QUESTIONS AND ANSWERS
Which of the following entities is responsible for implementing the various
provisions of HIPAA in health care?
Centers for Medicare and Medical Services CMS
Which of the following is not a key component in selecting a level of Evaluation
and Management (E&M) services?
Date
Which of the following is incorrect in reference to add-on codes?
They may be reported as stand-alone codes
A physician whis specialized in the study of the nervous system is called a/an:
Neurologist
While reviewing delinquent accounts, the billing and coding specialist comes
across one that was previously billed but never paid by the insurance company.
the next step is:
Review the previous submission for errors and resubmit if necessary.
The suffix meaning surgical repair is:
-Plasty
A triangle placed in front of a code in the CPT manual means:
The description for the code has changed
In which section of the CPT manual should the billing and coding specialist find
the codes for X-ray procedures?
Radiology
Medical ethics are:
Standards of conduct
In a state that has Worker's Compensation, a patient being treated by a physician
for a work- related fracture is found to have a non-work related poison ivy rash.
Which of the following is not an option for the physician?
Treat the patient for the poison ivy and bill the Worker's Compensation carrier
This body system involves the skin, hair,nails, absorbs vitamin D and calcium
from sunlight.
, Integumentary System
Which of the following is the correct format to enter a patient's birthday on the
CMS-1500 form?
MM/DD/YYYY
To ensure all claims are being submitted and recieved, a billing and coding
specialist should document all claims processing on which of the following?
An insurance claims register
A patient was admitted for a full-term delivery of a healthy infant. Which of the
following specialist should privide a patient care?
Obstetrician
Incorrect payments from an insurance company should be:
Investigated and appealed
A claim for services not medically necessary is an example of:
Abuse
When a non-member physician treats an HMO patient, the service rendered is
termed:
Out of plan or out of network
Which CPT modifier should the billing and coding specialist attach to a
consultation code when the service performed is required by a third-party payer
or goverment regulatory body?
-32 (Mandated Services)
Which of the following is an example of why claims can be denied for reasons
other than processing error?
Not medically necessary
A 24-years-old man suffered multiple lacerations in different parts of the body due
to a vehicular accident. The following are the codes and the procedures done on
the patient. (Applicable modifiers are intentionally omitted.)
CODE: PROCEDURE:
12005 Repair,simple,15cm,right thigh; $100.00
12002 Repair,simple,7cm,left forearm; $75.00
12032 Repair, intermediate,5cm,right arm; $150.00