CERTIFIED BILLING AND CODING
SPECIALIST EXAM PREP
QUESTIONS & ANSWERS(RATED
A+)
The insured may not necessarily be the patient seen for the medical service. -
ANSWERTrue
Personal insurance is usually less expensive than other health insurance. -
ANSWERFalse
Time limits stated in individual health insurance policies about an insurance
company's obligation to pay benefits are the same for all insurance companies. -
ANSWERFalse
There is standardization of format for the explanation of benefit document for all
private insurance carriers. - ANSWERFalse
What organization publishes diagnostic and procedure coding competencies for
outpatient services and diagnostic coding and reporting requirements for physician
billing? - ANSWERAmerican Health Information Management Association (AHIMA)
Medical etiquette refers to: - ANSWERConsideration of others
CPT codes are assigned to which of these? - ANSWERCoding procedures and
services
Exceptions to the right of privacy rule include: - ANSWERGunshot wound cases
A common format for medical record documentation is called: - ANSWERSOAP
Most physician/patient contracts are: - ANSWERImplied
An inventory of body systems for which the patient complains of signs and symptoms
is called? - ANSWERROS
When coding a front torso burn, which percentage of body would be indicated? -
ANSWER18%
To which of the following would be assigned CPT code? - ANSWERTonsillectomy
Urine moves through the kidneys to the bladder through the: - ANSWERUreters
Which box of the CMS-1500 Form would be completed with codes for procedures,
services or supplies? - ANSWERBox 24d
, Which of these is considered PHI? - ANSWERPhotographic images, even in profile
This means "Let the Master Answer"? - ANSWERRespondeat Superior
Patient sees the physician for a regular office visit which is charged at $90. The
allowable amount for the patient's insurance company covers the office visit in full,
with a $10 copay, and the patient has not met the $125 deductible. How much does
the patient owe? - ANSWER$90
Using SOAP notes, what would be found in the Assessment portion of the record? -
ANSWERDiagnosis
If a Medicare patient wants a procedure that is a non-covered benefit, what form do
they need to sign that indicates they are aware it is not covered? -
ANSWERAdvanced Beneficiary Notice
Who is responsible for entering proper medical documentation to support
reimbursement of procedures and services? - ANSWERClinician
The primary function of the spleen is: - ANSWERProduction and removal of blood
cells as part of the immune system
The pre-established percentage of expenses paid by the patient, or another
insurance carrier, after the primary insurance has made payment, and the deductible
is met:
Select one: - ANSWERCoinsurance
Which of these must be obtained by the patient prior to the provider rendering
medical treatment? - ANSWERConsent
Which of these limits access to patient information based on the user's position in an
organization: - ANSWERRole-Based Access
A DME provider has a contract with an insurance company to accept their allowed
amount as payment in full. The provider bills $125 and the insurance approves $100.
The patient has a coinsurance amount of $20, and there is no deductible. How much
does the provider write off? - ANSWER$25
What happens with information that is abstracted from the medical record? -
ANSWERCoded and forwarded to the insurance
The significant reason for which a patient is admitted to the hospital is coded using
the: - ANSWERPrincipal Diagnosis
Which of these is a common abbreviation for the test that assesses the electrical
activity of the heart? - ANSWERECG
Confidential information about patients should never be discussed with: -
ANSWERFamily
SPECIALIST EXAM PREP
QUESTIONS & ANSWERS(RATED
A+)
The insured may not necessarily be the patient seen for the medical service. -
ANSWERTrue
Personal insurance is usually less expensive than other health insurance. -
ANSWERFalse
Time limits stated in individual health insurance policies about an insurance
company's obligation to pay benefits are the same for all insurance companies. -
ANSWERFalse
There is standardization of format for the explanation of benefit document for all
private insurance carriers. - ANSWERFalse
What organization publishes diagnostic and procedure coding competencies for
outpatient services and diagnostic coding and reporting requirements for physician
billing? - ANSWERAmerican Health Information Management Association (AHIMA)
Medical etiquette refers to: - ANSWERConsideration of others
CPT codes are assigned to which of these? - ANSWERCoding procedures and
services
Exceptions to the right of privacy rule include: - ANSWERGunshot wound cases
A common format for medical record documentation is called: - ANSWERSOAP
Most physician/patient contracts are: - ANSWERImplied
An inventory of body systems for which the patient complains of signs and symptoms
is called? - ANSWERROS
When coding a front torso burn, which percentage of body would be indicated? -
ANSWER18%
To which of the following would be assigned CPT code? - ANSWERTonsillectomy
Urine moves through the kidneys to the bladder through the: - ANSWERUreters
Which box of the CMS-1500 Form would be completed with codes for procedures,
services or supplies? - ANSWERBox 24d
, Which of these is considered PHI? - ANSWERPhotographic images, even in profile
This means "Let the Master Answer"? - ANSWERRespondeat Superior
Patient sees the physician for a regular office visit which is charged at $90. The
allowable amount for the patient's insurance company covers the office visit in full,
with a $10 copay, and the patient has not met the $125 deductible. How much does
the patient owe? - ANSWER$90
Using SOAP notes, what would be found in the Assessment portion of the record? -
ANSWERDiagnosis
If a Medicare patient wants a procedure that is a non-covered benefit, what form do
they need to sign that indicates they are aware it is not covered? -
ANSWERAdvanced Beneficiary Notice
Who is responsible for entering proper medical documentation to support
reimbursement of procedures and services? - ANSWERClinician
The primary function of the spleen is: - ANSWERProduction and removal of blood
cells as part of the immune system
The pre-established percentage of expenses paid by the patient, or another
insurance carrier, after the primary insurance has made payment, and the deductible
is met:
Select one: - ANSWERCoinsurance
Which of these must be obtained by the patient prior to the provider rendering
medical treatment? - ANSWERConsent
Which of these limits access to patient information based on the user's position in an
organization: - ANSWERRole-Based Access
A DME provider has a contract with an insurance company to accept their allowed
amount as payment in full. The provider bills $125 and the insurance approves $100.
The patient has a coinsurance amount of $20, and there is no deductible. How much
does the provider write off? - ANSWER$25
What happens with information that is abstracted from the medical record? -
ANSWERCoded and forwarded to the insurance
The significant reason for which a patient is admitted to the hospital is coded using
the: - ANSWERPrincipal Diagnosis
Which of these is a common abbreviation for the test that assesses the electrical
activity of the heart? - ANSWERECG
Confidential information about patients should never be discussed with: -
ANSWERFamily
