Assessment 2 Module 11: Exam
Questions and Answers (Latest Update
2026
When a medical claim is denied, the medical biller will receive a
code giving an explanation for the denial. What is that code? -
correct answer ✅CARC - claim adjustment reason code
Match the phrases to complete these statements about coding
audits. -
correct answer ✅Retrospective audits occur after claim
submission and reimbursement
Audits can identify payer reimbursement issues, software
Prospective audits identify errors before claims are
Abiding by a Code of Ethics requires medical coders and billers to
use technology, data, and information resources in the way they are
intended. -
correct answer ✅True
Accurate and detailed ___ is crucial for coding in ICD-10. -
correct answer ✅documentation
, Diploma in Medical Coding and Billing -
Assessment 2 Module 11: Exam
Questions and Answers (Latest Update
2026
Coding audits may include validation of present-on-admission
assignment, reason for visit and HCPCS use and modifiers. -
correct answer ✅True
The Code of Ethics for coders and billers includes the intention to
"Advocate, uphold, and defend the consumer's right to __ and the
doctrine of confidentiality in the use and disclosure of information.
-
correct answer ✅privacy
Private health insurance plans often include a "deductible" which is
the amount the patient must pay before the policy is activated. -
correct answer ✅True
Which of the following are commonly used reimbursement
methodologies in healthcare? Select four correct answers. -
correct answer ✅Payment for Performance
Diagnosis Related Groups
Capitation
Fee for Service