FINAL EXAM MEDICAL BILLING AND
CODING Q&A
A4500 - Answer-Following surgery the patient was provided with below knee length
surgical stockings. What is the correct HCPCS level II code?
AS - Answer-What is the correct level II modifier used for a PA's role to assist a
surgeon during a procedure?
Intravenous - Answer-What is the fastest but also most dangerous route of drug
administration?
Generic - Answer-What is a chemically equivalent lower cost version of a brand
name drug?
Medication list - Answer-Where are the names, dosages, and all reasons for all
drugs that patient currently takes documented in a medical record?
Physician query - Answer-What is a written request to a physician to clarify or
complete the information in clinical documentation to ensure accurate health
records?
Laboratory report - Answer-A test that screens for antibodies in the cloud would be
reported on what medical report?
It provides an opportunity for physicians to demonstrate the quality of care that was
provided. - Answer-Which of the following is one reason why clinical documentation
improvement (CDI) efforts are necessary?
Breast cancer - Answer-The patient was referred for a bone scan to check for
metastatic disease. Which diagnosis would support medical necessity for this
procedure?
Place of service - Answer-What is the physical location where healthcare services
are provided to patients?
National Provider Identifier (NPI) - Answer-What is the standard unique health
identifier that is mandated by HIPAA for each healthcare provider and used for
claims processing, patient eligibility inquiries, claims inquiries, patient referrals, and
generation of remittance advices?
Group practice - Answer-What is the term for two or more physicians who share
space, equipment, supplies, and personnel and may represent a single specialty or
multiple specialities?
Commercial - Answer-What is health insurance issued by private companies?
, Consolidated Omnibus Budget Reconciliation Act (COBRA) - Answer-Which of the
following allows employees to continue healthcare coverage beyond the benefit
termination date?
usual, customary, and reasonable (UCR) - Answer-What is defined as the amount
commonly charged for a particular medical service by providers with a certain
geographic area?
The local BCBS plan where the services were provided - Answer-Where are BCBS
claims submitted for processing?
Preauthorization - Answer-What is a review by BCBS that grants prior approval for
reimbursement of a healthcare service?
Deductible - Answer-Which of the following is an example of an out of pocket cost?
Medicare part B - Answer-Which Medicare program pays for physic services,
outpatient care, and durable medical equipment?
Advance Beneficiary Notice (ABN) - Answer-What is the form required for all
physician services or procedures that might not be covered by the Medicare
program?
Medigap - Answer-What type of coverage can Medicare beneficiaries obtain to help
with the costs not reimbursed by their original Medicare plan?
National Correct Coding Initiative (NCCI) - Answer-Because CMS has a financial
incentive to ensure coding accuracy, what did they create to reduce inappropriate
payments of Medicare part B claims?
Allowable charge - Answer-What is the maximum amount that an insurer will
reimburse for a covered service or procedure?
Patients are informed about what charges to expect. - Answer-What is the price
transparency in healthcare?
Emancipated minor - Answer-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?
Protected Health Information (PHI) - Answer-What is any information that can link a
specific individual to medical records?
The patient allows insurance benefits to be paid directly to the provider. - Answer-
Which of the following is an example of consent?
Electronic - Answer-The HIPAA security rule provides standards for health
information maintained or transmitted in what format?
CODING Q&A
A4500 - Answer-Following surgery the patient was provided with below knee length
surgical stockings. What is the correct HCPCS level II code?
AS - Answer-What is the correct level II modifier used for a PA's role to assist a
surgeon during a procedure?
Intravenous - Answer-What is the fastest but also most dangerous route of drug
administration?
Generic - Answer-What is a chemically equivalent lower cost version of a brand
name drug?
Medication list - Answer-Where are the names, dosages, and all reasons for all
drugs that patient currently takes documented in a medical record?
Physician query - Answer-What is a written request to a physician to clarify or
complete the information in clinical documentation to ensure accurate health
records?
Laboratory report - Answer-A test that screens for antibodies in the cloud would be
reported on what medical report?
It provides an opportunity for physicians to demonstrate the quality of care that was
provided. - Answer-Which of the following is one reason why clinical documentation
improvement (CDI) efforts are necessary?
Breast cancer - Answer-The patient was referred for a bone scan to check for
metastatic disease. Which diagnosis would support medical necessity for this
procedure?
Place of service - Answer-What is the physical location where healthcare services
are provided to patients?
National Provider Identifier (NPI) - Answer-What is the standard unique health
identifier that is mandated by HIPAA for each healthcare provider and used for
claims processing, patient eligibility inquiries, claims inquiries, patient referrals, and
generation of remittance advices?
Group practice - Answer-What is the term for two or more physicians who share
space, equipment, supplies, and personnel and may represent a single specialty or
multiple specialities?
Commercial - Answer-What is health insurance issued by private companies?
, Consolidated Omnibus Budget Reconciliation Act (COBRA) - Answer-Which of the
following allows employees to continue healthcare coverage beyond the benefit
termination date?
usual, customary, and reasonable (UCR) - Answer-What is defined as the amount
commonly charged for a particular medical service by providers with a certain
geographic area?
The local BCBS plan where the services were provided - Answer-Where are BCBS
claims submitted for processing?
Preauthorization - Answer-What is a review by BCBS that grants prior approval for
reimbursement of a healthcare service?
Deductible - Answer-Which of the following is an example of an out of pocket cost?
Medicare part B - Answer-Which Medicare program pays for physic services,
outpatient care, and durable medical equipment?
Advance Beneficiary Notice (ABN) - Answer-What is the form required for all
physician services or procedures that might not be covered by the Medicare
program?
Medigap - Answer-What type of coverage can Medicare beneficiaries obtain to help
with the costs not reimbursed by their original Medicare plan?
National Correct Coding Initiative (NCCI) - Answer-Because CMS has a financial
incentive to ensure coding accuracy, what did they create to reduce inappropriate
payments of Medicare part B claims?
Allowable charge - Answer-What is the maximum amount that an insurer will
reimburse for a covered service or procedure?
Patients are informed about what charges to expect. - Answer-What is the price
transparency in healthcare?
Emancipated minor - Answer-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?
Protected Health Information (PHI) - Answer-What is any information that can link a
specific individual to medical records?
The patient allows insurance benefits to be paid directly to the provider. - Answer-
Which of the following is an example of consent?
Electronic - Answer-The HIPAA security rule provides standards for health
information maintained or transmitted in what format?
