NHA BILLING AND CODING EXAM 2023 TEST BANK 200
QUESTIONS AND CORRECT ANSWERS(CBCS)
billing & Coding Specialist should 1st divide the E&M code by - ANSWER: Place of
Service
complaint with HIPAA the following position should be assigned in each office -
ANSWER: Privacy officer
coding on the UB04 form must sequence the DX code. Which is 1st listed diagnosis
code? - ANSWER: Principle code
obstruction of the Urethra - ANSWER: Urethratresia
ambulatory surgery centers, home health center, and Hospice use - ANSWER: UBO4
forms
form that contains DOS, CPT, ICD codes, fees and copay information is called -
ANSWER: encounter forms
anesthesia section of CPT manual which are considered qualifying circumstances -
ANSWER: add on codes
patient presents with chest pain & shortness of breath with an abnormal ECG
provider call a cardiologist. What portion of the HIPAA allows this - ANSWER: Title II
Communication with parties involved in the pt care
HIPAA compliance guideline affecting EHR - ANSWER: Code sets standards pertain to
all providers
color formats on CMS 1500 form acceptable - ANSWER: Red
financial record generated by a provider office - ANSWER: patient ledger account
which of the following includes procedures and best practices for correct coding -
ANSWER: coding compliance plan
which of the following planes divide the body into left and right - ANSWER: sagittal
3rd party payers validates a claim which takes place next - ANSWER: claim
adjudication
developed to reduced medicare program expenditure by detecting in appropriate
codes & eliminating improper coding - ANSWER: NCCI
, beneficiary of Medicaid/medicare crossover claim is responsible for percentage -
ANSWER: 0
which of the following steps would be part of a physicians practice compliance
program - ANSWER: internal monitoring & auditing
which of the following acts applies to the administrative simplification guidelines -
ANSWER: HIPAA
patient charges that have not been paid will appear in which of the following -
ANSWER: account receivable
which of the following is considered the final determination of the issues involving
settlement of an insurance claim - ANSWER: adjudication
a prospective billing account audit prevents fraud by reviewing & comparing a
completed claim form with which of the following documents - ANSWER: a billing
worksheet from the pt acct
which of the following parts of the body system regulates immunity - ANSWER:
lymphatic system
which of the following is allowed when billing procedural codes - ANSWER: billing
using 2 digit cpt modifiers to indicate a procedure as performed differs from its usual
5 digit code
a biller will electronically submit a claim to the carrier via which of the following -
ANSWER: direct data entry
medicare enforces mandatory submission of electronic claims for most providers.
which of the following providers is allowed to submit paper claims to medicare -
ANSWER: a providers office with fewer than 10 full time employees
which of the following organizations identifies improper payments made on CMS
claims - ANSWER: recovery audit contractor (RAC)
if a pt has osteomyelitis he has problems with which of the following areas -
ANSWER: bones and bone marrow
which of the following is requirement of some 3rd party payers before a procedure is
performed - ANSWER: preauthorization form
ensure appropriate insurance coverage for an outpt procedure by first using the
following process - ANSWER: precertification
key component of an evaluation & management service - ANSWER: history
QUESTIONS AND CORRECT ANSWERS(CBCS)
billing & Coding Specialist should 1st divide the E&M code by - ANSWER: Place of
Service
complaint with HIPAA the following position should be assigned in each office -
ANSWER: Privacy officer
coding on the UB04 form must sequence the DX code. Which is 1st listed diagnosis
code? - ANSWER: Principle code
obstruction of the Urethra - ANSWER: Urethratresia
ambulatory surgery centers, home health center, and Hospice use - ANSWER: UBO4
forms
form that contains DOS, CPT, ICD codes, fees and copay information is called -
ANSWER: encounter forms
anesthesia section of CPT manual which are considered qualifying circumstances -
ANSWER: add on codes
patient presents with chest pain & shortness of breath with an abnormal ECG
provider call a cardiologist. What portion of the HIPAA allows this - ANSWER: Title II
Communication with parties involved in the pt care
HIPAA compliance guideline affecting EHR - ANSWER: Code sets standards pertain to
all providers
color formats on CMS 1500 form acceptable - ANSWER: Red
financial record generated by a provider office - ANSWER: patient ledger account
which of the following includes procedures and best practices for correct coding -
ANSWER: coding compliance plan
which of the following planes divide the body into left and right - ANSWER: sagittal
3rd party payers validates a claim which takes place next - ANSWER: claim
adjudication
developed to reduced medicare program expenditure by detecting in appropriate
codes & eliminating improper coding - ANSWER: NCCI
, beneficiary of Medicaid/medicare crossover claim is responsible for percentage -
ANSWER: 0
which of the following steps would be part of a physicians practice compliance
program - ANSWER: internal monitoring & auditing
which of the following acts applies to the administrative simplification guidelines -
ANSWER: HIPAA
patient charges that have not been paid will appear in which of the following -
ANSWER: account receivable
which of the following is considered the final determination of the issues involving
settlement of an insurance claim - ANSWER: adjudication
a prospective billing account audit prevents fraud by reviewing & comparing a
completed claim form with which of the following documents - ANSWER: a billing
worksheet from the pt acct
which of the following parts of the body system regulates immunity - ANSWER:
lymphatic system
which of the following is allowed when billing procedural codes - ANSWER: billing
using 2 digit cpt modifiers to indicate a procedure as performed differs from its usual
5 digit code
a biller will electronically submit a claim to the carrier via which of the following -
ANSWER: direct data entry
medicare enforces mandatory submission of electronic claims for most providers.
which of the following providers is allowed to submit paper claims to medicare -
ANSWER: a providers office with fewer than 10 full time employees
which of the following organizations identifies improper payments made on CMS
claims - ANSWER: recovery audit contractor (RAC)
if a pt has osteomyelitis he has problems with which of the following areas -
ANSWER: bones and bone marrow
which of the following is requirement of some 3rd party payers before a procedure is
performed - ANSWER: preauthorization form
ensure appropriate insurance coverage for an outpt procedure by first using the
following process - ANSWER: precertification
key component of an evaluation & management service - ANSWER: history
