Medical Billing and Coding Practice Test | 298 Questions and Answers(A+ Solution guide)

National Coverage Determination (NCD) - ✔✔ Which of the following Medicare policies determines if a particular item or service is covered by Me dicare? Adjudication - ✔✔ Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Encounter Form - ✔✔ A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Admitting clerk - ✔✔ A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff members is responsible for the initial patient interview, obtaining demographic and insurance information and documenting the chief compla int. Using data encryption software on office workstations - ✔✔ Which of the following privacy measures ensures protected health information (PHI) Sagittal - ✔✔ Divides the body from left and right Coordination of Benefits - ✔✔ Which of the following provi sions ensures that an insured's benefits from all insurance companies do not exceed 100% of allowable medical expenses? Verify the age of the account - ✔✔ Which of the following actions should be taken first when reviewing a delinquent claim? Claims are e xpedited - ✔✔ Advantage of electronic claim submission Claim control number - ✔✔ Which of the following components of an explanation of benefits expedites the process of a phone appeal? Billing for services not provided - ✔✔ Which of the following actions b y a billing and coding specialist is considered fraud? Blocks 14 through 33 - ✔✔ The patient's condition and the provider's information are shown in what blocks in CMS 1500 form? Coding Compliance Plan - ✔✔ Which of the following includes procedures and be st practices for correct coding? Use Arial size 10 font - ✔✔ When completing a CMS 1500 form which of the following is an acceptable action for the billing and coding specialist to take The claim requires an attachment - ✔✔ Which of the following indicates a claim should be submitted on paper instead of electronically? NPI (National Provider Identifier) - ✔✔ According to HIPAA Standards which of the following identifies the rendering provider on the CMS 1500 claim form in Block 24J? Block 32 - ✔✔ Service facility location information in CMS 1500 Block 31 - ✔✔ Signature of the Physician in CMS 1500 Block 27 - ✔✔ Accept Assignment in CMS 1500 Block 26 - ✔✔ Patient's Account Number in CMS 1500 Block 25 - ✔✔ Federal Tax I.D. Number / SSN / EIN in CMS 1500 Block 24J - ✔✔ Rendering Provider ID # in CMS 1500 Block 24G - ✔✔ Days or Units in CMS 1500 Block 24F - ✔✔ Charges in CMS 1500 Block 24E - ✔✔ Diagnosis Pointer in CMS 1500 Block 24 D - ✔✔ Procedures, Services or Supplies in CMS 1500 Block 24 B - ✔✔ Place of Service in CMS 1500 Block 24 A - ✔✔ Dates of Services in CMS 1500 Block 23 - ✔✔ Prior Authorization Number in CMS 1500 Block 21 - ✔✔ Diagnosis or nature of illness or injury in CMS 1500 Block 20 - ✔✔ Outside Lab in CMS 1500 Block 22 - ✔✔ Resubmission code in CMS 1500 Block 18 - ✔✔ Hospitalization Dates related to current services in CMS 1500 Block 17 - ✔✔ Name of referring provider or other source in CMS 1500 Block 17A - ✔✔ Referring provider NPI in CMS 1500 Block 14 - ✔✔ Date of Current Illness, Injury or Pregnancy (LMP)