NHA Medical Coding and billing exam
(RAC) Recovery audit Contractor - Answer -Which of the following organizations identifies improper
payments made on CMS claims
(S) Subjective - Answer -Soap note to indicate patient level of pain to provider
0% - Answer -Beneficiary of Medicaid/ Medicare crossover claim is responsible for the percentage
18% - Answer -Coding a front torso burn, what % should be used?
2 Pieces of Information that need to be collected from patients - Answer -Patients name and date of
birth
2 reasons a claim may be denied - Answer -Invalid subscriber name was given or coding error was made
3rd Party Payer - Answer -Insurance Carrier is a
837 - Answer -Format used to submit electronic claims and 3rd Party payer
A bilateral procedure - Answer -A billing and coding specialists should add modifier -50 when reporting
which procedure
, A billing worksheet from the patient account - Answer -A prospective billing account audit prevents
fraud by reviewing & comparing a completed claim for with which of the following documents
A patients signature authorizing the release of any medical information necessary to process the claim. -
Answer -Block 12
A Providers office with fewer than 10 fulltime employees - Answer -Medicare enforces mandatory
submission of electronic claims for most providers. Which of the providers is allowed to submit paper
claims to Medicare?
Abuse - Answer -Practices that directly or indirectly result in unnecessary cost to the Medicare program
Accounts recievable - Answer -Patient charges that have not been paid will appear in which of the
following
Add on Codes - Answer -Anesthesia section of CPT manual which are considered qualifying
circumstances
adjudication - Answer -Which of the following is considered the final determination of the issues
involving settlement of an insurance claim
Advance Beneficiary Notice (ABN) - Answer -Advanced beneficiary notice, or ABN is a form that is
required for Medicare recipients.
An italicized code used as the 1st listed diagnosis - Answer -Result of a claim being denied
APC Grouper - Answer -Determine the appropriate ambulatory payment classification for outpatient
encounter
Assignment of Benefits - Answer -Contract in which the provider directly bills the payer and accepts the
allowable charge.
(RAC) Recovery audit Contractor - Answer -Which of the following organizations identifies improper
payments made on CMS claims
(S) Subjective - Answer -Soap note to indicate patient level of pain to provider
0% - Answer -Beneficiary of Medicaid/ Medicare crossover claim is responsible for the percentage
18% - Answer -Coding a front torso burn, what % should be used?
2 Pieces of Information that need to be collected from patients - Answer -Patients name and date of
birth
2 reasons a claim may be denied - Answer -Invalid subscriber name was given or coding error was made
3rd Party Payer - Answer -Insurance Carrier is a
837 - Answer -Format used to submit electronic claims and 3rd Party payer
A bilateral procedure - Answer -A billing and coding specialists should add modifier -50 when reporting
which procedure
, A billing worksheet from the patient account - Answer -A prospective billing account audit prevents
fraud by reviewing & comparing a completed claim for with which of the following documents
A patients signature authorizing the release of any medical information necessary to process the claim. -
Answer -Block 12
A Providers office with fewer than 10 fulltime employees - Answer -Medicare enforces mandatory
submission of electronic claims for most providers. Which of the providers is allowed to submit paper
claims to Medicare?
Abuse - Answer -Practices that directly or indirectly result in unnecessary cost to the Medicare program
Accounts recievable - Answer -Patient charges that have not been paid will appear in which of the
following
Add on Codes - Answer -Anesthesia section of CPT manual which are considered qualifying
circumstances
adjudication - Answer -Which of the following is considered the final determination of the issues
involving settlement of an insurance claim
Advance Beneficiary Notice (ABN) - Answer -Advanced beneficiary notice, or ABN is a form that is
required for Medicare recipients.
An italicized code used as the 1st listed diagnosis - Answer -Result of a claim being denied
APC Grouper - Answer -Determine the appropriate ambulatory payment classification for outpatient
encounter
Assignment of Benefits - Answer -Contract in which the provider directly bills the payer and accepts the
allowable charge.
