Medical Coding And Billing Final Exam
Questions And Answers
During bMrs. bSmith's bvisit bto bDr. bJohnson bshe bprovides ba bdescription bof ba
bconcerning bhealth bcondition.. bMrs. bSmith bbelieves bthat bDr. bJohnson bwill buse bthis
binformation bto bevaluate band bmanage bher bcondition band bfor bno bother bpurpose.
bMrs. bSmith's bbelief bis ban bexpectation bof b____. b- bcorrect banswers✔✔confidentiality
The bdocumentation btype bthat bcontains bvarious btypes bof banalyses bor bexaminations
bof bbody bsubstances bcollected bfrom bthe bpatient. b- bcorrect banswers✔✔Lab bReport
Vital bstatistics bfor blive bbirths bthat bare bsent bto ba bhealthcare bdatabase bare ban
bexample bof b_____. b- bcorrect banswers✔✔secondary bdata
Which bof bthe bfollowing bis bNOT ba bbenefit bof bswitching bfrom ba bpaper-based brecord
bto ban belectronic-based brecord? b- bcorrect banswers✔✔Coding baccuracy
A bportal bthrough bwhich bpatients bcan bview band bmanage btheir bhealthcare
binformation bonline bis bcalled ba(n)_____ bthis binformation bis bowned band bmanaged
bby b______. b- bcorrect banswers✔✔personal bhealth brecord; bthe bpatient
Which bof bthe bfollowing bis ban bancillary breport? b- bcorrect banswers✔✔Radiology
Which bof bthe bfollowing bis btrue bin bregard bto bthe brelease bof bprotected bhealth
binformation b(ROI)? b- bcorrect banswers✔✔A bcovered bentity bmust bprovide baccess bto
bPHI bin bthe bmanner brequested bby bthe bindividual
Healthcare bDelivery bSystems b- bcorrect banswers✔✔
After bsuffering ba bstroke, ba bpatient brequires btherapy bto bassist bin bperforming
bactivities bof bdaily bliving bsuch bas bgetting bdressed band bcooking. bWhich bdepartment
bwould bassist bthis bpatient? b- bcorrect banswers✔✔Occupational btherapy
Which bfederal bagency bis btasked bwith bgoverning band bregulating bhealthcare bin bthe
bUnited bStates? b- bcorrect banswers✔✔Department bof bHealth band bHuman bServices
b(DHHS)
,Dr. bTaylor bwants bto bjoin bthe bmedical bstaff bat bABC bhospital. bWhich bof bthe
bfollowing bwould bthe bmedical badministration boffice bcheck bto bsee bif bDr. bTaylor
bmeets bthe bqualifications bfor bhospital bprivileges? b- bcorrect banswers✔✔Medical bstaff
bbylaws
Which bof bthe bfollowing bis banother bname bfor boutpatient bcare? b- bcorrect
banswers✔✔Ambulatory bcare
Which bof bthe bfollow bdepartments/specialties buses bradioactive bsubstances bto
bdiagnose band btreat bpatients? b- bcorrect banswers✔✔Nuclear bMedicine band
bRadiation bTherapy
Mrs.Thomas bis bdischarged bfrom bthe bhospital bbut bshe bwill bcontinue bwith bIV
bantibiotics bfor b2 bweeks. bWhich btype bof bcare bwould bmanage bthe badministration bof
bher bantibiotics? b- bcorrect banswers✔✔Home bCare
Mr. bThomas bhas bmoved bto ba bnew bcity band bis blooking bfor ba bphysician bto bhelp
bmanage bhis bdiabetes. bWhich btype bof bspecialist bwould bhe blook bfor? b- bcorrect
banswers✔✔Endo
Legal bAnd bCompliance b- bcorrect banswers✔✔
Which bof bthe bfollowing bshould bNOT bbe bincluded bin ba btracking bsystem bfor
bdisclosures bof bPHI? b- bcorrect banswers✔✔Social bsecurity bnumbers band bdiagnosis
bcodes bfor bthe bpatient
Which bof bthe bfollowing bis bNOT ban bexample bof ba bsecure bsite bthrough bwhich bPHI
bcould bbe bsent belectronically? b- bcorrect banswers✔✔Registries band bdatabases
In ba bmedical bmalpractice blawsuit, bthe bphysician bwould bbe bconsidered bthe
b________. b- bcorrect banswers✔✔defendant
The blegal bhealth brecord bmust bbe bmaintained baccording bto ball bof bthe bfollowing
bexcept: b- bcorrect banswers✔✔The bOIG bwork bplan
Which bof bthe bfollowing bis btrue babout bdestruction bof bthe bhealth brecord? b- bcorrect
banswers✔✔Destruction bmust bbe bdone bas bpart bof bthe borganization's busual bcourse
bof bbusiness
For bwhich bof bthe bfollowing bis bauthorization bNOT brequired bfor bthe brelease bof
bprotected bhealth binformation? b- bcorrect banswers✔✔All bof bthe babove
Mary bis ba bcoder bat bABC bhospital. bDuring bher breview bof bthe bdocumentation bin
bMiss bMiller's belectronic bhealth brecord, bshe breads breports bfrom bprevious bvisits.
bMary's bactions bare ba bviolation bof b______. b- bcorrect banswers✔✔the bstandard bof
bminimum bnecessary
, Reimbursement bMethodologies b- bcorrect banswers✔✔
Teri bis bverifying bMedicare bbenefits bfor ba bcertain bprocedure. bThe bnational bcoverage
bdetermination b(NCD) bhe breviewed bdoes bnot banswer ball bhis bquestions. bWhich bof
bthe bfollowing bis bthe bnext bresource bTeri bshould bconsult bfor badditional binformation?
b- bcorrect banswers✔✔Local bcoverage bdeterminations b(LCDs)
Fee-for-service breimbursement bprovided bafter bhealth bservices bhave bbeen bgiven bis
bcalled____? b- bcorrect banswers✔✔retrospective bpayment
Billing bfor btwo bor bthree bcodes bwhen bone bcomprehensive bcode bis bmore
bappropriate? b- bcorrect banswers✔✔Unbundling
Capitation, bglobal/prospective bpayment, band bprospective bpayment bare bexamples bof
bthis btype bof breimbursement bmethod. b- bcorrect banswers✔✔Episode-of-care
Under bthis breimbursement bmethod, ba bthird-party bpayer bcontracts bwith ba bhealthcare
bprovider bto bpay ba bflat bfee bper bindividual benrolled bin bthe bhealthcare bplan. b-
bcorrect banswers✔✔Capitation
Dr. bJohnson brecommends ba bprocedure bfor bMr. bThomas bwho bis ba bMedicare
bpatient. bThe bprocedure bis bnot breimbursed bunder bMr. bThomas' bMedicare bpolicy. bIn
border bto bbill bMr. bThomas bfor bthe bprocedure, bDr. bJohnson's boffice bmust bcollect
ba(n)____ bfrom bMr. bThomas. b- bcorrect banswers✔✔advance bbeneficiary bnotice bof
bnoncoverage
Which bof bthe bfollowing bis bNOT ban belement bof bthe bhealthcare breimbursement
bprocess? b- bcorrect banswers✔✔clinical bdocumentation breview
Sue bwas badmitted bto bABC bhospital bas ban binpatient. bDuring bthe badmission, bDr.
bButler bremoved bher bappendix. bDr. bButler bwould bbill bfor bhis bservices bwith b___
bcodes bsubmitted bon ba b____ bclaim bform. b- bcorrect banswers✔✔CPT; bCMS-1500
A bpre-existing bcondition bwhich, bbecause bof bits bpresence, bcauses ban bincrease bin
blength bof bstay bby bat bleast bone bday bin bapproximately b75% bof bcases. b- bcorrect
banswers✔✔Comorbid bcondition
Of bthe bfollowing, bwhich bdoes bNOT bdirectly binfluence bthe bassignment bof bMS-
DRGs? b- bcorrect banswers✔✔Severity bof billness
Medical bTerminology b- bcorrect banswers✔✔
Which bof bthe bfollowing bterms bdescribes ba bwoman bwho bloses bher bfirst bpregnancy
bat b13 bweeks bgestation? b- bcorrect banswers✔✔Nullipara
Questions And Answers
During bMrs. bSmith's bvisit bto bDr. bJohnson bshe bprovides ba bdescription bof ba
bconcerning bhealth bcondition.. bMrs. bSmith bbelieves bthat bDr. bJohnson bwill buse bthis
binformation bto bevaluate band bmanage bher bcondition band bfor bno bother bpurpose.
bMrs. bSmith's bbelief bis ban bexpectation bof b____. b- bcorrect banswers✔✔confidentiality
The bdocumentation btype bthat bcontains bvarious btypes bof banalyses bor bexaminations
bof bbody bsubstances bcollected bfrom bthe bpatient. b- bcorrect banswers✔✔Lab bReport
Vital bstatistics bfor blive bbirths bthat bare bsent bto ba bhealthcare bdatabase bare ban
bexample bof b_____. b- bcorrect banswers✔✔secondary bdata
Which bof bthe bfollowing bis bNOT ba bbenefit bof bswitching bfrom ba bpaper-based brecord
bto ban belectronic-based brecord? b- bcorrect banswers✔✔Coding baccuracy
A bportal bthrough bwhich bpatients bcan bview band bmanage btheir bhealthcare
binformation bonline bis bcalled ba(n)_____ bthis binformation bis bowned band bmanaged
bby b______. b- bcorrect banswers✔✔personal bhealth brecord; bthe bpatient
Which bof bthe bfollowing bis ban bancillary breport? b- bcorrect banswers✔✔Radiology
Which bof bthe bfollowing bis btrue bin bregard bto bthe brelease bof bprotected bhealth
binformation b(ROI)? b- bcorrect banswers✔✔A bcovered bentity bmust bprovide baccess bto
bPHI bin bthe bmanner brequested bby bthe bindividual
Healthcare bDelivery bSystems b- bcorrect banswers✔✔
After bsuffering ba bstroke, ba bpatient brequires btherapy bto bassist bin bperforming
bactivities bof bdaily bliving bsuch bas bgetting bdressed band bcooking. bWhich bdepartment
bwould bassist bthis bpatient? b- bcorrect banswers✔✔Occupational btherapy
Which bfederal bagency bis btasked bwith bgoverning band bregulating bhealthcare bin bthe
bUnited bStates? b- bcorrect banswers✔✔Department bof bHealth band bHuman bServices
b(DHHS)
,Dr. bTaylor bwants bto bjoin bthe bmedical bstaff bat bABC bhospital. bWhich bof bthe
bfollowing bwould bthe bmedical badministration boffice bcheck bto bsee bif bDr. bTaylor
bmeets bthe bqualifications bfor bhospital bprivileges? b- bcorrect banswers✔✔Medical bstaff
bbylaws
Which bof bthe bfollowing bis banother bname bfor boutpatient bcare? b- bcorrect
banswers✔✔Ambulatory bcare
Which bof bthe bfollow bdepartments/specialties buses bradioactive bsubstances bto
bdiagnose band btreat bpatients? b- bcorrect banswers✔✔Nuclear bMedicine band
bRadiation bTherapy
Mrs.Thomas bis bdischarged bfrom bthe bhospital bbut bshe bwill bcontinue bwith bIV
bantibiotics bfor b2 bweeks. bWhich btype bof bcare bwould bmanage bthe badministration bof
bher bantibiotics? b- bcorrect banswers✔✔Home bCare
Mr. bThomas bhas bmoved bto ba bnew bcity band bis blooking bfor ba bphysician bto bhelp
bmanage bhis bdiabetes. bWhich btype bof bspecialist bwould bhe blook bfor? b- bcorrect
banswers✔✔Endo
Legal bAnd bCompliance b- bcorrect banswers✔✔
Which bof bthe bfollowing bshould bNOT bbe bincluded bin ba btracking bsystem bfor
bdisclosures bof bPHI? b- bcorrect banswers✔✔Social bsecurity bnumbers band bdiagnosis
bcodes bfor bthe bpatient
Which bof bthe bfollowing bis bNOT ban bexample bof ba bsecure bsite bthrough bwhich bPHI
bcould bbe bsent belectronically? b- bcorrect banswers✔✔Registries band bdatabases
In ba bmedical bmalpractice blawsuit, bthe bphysician bwould bbe bconsidered bthe
b________. b- bcorrect banswers✔✔defendant
The blegal bhealth brecord bmust bbe bmaintained baccording bto ball bof bthe bfollowing
bexcept: b- bcorrect banswers✔✔The bOIG bwork bplan
Which bof bthe bfollowing bis btrue babout bdestruction bof bthe bhealth brecord? b- bcorrect
banswers✔✔Destruction bmust bbe bdone bas bpart bof bthe borganization's busual bcourse
bof bbusiness
For bwhich bof bthe bfollowing bis bauthorization bNOT brequired bfor bthe brelease bof
bprotected bhealth binformation? b- bcorrect banswers✔✔All bof bthe babove
Mary bis ba bcoder bat bABC bhospital. bDuring bher breview bof bthe bdocumentation bin
bMiss bMiller's belectronic bhealth brecord, bshe breads breports bfrom bprevious bvisits.
bMary's bactions bare ba bviolation bof b______. b- bcorrect banswers✔✔the bstandard bof
bminimum bnecessary
, Reimbursement bMethodologies b- bcorrect banswers✔✔
Teri bis bverifying bMedicare bbenefits bfor ba bcertain bprocedure. bThe bnational bcoverage
bdetermination b(NCD) bhe breviewed bdoes bnot banswer ball bhis bquestions. bWhich bof
bthe bfollowing bis bthe bnext bresource bTeri bshould bconsult bfor badditional binformation?
b- bcorrect banswers✔✔Local bcoverage bdeterminations b(LCDs)
Fee-for-service breimbursement bprovided bafter bhealth bservices bhave bbeen bgiven bis
bcalled____? b- bcorrect banswers✔✔retrospective bpayment
Billing bfor btwo bor bthree bcodes bwhen bone bcomprehensive bcode bis bmore
bappropriate? b- bcorrect banswers✔✔Unbundling
Capitation, bglobal/prospective bpayment, band bprospective bpayment bare bexamples bof
bthis btype bof breimbursement bmethod. b- bcorrect banswers✔✔Episode-of-care
Under bthis breimbursement bmethod, ba bthird-party bpayer bcontracts bwith ba bhealthcare
bprovider bto bpay ba bflat bfee bper bindividual benrolled bin bthe bhealthcare bplan. b-
bcorrect banswers✔✔Capitation
Dr. bJohnson brecommends ba bprocedure bfor bMr. bThomas bwho bis ba bMedicare
bpatient. bThe bprocedure bis bnot breimbursed bunder bMr. bThomas' bMedicare bpolicy. bIn
border bto bbill bMr. bThomas bfor bthe bprocedure, bDr. bJohnson's boffice bmust bcollect
ba(n)____ bfrom bMr. bThomas. b- bcorrect banswers✔✔advance bbeneficiary bnotice bof
bnoncoverage
Which bof bthe bfollowing bis bNOT ban belement bof bthe bhealthcare breimbursement
bprocess? b- bcorrect banswers✔✔clinical bdocumentation breview
Sue bwas badmitted bto bABC bhospital bas ban binpatient. bDuring bthe badmission, bDr.
bButler bremoved bher bappendix. bDr. bButler bwould bbill bfor bhis bservices bwith b___
bcodes bsubmitted bon ba b____ bclaim bform. b- bcorrect banswers✔✔CPT; bCMS-1500
A bpre-existing bcondition bwhich, bbecause bof bits bpresence, bcauses ban bincrease bin
blength bof bstay bby bat bleast bone bday bin bapproximately b75% bof bcases. b- bcorrect
banswers✔✔Comorbid bcondition
Of bthe bfollowing, bwhich bdoes bNOT bdirectly binfluence bthe bassignment bof bMS-
DRGs? b- bcorrect banswers✔✔Severity bof billness
Medical bTerminology b- bcorrect banswers✔✔
Which bof bthe bfollowing bterms bdescribes ba bwoman bwho bloses bher bfirst bpregnancy
bat b13 bweeks bgestation? b- bcorrect banswers✔✔Nullipara
