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Ch1 test
Med'l bsns
| Question | Answer |
|---|---|
| 1. When coding an operative report, what action would NOT be recommended? | Coding from the header without reading the body of the report. |
| 2. A covered entity may obtain consent from an individual to use or disclose protected health information to carry out all of the following EXCEPT what? | Research |
| 3. A covered entity does NOT include | patients |
| 4. Local Coverage Determinations are administered by whom? | Each regional MAC |
| 5. Many coding professionals go on to find work as: | consultants |
| 6. According to the OIG, internal monitoring and auditing should be performed by what means? | periodic audits |
| 7. Which CMS product describes whether specific medical items, services, treatment procedures or technologies are considered medically necessary under Medicare? | National Coverage Determinations Manual |
| 8. Voluntary compliance programs also provide benefits by not only helping to prevent erroneous or ____, but also by showing that the provider practice is making additional good faith efforts to submit claims appropriately. | fraudulent claims |
| 9. HITECH provides a ____ day window during which any violation not due to willful neglect may be corrected without penalty. | 30 |
| 10. Which provider is NOT a mid-level provider? | Anesthesiologist |
| 11. Which coding manuals do outpatient coders focus on learning? | CPT®, HCPCS Level II and ICD-10-CM |
| 12. What type of insurance is Medicare Part D? | Prescription drug coverage available to all Medicare beneficiaries. |
| 13. Evaluation and management services are often provided in a standard format such as SOAP notes. What does the acronym SOAP stand for? | Subjective, Objective, Assessment, Plan |
| 14. What will the scope of a compliance program depend on? | a. The size and resources of the provider’s practice |
| 15. What type of health insurance provides coverage for low-income families? | Medicaid |
| 16. What does CMS-HCC stand for? | b. Centers for Medicare & Medicaid Services – Hierarchal Condition Category |
| 17. The AAPC offers over 500 local chapters across the country for the purpose of | Continuing education and networking |
| 18. The OIG releases a ____ outlining its priorities for the fiscal year ahead and beyond. | work plan |
| 19. How many components are included in an effective compliance plan? | 7 |
| 20. 20. What form is used to submit a provider’s charge to the insurance carrier? | CMS-1500 |
| 21. The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer? | Part B |
| 22. The OIG recommends that provider practices enforce disciplinary actions through well publicized compliance guidelines to ensure actions that are ______. | Consistent and appropriate |
| 23. LCDs only have jurisdiction in their ____. | region |
| In what year was HITECH enacted as part of the American Recovery and Reinvestment Act? | 2009 |
| 25. Healthcare providers are responsible for developing ____ ____ and policies and procedures regarding privacy in their practices. | notices of privacy practices |
| Professionals who specialize in coding are called: | Coding specialists |
| What does the abbreviation MAC stand for? | Medicare Administrative Contractor |
| What is the value of a remittance advice? | It states what will be paid and why any changes to charges were made. |
| What is the purpose of National Coverage Determinations? | To explain CMS policies on when Medicare will pay for items or services |
| What is PHI? | Protected health information |
| Which type of information is NOT maintained in a medical record? | Financial records |
| Who is responsible for enforcing the HIPAA security rule? | The Office for Civil Rights (OCR) enforces the HIPAA Security Rule. |
| EHR stands for? | Electronic health record |
| If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage? | Medicare Administrative Contractor (MAC) |
| What type of provider goes through approximately 26.5 months of education, after completion of a bachelor’s degree, and is licensed to practice medicine with the oversight of a physician? | Physician Assistant (PA) |
Created by:
Merc9496