MEDICARE CERTIFICATION EXAM(ACTUAL
2024-2025) QUESTION WITH ANSWER
T/F: The Medical Review (MR) Program identifies and
addresses billing errors through the following: identifying
potential billing errors concerning coverage and coding;
profiling of providers, services, and/or beneficiary utilization;
evaluation of complaints, enrollment, and/or cost report data;
and data analysis. - ANSWWERS___True
T/F: Decimal digit .6 is usually used to indicate Other
Specified, Unspecified, and Not Otherwise Specified
conditions. - ANSWWERS___False
T/F: Diagnosis codes are used to determine how much money
a provider will get for procedures performed at a health care
facility. - ANSWWERS___False
T/F: Diagnosis codes are used to help evaluate the
appropriateness and timelines of medical care. -
ANSWWERS___True
T/F: Five-digit diagnosis codes are only necessary when there
has been an accident injury. - ANSWWERS___False
Medicare requires all providers to submit claims
_______________ with limited exceptions. -
ANSWWERS___electronically
, MEDICARE CERTIFICATION EXAM(ACTUAL
2024-2025) QUESTION WITH ANSWER
T/F: Billing for services not furnished and/or supplies not
provided is considered fraud. - ANSWWERS___True
T/F: Unbundling or "exploding" charges is considered fraud. -
ANSWWERS___True
T/F: Misrepresentations of dates and descriptions for services
furnished is considered fraud. - ANSWWERS___True
T/F: Billing non-covered or non-chargeable services as
covered items is considered fraud. - ANSWWERS___True
______________ are used as a classification for external
causes of injury and poisonings. - ANSWWERS___E codes
___________ is a national health insurance program that
provides hospital insurance, medical insurance, and a
voluntary prescription drug benefit. -
ANSWWERS___Medicare
In which volume would you find the hypertension table? -
ANSWWERS___Volume 2
T/F: Hospice care and services are excluded from
Consolidated Billing for Part A residents who are in the
2024-2025) QUESTION WITH ANSWER
T/F: The Medical Review (MR) Program identifies and
addresses billing errors through the following: identifying
potential billing errors concerning coverage and coding;
profiling of providers, services, and/or beneficiary utilization;
evaluation of complaints, enrollment, and/or cost report data;
and data analysis. - ANSWWERS___True
T/F: Decimal digit .6 is usually used to indicate Other
Specified, Unspecified, and Not Otherwise Specified
conditions. - ANSWWERS___False
T/F: Diagnosis codes are used to determine how much money
a provider will get for procedures performed at a health care
facility. - ANSWWERS___False
T/F: Diagnosis codes are used to help evaluate the
appropriateness and timelines of medical care. -
ANSWWERS___True
T/F: Five-digit diagnosis codes are only necessary when there
has been an accident injury. - ANSWWERS___False
Medicare requires all providers to submit claims
_______________ with limited exceptions. -
ANSWWERS___electronically
, MEDICARE CERTIFICATION EXAM(ACTUAL
2024-2025) QUESTION WITH ANSWER
T/F: Billing for services not furnished and/or supplies not
provided is considered fraud. - ANSWWERS___True
T/F: Unbundling or "exploding" charges is considered fraud. -
ANSWWERS___True
T/F: Misrepresentations of dates and descriptions for services
furnished is considered fraud. - ANSWWERS___True
T/F: Billing non-covered or non-chargeable services as
covered items is considered fraud. - ANSWWERS___True
______________ are used as a classification for external
causes of injury and poisonings. - ANSWWERS___E codes
___________ is a national health insurance program that
provides hospital insurance, medical insurance, and a
voluntary prescription drug benefit. -
ANSWWERS___Medicare
In which volume would you find the hypertension table? -
ANSWWERS___Volume 2
T/F: Hospice care and services are excluded from
Consolidated Billing for Part A residents who are in the
