Medical Billing and Coding Practice Test with Complete Solutions

Medical Billing and Coding Practice Test with Complete Solutions Which of the following Medicare policies determines if a particular item or service is covered by Medicare? National Coverage Determination (NCD) Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Encounter Form 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 complaint. Admitting clerk Which of the following privacy measures ensures protected health information (PHI) Using data encryption software on office workstations Divides the body from left and right Sagittal Which of the following provisions ensures that an insured's benefits from all insurance companies do not exceed 100% of allowable medical expenses? Coordination of Benefits Which of the following actions should be taken first when reviewing a delinquent claim? Verify the age of the account Advantage of electronic claim submission Claims are expedited Which of the following components of an explanation of benefits expedites the process of a phone appeal? Claim control number Which of the following actions by a billing and coding specialist is considered fraud? Billing for services not provided The patient's condition and the provider's information are shown in what blocks in CMS 1500 form? Blocks 14 through 33 Which of the following includes procedures and best practices for correct coding? Coding Compliance Plan When completing a CMS 1500 form which of the following is an acceptable action for the billing and coding specialist to take Use Arial size 10 font Which of the following indicates a claim should be submitted on paper instead of electronically? The claim requires an attachment According to HIPAA Standards which of the following identifies the rendering provider on the CMS 1500 claim form in Block 24J? NPI (National Provider Identifier) Service facility location information in CMS 1500 Block 32 Signature of the Physician in CMS 1500 Block 31 Accept Assignment in CMS 1500 Block 27 Patient's Account Number in CMS 1500 Block 26 Federal Tax I.D. Number / SSN / EIN in CMS 1500 Block 25 Rendering Provider ID # in CMS 1500