BlueCross, BlueShield - Answer-_____________________ and ________________
is a nationwide federation of nonprofit and for-profit service organization that provide
prepaid healthcare services to subscribers.
