CBCS NHA practice exam 2 Questions And Answers

CBCS NHA practice exam 2 Questions And Answers Which of the following is used to communicate why a claim line item was denied or paid differently than it was billed? - ANS Claim adjustment reason codes A billing and coding specialist is reviewing a claim edit report and identifies a rejection for missing patient demographic information. Which of the following missing pieces of patient demographic information would cause a rejection from the clearinghouse? - ANS DOB A billing and coding specialist is reviewing paperwork that indicates overpayment by Medicare for six patients over the past year. Which of the following describes this process ? - ANS Audit Which of the following describes an insurance company that offers plans that pay health care providers who render services to patients? - ANS Third party payer Which of the following sections of the CPT® manual lists the code for WBC with differential, automated? - ANS Pathology and laboratory A billing and coding specialist is reviewing provider notes to complete a claim. They need clarification on whether the procedure performed was on the left side, right side, or bilaterally. The specialist queries the provider and the provider confirms it was a bilateral procedure. Which of the following modifiers should be billed? - ANS 50 A provider orders a comprehensive metabolic panel for a 70-year-old patient who has Medicare as their primary insurance. Which of the following is required to inform the patient they may be responsible for payment? - ANS Advanced beneficiary notice A billing and coding specialist is appealing a Medicare denial. Which of the following is the first step in the appeals process? - ANS Redetermination Which of the following are used to code provider and outpatient services? - ANS CPT codes Which of the following is a covered entity affected by HIPAA security rules? - ANS Health care clearinghouses Which of the following actions by a billing and coding specialist is an example of fraud ? - ANS Billing for services not provided to obtain higher reimbursement Which of the following should be included on a claim form that is sent from a specialist to a managed health care organization? - ANS The referring providers NPI Which of the following is a document used to analyze accounts receivable based on dates of service? - ANS Aging report A provider accepts assignment for a patient who has a $10 copayment and has already met 100 of their $150 deductible. The office charge is $100 and the allowed amount is 70. How much should the provider's office adjust off the patient's account? - ANS $30 A patient has a new diagnosis of hypothyroidism. In which of the following body systems is the thyroid gland located? - ANS Endocrine system A patient's portion of the bill should be discussed with the patient before a procedure is performed for which of the following reasons? - ANS To ensure the patient understands his portion of the bill Which of the following introduced documentation guidelines to Medicare carriers to ensure that services paid for have been provided and were medically necessary? - ANS CMS A billing and coding specialist is reviewing a remittance advice for a claim that was denied for medical necessity. which of the following is an example of this type of error? - ANS The ICD-10-CM code for tonsillitis was listed with the CPT code for an appendectomy