Expected Questions and Verified Answers
100% Guarantee Pass
1. Two providers are having a conversation about a patient's test results a
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t the nursing station. A different patient overhears them talking.This type o
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f privacy exposure is known as which of the following?
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Ans>> Incidental disclosure
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2. Which of the following is an example of a consultation?
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Ans>> When a provider requests the advice of another provider
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3. Which of the following coding manuals is used to identify products, sup-
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g plies, and services?
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1g/g 10
,Ans>> HCPCS Level II g g g
4. A billing and coding specialist is resubmitting denied claims. Which of the follo
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wing should alert the specialist that a claim will require additional medical record
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g documentation before the third-party payer can approve it? g g g g g g g
Ans>> The patient is now deceased.
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5. In which of the following scenarios is it appropriate to release a patien
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t's psychiatric records without the patient's consent?
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Ans>> When the patient is being investigated by the police
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6. A billing and coding specialist is reviewing a Medicare Part C denial for a patie
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nt who was injured on the job.The specialist should expect which of the followin
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g to be the reason for the denial?
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Ans>> Medicare is not the primary insurance.
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2g/g 10
,7. Which of the following is the purpose of precertification?
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Ans>> To verify coverage
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8. Which of the following entities outlines the minimum essential element
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s of a comprehensive compliance program?
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Ans>> Office of Inspector General (O1G)
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9. Which of the following is the process of sending an insurance claim through a se
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ries of edits for final determination?
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Ans>> Adjudicationg
10. Which of the following actions by a billing and coding specialist prevents fraud
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Ans>> Performing periodic Audits
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11. A billing and coding specialist is preparing a claim using procedure code 43286
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3g/g 10
, Based on this code, which of the following types of service is being provided?
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Ans>> Removal g
12. Which of the following is the purpose of a claims clearinghouse?
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Ans>> To identify errors that will prevent a claim from being paid
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13. An internal retrospective billing account audit prevents fraud and abus
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e by reviewing and comparing completed claim forms with which of the foll
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ow- ing? g
Ans>> Documentation from patient encounters
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14. Which of the following types of insurance do health care professionals purc
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hase to protect themselves from liability relating to claims arising from patien
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t treatments?
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Ans>> Medical malpractice g g
4g/g 10