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NCCT Practice ?s

QuestionAnswer
1. If you have eye contact with a person during conversation, if probably means that he or she is: Paying Attention to you
2. The two main types of boundaries are: Physical and emotional
3. All communication between members of the health care team should be: Professional and Respectful
4. Which of the following is an example of fraud? falsifying certificates of medical necessity plans of treatment
5. Which of these is a nonadaptive coping skills? Drinking
6.
7. The Shark Law was enacted to govern the practice of _______. Physician Referrals to Facilities that she has a Financial Interest in
8. In order to have claim paid as quickly as possible, the insurance specialist must be familiar with which of the following? Payer's claim processing procedures
9. Which of the following includes examples of four of nonverbal communication? Appearance , facial expression, silence , gestures
10. which act governs privacy, security and electronic transaction standards for the heath care information and was implemented to provide better access to health insurance, limit fraud and abuse and reduce administrative cost? HIPAA
11. it is almost always best to take which of the following issues ti the office manager ? A coworker's habitual tardiness that affects the practice
12. Patient should never be expected to undergo invasive procedures or surgeries without: Providing informed consent
13. Record retention is the _____ do documentation for an established period of time, usually mandated by federal and / or state law. Storage
14. Which act amendment provides health care benefits to the elderly and low income population? Social Security of Act 1965
15. Which is another name for professional liability insurance? Errors and Omission insurance
16. Which of the following forms should be transmitted to obtain reimbursement following a physician's office visit for a patient with active medicaid coverage? CMS-1500
17. Worker's compensation premiums are paid by the Employer
18. Which insurance claim is submitted to receive reimbursement under Medicare Part B? CMS-1500
19. which is a quasi-public agency that provides workers compensation insurance coverage to private and public employers and acts as as agent in state workers compensation cases involving state employees? State insurance fund
20. Which type of insurance is defined as reimbursement for income lost as a result of a temporary or permanent illness or injury? Disability
21. Which is a form required by medicare for all outpatient and physician office procedures/services that are not covered by the medical re program? Advance beneficiary notice
22. TRICARE _______ are uniformed service personnel who are either active duty, retired, or deceased. Sponsors
23. Managed health care was developed as a way to provide affordable, comprehensive, prepaid health care services to _____. Enrolles
24. Which is offered to members and marketed to small business owners as a way to provide coverage to employees? Association health insurance
25. Individual who wait until they turn 65 to apply for medicare will cause a a delay in the state of part B coverage, because they will have to wait until the next __ enrollment period, which is held in jan 1 through march 31 of each year with part b cov General
26. The federal name for the title 19 medical assistance program is ? Medicaid
27. The filling deadline for the first report of injury form is determined by? state requirements
28. What is an authorization for release of medical information? A consent to release medical information to third party payers
29. Which includes health maintenance organizations and preferred provider organizations? Managed care
30. The safekeeping of patient information by controlling access to hard-copy and computerized records is a form of ______? Security management
31. What does the abbreviation EOB stand for? Explanation of benefits
32. Which program helps low-income individuals by requiring states to pay their medicare part B premiums? Qualified Medicare beneficiary program
33. The medicare coverage database (MCD) is used by medicare administrative contractors, providers, and other health care industry professionals to determine whether a procedure or service is ___ for the diagnosis or treatment of illness or injury. Reasonable and necessary
34. Which type of heath insurance covers the medical expenses of individual and groups? Commercial
35. which of the following reports is used to follow up on outstanding claims to third party payers? Aging
36. The fifth character of the neoplasm for an eye identifies what?
37. What is pathologic fracture? A fracture caused by disease
38. What is the ICD-10-CM code for Otitis media , left arm unspecified? H66.92
39. What is the ICD-10-CM code for osteoarthritis, left shoulders? M19.012
40. What body part does TA refer to?
41. A patient presents to the ED with severe abdominal pain and constipation. x-rays were ordered to rule out a blockage in the intestine. which of the following is the correct ICD-10-CM code? R10.0, K59.00
42. What is the ICD-10-CM code for psoriatic arthropathy and parapsoriasis?
43. 99601 x 13, 99602 x 13, 99059 x 4
44. A patient presents to the Ob/ gyn office, 10 weeks of pregnancy, with wild hypertension. what are the ICD-10-CM diagnosis code? O21.0, Z3A.10
45. What is the category for a patient who is a carrier of a communicable disease?
46. What is the ICD-10-CM code for severe sepsis without septic shock? R65.20
47. what is the ICD-10-CM code for diverticulosis with Diverticulitis? K57.90, K57.92
48. What is the main term in "acute confusion" Confusion
49. What the ICd-10-CM code for a benign neoplasm of the skin of the left leg? D23.72
50. what is the ICD-10-CM diagnosis for a burn of the second degree of left forearm , initial encounter? T22.212A, T31.0. X101XXA
51. ICD-10-CM codes require up to _____ characters are entirely alphanumeric and have unique coding conventions such as excludes 1 and excludes 2. seven
52. What is the ICD-10-CM code for epigastric pain? R10.13
53. what is the ICD-10-CM diagnosis code for the low-grade squamous intraepithelial lesion? R87.622
54. The patient present to the physicians office for an initial encounter of a crushing injury of the left middle finger. which of the following ICD-10-CM codes should be assigned? S67.193A
55. What is the guideline on coding "impending and threatened conditions"? Look up impending or threatened, if no code available, code for actual condition
56. which supply patients with durable medical equipment? DMEPOS dealers
57. what is the correct code for behavioral health counseling and therapy, 30 minutes? H0004x2
58. a patient has a home health aide come to his home to clean and dress a burn on his lower leg. the aide uses a absorptive , sterile dressing to cover 20 sq. in area. she also covers 15 sq. in are with a self adhesive sterile gauze pad. A6262, A6219
59. HCPCS level II _____ codes are reported when a DMEPOS dealer submits a claim for a product or services for which there is no existing HCPCS level II code. Miscellaneous
60. what is the code range for psychiatric services? 90785-90899
61. what is the CPT or HCPCS level II modifier for "Surgical team" 66
62. What is the CPT code for removal of a corneal epithelium? 65435
63. what is the CPT E/M code for office visit, new patient, level II? 99203
64. What is the subcategory for a pregnancy test? Z32
65. What are the three examples sections of the CPT manual? E/M, Surgery, Medicine
66. Which modifier can most likely trigger an audit? (-22)
67. 29125
68. what does CPT stand for? Current Procedural Terminology
69. What are the category codes of the CPT manual? Category 1, category II, category III
70. what is another name for the CPT Manual? HCPCS level 1
72. Which is a CPT cross-reference that directs coders to an index entry under which codes are listed? See
73. What does acute care mean? A facility that provides medial care and treatment to patients who require care for their acute condition, illness or injury
74. which type of modifier is listed first? CPT
75. What is the CPT code for radiologic examination, Chest, two views, frontal and lateral? 71020
76. what type of codes are procedures/services identified by a five-digit CPT code and descriptor nomenclature ( these are codes traditionally associated with the CPT and organized within six sections)? category 1 codes
77. What are the incision codes for the testis? there are no incision codes for the testis.
78. what is the CPT code for an unlisted procedure of the endocrine system? 60699
79. what is the code for continuous administrative of anesthesia for postoperative pain management? 64448
80. what is the CPT code for radiological examination, abdomen, single anteroposterior view? 74020
81. what is NOT one of the three categories of the nervous system divided by the CPT? Urinary and Endocrine system
82. The patient presents today for upper gastrointestinal (GI) endoscopy and a biopsy of the stomach, which of the following is the correct CPT code assignment? 43239
83. An insurance and coding specialist is reviewing appendix M in the CPT book. which if the following tasks is most likely performing? Checking for renumbered codes
84. which of the following information should be used to capture charges from an encounter form? Services rendered and reason for visit
85. what is the eighth step in the Billing Revenue Cycle? Monitor Payer Adjudication
86. The _____ Is generally the first person to inspect reports. Medical Assistant
87. Which of the following is not an advantage of EHRs? The facilities coordination of care among providers
88. When reviewing the charges for a patient procedure using computer assisted coding software (CAC), the insurance and coding specialist should first? Review the chart for needed information
89. What is the ninth step in the billing revenue cycle? Generate patient statements
90. What does the P in SOAP stand for? Plans for further studies, treatment, or management
91. The correct order in the steps of filling are: Inspect, coding, indexing, sort and storing
92. When using EHR software, the electronic superbill: can be done in conjunction with charting
93. What is the second stop in the Billing Revenue Cycle? Establish financial responsibility
94. Which is a typical responsibility of a health insurance specialist? Correcting claims processing claims
95. Which of the following fees posted to the patients account is an example of "usual, customary, and reasonable? Allowed amount
96. Which person is responsible for paying the charges? payer
97. Conduct and qualities that characterize a professional person care called? Professionalism
98. Define accounts receivable (A/R). The outstanding accounts or amounts still due from the patient or customer to the doctor.
99. Provider service for inpatient medical cases are billed on what basis? fee for service
100. When following up on a denied claim, an insurance and coding specialist should have which of the following information available when speaking with an insurance company? *date of service *physician's NPI *patient's insurance ID number
101. Health insurance specialists play an important role in the ______ of denied or underpaid claims. adjudication
102. Which is the financial record source document used by health care providers and other personnal to record treated diagnosis and service rendered to the patient during the current visit? Encounter form
103. The monthly bank statement shows a balance of 5060.13. three checks in the amounts of 89.50,310.92 and 25.00 are still outstanding. calculate the monthly service charge of 10 into the actual available balance. what is the actual available balance aft 4,624.71
104. A medicare medical necessity denial is a denial of otherwise covered services that were found to be not _______. reasonable and necessary
105. When the patient calls to inquire about an account, which of the following does the insurance and coding specialist need to ask for before discussing the account? Patients name, Patients date of birth, patients insurance ID number
106. Claims are often rejected because a provider needs to obtain? Pre-Authorization
107. Which of the following is an appropriate way to open the discussion when explaining practice fees to a patient? "do you have any questions about the cost of todays visit"
108. There are two main types of bookkeeping single methods entry and ___ method? double
109. a ___ indicates that the amount paid is less than the total due? Debit balance
110. Most financial accounting is based on the ___ method bookkeeping. double-entry
111. Based on the CMS manual system, when updating or maintaining the billing code database, which of the following does the "R" denote? Revised
112. When entering codes for diagnosis on a CMS-1500 claim, qualified diagnosis codes are never reported. Instead, codes for the patients __ are entered. signs and symptoms
113. The procedures or services provided is linked with the ___ that provided medical necessity for performing or service. diagnosis
114. What is the facility charge? A charge for an ambulance to the hospital or A charge for services such as a consultation from a specialist
115. Physician office ___ codes are submitted for reimbursement purposes. Both of the above
116. which answer is not considered a professional service? Surgeon
117. When filing an electronic insurance claim, the insurance and coding specialist processes which of the following forms? Assignment of benefits
118. A claims examiner employed by a third-party payer reviews health- related claims to determine whether the charges are reasonable in addition to determining medical necessity of services/procedures.
119. What is charge capturing? The gathering of charges and charge documents from all departments for billing purposes.
120. When it is acceptable to code signs or symptoms? When a diagnosis has not been established or confirmed by the provider at the conclusion of the outpatient encounter
121. Medical practices and health care facilities should routinely participate in an auditing process, which involves reviewing patient records and CMS-1500 or UB-04 claims to _______. assess coding accuracy and completeness of documentation
122. Which coding system is used to report procedures and services on claims? CPT
123. A new patient is one who has not received any progressional service from the physician or from another physician of the same specialty who belongs to the same group practice within the past ______ year(s). Three
124. The process of reporting ___ as numeric and alphanumeric characters on the insurance claim is called coding. Diagnosis and procedures/services
125. Which of the following financial reports produces a quarterly review of any dollar amount a patient still owes after all insurance carriers claim payments have been received. aging.
Created by: Lech8670
 

 



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