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Insurance Claims
| Question | Answer |
|---|---|
| The CPT symbol identifying add-on codes for procedures that are commonly performed at the same time is | plus (+) |
| Determining medical necessity before a hospital admission is approved is called | preadmission certification |
| The ICD Glossary of Mental Disorders is | Appendix B |
| Which of the following is the universal claim form developed by CMS? | CMS-1500 |
| Which of the following would require an ICD-9-CM code? | glossitis |
| Which of the following commonly serves as a fiscal intermediary for the Medicare program? | Blue Cross/Blue Shield |
| Title 18 of the Social Security Act best describes | Medicare |
| Which of the following ICD-9-CM codes refer to factors that influence health status? | V-codes |
| Which of the following programs is available to active duty military dependents? | Tricare |
| COBRA requires that government claim forms and attachments be maintained for at least | 5 years |
| An addition to an insurance policy is called a(n) | addendum |
| Short-term disability plans | cover limited illness or injury, a percentage of your normal salary, have a waiting period before payouts |
| The person or party designated by the policyholder to receive the value of a policy is the | beneficiary |
| CPT stands for | current procedural terminology |
| Which CPT modifier indicates that multiple modifiers have been assigned? | -99 |
| HCPCS is associated with | Medicare, Medicaid, Blue Cross |
| According to CPT coding conventions, terms after a semicolon (;) | are part of, or clarify, a main term |
| All of the following are government sponsored programs EXCEPT | Blue Cross/Blue Shield |
| All of the following would require a CPT code EXCEPT | atherosclerosis |
| The CPT symbol identifying codes that are not to be used with modifier -51 is | circle with forward slash (ø) |
| The method of controlling health care delivery by reviewing the appropriateness and necessity of care before (prospectively) and after (retrospectively) the care is provided is called | utilization review |
| An organizational arrangement that provides medical service for a fixed, prepaid fee best describes | HMO |
| The ICD Glossary of Mental Disorders is | Appendix B |
| The CPT symbol indicating a code description has been revised is | triangle (▲) |
| An amount that is paid on an insurance contract before the payment of benefits is called | deductible |
| An insurance policy designed to pay fees not covered by conventional plans is a | companion plan |
| A prepaid health plan that emphasizes health prevention and promotion is | HMO |
| ho of the following is most likely eligible for Medicaid? | persons receiving Supplemental Security Income (SSI) for the aged and disabled |
| Anesthesiology is a section in which coding system? | CPT |
| An insurance policy clause that restricts the overpayment of benefits when an insured has more than one policy is called | coordination of benefits |
| Determining medical necessity before a hospital admission is approved is called | preadmission certification |
| An insurance company that sells or administers an insurance contract is also known as the | carrier |
| The CPT symbol located after a code number indicating variable preoperative and postoperative services is | asterisk (*) |
| Which of the following is funded by both federal and state revenues? | Medicaid |
| Which of the following acronyms refers to diagnosis coding? | ICD |
| A federally qualified health care program that ensures the quality of care is appropriate and likely to benefit the patient is called | quality assurance |
| Medicaid is | secondary to Medicare |
| A fixed, prepaid fee per person enrolled in a managed care program is a(n) | capitation |
| For nonparticipating Medicare providers | the patient pays the provider |
| A health care entitlement program for the indigent that is funded by both state and federal revenues but is administered by the state is | Medicaid |
| A term after the brace ( } ) indicates | a required modifier of the statement before the brace |
| Care that is financed according to a fixed, prepaid payment for each enrolled patient during a fixed period, usually annually is called | capitation |
| The ICD Classification of Industrial Accidents According to Agency is | Appendix D |
Created by:
ashrey0433
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