Medical billing and coding Final Exam Questions and Answers with verified solutions

Medical billing and coding Final Exam Questions and Answers with verified solutions Which of the following is a reason for why the field of medical billing and coding is in high demand? - ANS- An aging population will use more healthcare services to manage a multitude of chronic diseases. What is the process of reporting diagnoses and procedures/services as numeric and alphanumeric characters on the insurance claim? - ANS- Medical coding What is the two-way, real time video visit between the patient and the physician at a distant site? - ANS- Telehealth What is the amount for which the patient is financially responsible before an insurance policy provides payment? - ANS- Deductible What type of health insurance is provided through your employer or purchased directly from an insurance company? - ANS- Commercial What is the missing word in the following phrase: "If it wasn't ___________, it wasn't done." - ANS- Documented What section of the SOAP note contains the chief complaint and the patient's description of the presenting problem? - ANS- Subjective What is health information in a digital format that is created and shared by providers across more than one healthcare setting? - ANS- Electronic health record (EHR) What is the reimbursement method where one payment covers all services during an episode of care? - ANS- Bundled payment What is a written order from your primary care provider for you to see a specialist or get certain medical services? - ANS- Referral What health plans are designed to put more responsibility on the employee for their healthcare spending? - ANS- Consumer-directed health plans In a physician practice, revenue cycle management is also called what? - ANS- Accounts receivable What is the computer-to-computer transfer of data between providers and third-party payers? - ANS- Electronic data interchange (EDI) What type of claim was never entered into the computer system of the insurance company because it failed to meet specific data requirements? - ANS- Rejected claim What is the maximum amount that an insurer will reimburse for a covered service or procedure? - ANS- Allowable charge What is price transparency in healthcare? - ANS- Patients are informed about what charges to expect. What is the term for an individual who has not reached the age of majority (usually 18) but is no longer under the care and control of parents? - ANS- Emancipated minor What is any information that can link a specific individual to medical records? - ANS- Protected Health Information (PHI) Which of the following is an example of consent? - ANS- The patient allows insurance benefits to be paid directly to the provider. The HIPAA Security Rule provides standards for health information maintained or transmitted in what format? - ANS- electronic Which of the following is an example of fraud? - ANS- Falsifying patient records to justify the medical necessity of services. Which of the following is true concerning the release of patient information? - ANS- Original records should never be released. What is the "main term" for primary pancreatic neoplasm of the head of the pancreas? - ANS- Neoplasm The ICD-10-CM code book is updated annually on what date? - ANS- October 1 The patient was evaluated in the emergency room for anterior chest wall pain, suspected unstable angina. What is the correct ICD-10-CM code? - ANS- R07.89 The patient was seen in follow-up for hypertension and chronic kidney disease, stage 5. What is/are the correct ICD-10-CM code(s)? - ANS- I12.0 N18.5 The patient was seen for pre-operative cardiovascular examination prior to undergoing cholecystectomy. What is the correct ICD-10-CM code? - ANS- Z01.810 The patient's diagnosis is idiopathic scoliosis of the cervicothoracic region. What is the correct ICD-10-CM code? - ANS- M41.23 In which main section of the CPT codebook would you find the code for a cholecystectomy? - ANS- Surgery The patient requested removal of 20 skin tags. What is/are the correct CPT code(s)? - ANS- 11200, 11201 The hand surgeon performed a neuroplasty of the ulnar nerve of the left wrist. What is the correct CPT code? - ANS- 64719-LT The surgeon performed debridement of an open leg wound. Two days later, the surgeon performed a more extensive debridement of the same wound. What modifier is reported with the second service? - ANS- 58 The patient with a history of osteopenia was referred for a DXA scan of the axial skeleton. What is the correct CPT code, professional component only? - ANS- 77080-26