ACTUAL Exam Questions and CORRECT
Answers
________ is the percentage of each covered claim that the insured must pay, according to the
terms of the insurance policy. - CORRECT ANSWER -coinsurance
A coding system that uses all the codes in the CPT and additional codes that cover many
supplies, such as sterile trays and durable medical equipment, is known as ________. -
CORRECT ANSWER -HCPCS
COB stands for ________. - CORRECT ANSWER -coordination of benefits
A physician who accepts an assignment of benefits agrees to receive payment directly from the
________ - CORRECT ANSWER -patient's insurance carrier
The letters "CM" in ICD-10-CM stand for ________. - CORRECT ANSWER -clinical
modification
________ is the form used in the medical office to record the patient's diagnosis (or diagnoses)
and the procedures performed during a patient's visit. - CORRECT ANSWER -patient
encounter form
The payment system used by Medicare is the ________. - CORRECT ANSWER -
Resource-based relative value scale
__ is the organization that administers Medicare and Medicaid. - CORRECT ANSWER -
CMS
PPOs ________ require referrals to specialists. - CORRECT ANSWER -do not
, The ICD-10-CM uses ________-digit codes for broad categories of diseases, injuries, and
symptoms - CORRECT ANSWER -three to seven
An analysis done in order to determine the connection between the diagnostic and procedural
information is known as ________. - CORRECT ANSWER -code linkage
________ payment is made by the insurance carrier after the patient has received medical
services. - CORRECT ANSWER -fee for services
Volume 2 of the ICD-10-CM manual is the ________. - CORRECT ANSWER -
Alphabetic Index
Which type of code is used to report what is wrong with the patient or what brought the patient
to see the physician? - CORRECT ANSWER -diagnostic
Volume 1 of the ICD-10-CM manual is the ________. - CORRECT ANSWER -tabular
index
CPT codes are ________ digit numbers. - CORRECT ANSWER -five
If the standard fee for a Medicare covered service is $150 and the Medicare non-PAR fee
schedule for the service is $80, what is the limiting charge for the services? - CORRECT
ANSWER -$92
Michael last visited his physician, which is a single-physician office practice, in September 2006.
He is at the office today for a sore throat and chest congestion. Since he was already a patient,
the medical insurance coder submitted an established patient E/M code to Michael's insurance
carrier for payment. The insurance carrier requested additional documentation regarding the
visit. Which of the following may have been the reason? - CORRECT ANSWER -
Michael's visit should have been coded from the new patient E/M category.