NHA Medical Coding and billing exam Questions With Solutions

NHA Medical Coding and billing exam Questions With Solutions Place of Service - ANS Billing and coding specialists should first divide the E & M Code by Privacy Officer - ANS Compliant with HIPPA the following position should be assigned in each office Principal Diagnosis - ANS Coding on the UB-04 Form, must sequence the diagnosis code. Which is the first listed diagnosis? Urethratresia - ANS Obstruction of the urethra is UB04 Forms - ANS Ambulatory surgery centers, home health center, and hospice use what form? Encounter forms - ANS Form that contains of DOS, CPT, ICD codes, fees and copay information is called Add on Codes - ANS Anesthesia section of CPT manual which are considered qualifying circumstances Title 11 - ANS Patient presents with chest pain & shortness of breath with abnormal ECG provider call a cardiologist. What portion of the HIPPA allows this Code set standards pertain to all providers - ANS HIPPA compliance guideline affecting EHR Red - ANS Color formats on CMS 1500 form acceptable Patient Ledger account - ANS Financial record generated by a provider office Coding Compliance Plan - ANS Which of the following includes procedures and best practices for correct coding Sagittal - ANS Which of the following planes divides the body into left and right Claim adjudication:( The term used in the industry to refer to the process of paying claims submitted on denying them after comparing claims to the benefit or coverage requirements) - ANS 3rd Party payer validates a claim which takes place next NCCI ( National Correct Coding Initiative) - ANS Developed to reduced Medicare Program expenditure by detecting in appropriate codes & eliminating improper coding 0% - ANS Beneficiary of Medicaid/ Medicare crossover claim is responsible for the percentage Internal monitoring and auditing - ANS Which of the following steps would be part of a physicians practice compliance program HIPPA - ANS Which of the following acts applies to the administrative simplification guidelines? Accounts recievable - ANS Patient charges that have not been paid will appear in which of the following adjudication - ANS Which of the following is considered the final determination of the issues involving settlement of an insurance claim A billing worksheet from the patient account - ANS A prospective billing account audit prevents fraud by reviewing & comparing a completed claim for with which of the following documents Lymphatic system - ANS Which of the following parts of the body system regulates immunity Billing using 2- digit CPT Modifiers to indicate a procedure as preformed differs from its usual 5 digit code - ANS Which of the following is allowed when billing procedural codes Direct Data entry - ANS A biller will electronically submit a claim to the carrier via which of the following? A Providers office with fewer than 10 fulltime employees - ANS Medicare enforces mandatory submission of electronic claims for most providers. Which of the providers is allowed to submit paper claims to Medicare? (RAC) Recovery audit Contractor - ANS Which of the following organizations identifies improper payments made on CMS claims Bone and bone marrow - ANS IF a patient has osteomyelitis he has problems with which of the following areas? Preauthorization form - ANS Which of the following is a requirement of some third-party payers before a procedure is performed? Precertification - ANS Ensure appropriate insurance coverage for an outpatient procedure by first using the following process History - ANS Key component if an evaluation and management service 837 - ANS Format used to submit electronic claims and 3rd Party payer Office of the Inspector General (OIG) - ANS Entity that defines the essential element of a comprehensive compliance program National Coverage Determination - ANS Medicare Policy determines if a particular item or service is covered Left upper quadrant - ANS Location of the stomach, spleen, part of the pancreas and liver 18% - ANS Coding a front torso burn, what % should be used? An italicized code used as the 1st listed diagnosis - ANS Result of a claim being denied Charging excessive fees - ANS Example of