COMPLETE SOLUTIONS
A billing and coding specialist is submitting additional medical
record information that is required to process a claim. Which of
the following actions should the specialist take to ensure the
additional information is sent efficiently and securely to the
third-party paver?
Send the information as an electronic attachment to the claim.
A billing and coding specialist should use which of the
following types of category codes to assign a diagnosis to a
patient who is seeking health services but is not sick?
Z
Which of the following is the goal of revenue cycle monitoring?
Ensuring financial viability using standards of measurement
A billing and coding specialist is reviewing a denied claim for
an assistant surgeon. The denial states duplicate services. Which
of the following actions should the specialist take?
Resubmit the claim with modifier -80.
,A patient who experienced identity theft is trying to investigate
how it occurred. The patient asks a billing and coding specialist
for assistance in determining if the breach might have originated
in the provider's office. Which of the following actions should
the specialist take?
Provide an accounting of disclosures.
Which of the following actions is an example of fraud?
Billing for services that are not medically necessary
ICD-10-CM codes must be a minimum of how many characters
without being subdivided?
3
Which of the following actions should a billing and coding
specialist take if Medicare denies a service as not medically
necessary?
Appeal the decision with supporting documentation.
A billing and coding specialist is completing a CMS-1500 claim
form for a patient who was involved in a motor-vehicle crash.
Which of the following information is required on the form?
Date of injury
, A patient who has a past due balance requests their records be
sent to another provider. Which of the following actions should
the billing and coding specialist take with regards to the records
request?
Send the records to the provider.
Which of the following describes a delinquent claim?
A claim that is overdue for payment
For which of the following is the provider responsible?
Professional courtesy
Which of the following is an example of electronic claim
submission?
Submitting claims via a secure network
64
In which of the following departments should a patient be seen
for a furuncle?
• Dermatology
Which of the following modifiers should be used to indicate a
professional service has been discontinued prior to completion?