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1. Which one of the following choices would probably flagged during an audit?
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2. You're performing an audit on patient record after the provider has already received payment. This procedure is known as a(n)
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Lesson 14

Auditing

QuestionAnswer
1. Which one of the following choices would probably flagged during an audit? Wrong not A
2. You're performing an audit on patient record after the provider has already received payment. This procedure is known as a(n) A.Retrospective
3. Which one of the following choices is a reason that physicians offices should regularly perform internal audits B. To ensure accuracy of documentation
4. A private payer has denied a physician offices billing claim but did not provide a reason. What should happen next? C. The physician office should file an appeal
5. A patient presents with a cold. What level of risk will probably be assigned to this case? A. minimal
6. The medical assistant is documenting a chronological description of the development of the patients current illness. The medical assistant is probably documenting the D. History of present illness
7. Federal law requires that all claims paid by Medicare B. Be medically reasonable and necessary
8. A government investigator is performing an audit a t a physicians office to ensure that documentation and codes are complete. This procedure is known as D. and external audit
9. To ensure records are coded correctly, compliance plans focus on training physicians to D. effectively use "Documentation Guidelines for Evaluation and Management Services".
10. Which one of the following choices required compliance programs including audits, for healthcare organizations? B. PPACA
11. With low complexity medical decision making, how much data must be received? B. Limited
12. Which type of history requires a problem oriented review of systems? B. Expanded problem focused
13. Which one of the following choices refers to the complex of establishing a diagnosis &/or selecting a management option? D. Medical decision making
14. Which of the following types of history requires a pertinent social or family history C. Detailed
15. With a high complexity of medical decision making, what amount of data must be reviewed? D. Extensive
16. A patient presents in unstable condition. A code 99233 is assigned. What will probably happen with this claim? B. It will be denied by the insurer
17. Which codes are the ones most likely to trigger an audit? B. E/M
18. A medical assistant is asking the patient a series of questions to help identify the patients signs and symptoms. The medical assistant is probably documenting C. Review of symptoms
19. "CC: sore throat. ROS: Positive for left side throat redness and swelling". This is an example of which type of review of system? D. problem pertinent
20. In a single organ system psychiatric examination, what is the minimum number of detailed elements that must be identified? C. 9
21. Which one of the following codes requires three key components to be documented, along with a comprehensive history and comprehensive examination? A. 99201
22. If audits aren't performed on a regular basis, C. Offices wont know if services provided are appropriate
23. A manager wants to assess the knowledge of the coders working in the office. Which type of audit may be helpful for the manager? A. Internal
24. An audit performed before the billing claim has been submitted is known as B. prospective
25. Pertinent and complete are both examples of D. PFSH
26. An independent medical record review should be performed a minimum of ___________________ to identify coding and documentation errors. C. Twice yearly
27. Which one of the following choices is one purpose of an audit A. to see of the healthcare organization lost money
28. Which one of the following choices is an audit that's conducted after a claim has been paid to ensure that providers have accurately billed for a procedure or visit? C. Retrospective
29. "Patient complains of sore throat for the last 24 hours" is an example of A. brief HPI
30. A patient presents with multiple traumas and having seizures. Which level of risk will probably be assigned to this case? D. High
31. Which one of the following choices would probably be flagged during an audit? WRONG not B.
Created by: Lulumac16
 

 



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