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MED112 CODE/BILL

MED112 EXAM STUDY GUIDE

QuestionAnswer
MED112 CODING & BILLING EXAM PREP
Medical insurance specialists use practice management programs to: A. schedule patients. B. collect data on patients' diagnoses and services. C. record payments from insurance companies. D. All of these are correct. All of these are correct.
Where are Inclusion notes located in ICD-10-CM? A. Hypertension Table B. Tabular List C. Alphabetic Index D. Neoplasm Table Tabular List
Which two sections follow the same types of guidelines? A. Radiology and Surgery B. E/M and Surgery C. Surgery and Anesthesia D. Radiology and Surgery Radiology and Surgery
PHI is the abbreviation for A. protected health information. B. patient history information. C. protected history Information. D. patient health information. protected health information.
Which physician uses the initial hospital care service codes? A. consulting physician B. None of these choices are correct. C. emergency department physician D. admitting physician admitting physician
Which of the following is an example of a private-sector payer? A. workers' compensation insurance B. insurance company C. Medicaid D. Medicare insurance company
The first health plan to pay when more than one plan is in effect is called the A. supplemental insurance. B. primary insurance. C. secondary insurance. D. tertiary insurance. primary insurance.
What type of coding uses a lower-level code? A. assumption coding B. upcoding C. truncated coding D. downcoding downcoding
An established patient is defined as one who has seen the provider within the last A. one year. B. two years. C. three years. D. four years. three years.
Verifying insurance is part of which revenue cycle step? A. Step 10, follow up patient payments. B. Step 4, review coding compliance. C. Step 2, establish financial responsibility for the visit. D. Step 8, monitoring payer adjudication Step 2, establish financial responsibility for the visit.
Which of the following regulates which tests can be completed in an in-office laboratory setting? A. CMS D. CLIA C. OIG D. OSHA CLIA
What type of coding uses diagnoses that are not as specific as possible? A. downcoding B. truncated coding C. recoding D. upcoding truncated coding
In the CCI, which type of codes cannot both be billed for a patient on the same day of service? A. mutually exclusive B. black box C. unbundled D. diagnostic mutually exclusive
In CPT, E/M is the abbreviation for Evaluation and A. Mammography. B. Manifestation. C. Maintenance. D. Management. Management.
In a SOAP format, which of the following is information from the patient? A. Subjective B. Objective C. Assessment D. Plan Subjective
Which of the following is a systematic, logical, and consistent recording of a patient's health status in a medical record? A. code set B. assessment C. documentation D. source-oriented medical record documentation
HIPAA identifies three types of covered entities: A. code sets, transactions, and safeguards. B. patients, legal representatives, or guardians. C. medical providers, payers, and patients. D. health plans, clearinghouses, and providers. health plans, clearinghouses, and providers.
Not otherwise specified codes are used: A. when no code matches the exact situation. B. when no other information is available for assigning the disease a more specific code. C. only when there is a manifestation code. D. never because they are not allowed in ICD-10-CM. when no other information is available for assigning the disease a more specific code.
What group is charged with detecting health care fraud and abuse? A. RCA B. CMS C. ACA D. OIG OIG
Patients' medical records must document all of the following except: A. diagnosis. B. provider signature C. next of kin. D. allergies. next of kin.
When a medical practice receives a revised edition of CPT, what activities should follow? A. Educate medical professional staff. B. Update encounter forms. C. Update patient billing software. D. All of these answers are correct. All of these answers are correct.
Morvan's disease is an example of a(n) A. convention. B. nonessential modifier. C. eponym. D. subterm. eponym.
The term to describe the person who is financially responsible for the bill is: A. guarantor. B. patient. C. insured. D. guardian. guarantor.
What is the definition of revenue cycle? A. complete documentation that is submitted to third-party payers B. clinical care provided for patients, from appointment to discharge C. all coding and billing steps involved in preparing correct claims D. all administrative and clinical functions which ensure that sufficient monies flow into the practice to pay bills all administrative and clinical functions which ensure that sufficient monies flow into the practice to pay bills
ICD-10-CM was mandated under the HIPAA A. Privacy Rule. B. Billing Rule. C. Security Rule. D. Transactions and Code Sets. Transactions and Code Sets.
As of October 1, 2015, the diagnosis codes that must be used in the United States are based on which of the following revisions of the International Classification of Diseases (ICD)? A. 5th Revision B. 9th Revision C. 10th Revision D. 15th Revision 10th Revision
When you see a colon (:) in the ICD-10-CM book, it informs you that A. you must go back to the Alphabetic Index for another word. B. you have an incomplete term. C. you can alter the description of the code. D. you have a complete term. you have an incomplete term.
How many digits are in Category I codes? A. two B. three C. four D. five five
What step is used when patient payments are later than permitted under the financial policy? A. Step 10, follow up patient payments and collections. B. Step 2, establish financial responsibility for the visit. C. Step 4, review coding compliance. D. Step 3, check in patients. Step 10, follow up patient payments and collections.
The Correct Coding Initiative (CCI) is a program of A. CHAMPVA. B. workers' compensation. C. TRICARE. D. Medicare. Medicare.
What is the main term in the sentence "the patient presents with blindness following an accident with a bow and arrow when he was a child"? A. injury B. blindness C. accident D. arrow blindness
The physician performed a carpal tunnel release on the right and left median nerves during the same operative session. What is a correct modifier? A. -22 Increased Procedural Services B. -50 Bilateral Procedure C. -52 Reduced services D. -58 Staged procedure -50 Bilateral Procedure
A new patient is defined as one who has NOT seen the provider within the last A. one year. B. two years. C. three years. D. four years. three years.
What is the fixed prepayment for each plan member in a capitation contract called? A. provider withhold B. capitation rate C. allowed amount D. usual fee capitation rate
Laterality coding in ICD-10-CM shows that the classification system can A. eliminate the need for two codes if both sides of the body are affected. B. increase reimbursement. C. inform the insurance carrier that both sides of the body were affected. D. capture which side of the body is being coded. capture which side of the body is being coded.
Discharge summaries include all of the following except A. physical examination. B. final diagnosis. C. reason for discharge. D. current condition of patient. physical examination.
NonPAR stands for A. participating. B. nonparticular. C. noncovered. D. nonparticipating. nonparticipating.
A patient's insurance card usually shows A. the name of the payer's representative. B. member identification number. C. the former employer's name. D. the date the policyholder first paid a premium or copayment. member identification number.
The federal government has used ICD-10 to categorize what since 1999? A. mortality data B. age statistics C. government spending D. morbidity data mortality data
In what ways can insurance policies be written? A. only individual B. only workers C. only group D. an individual or group an individual or group
A radiologist reads and prepares a written report for a frontal and lateral chest X-ray. What is a correct modifier? A. -26 Professional component B. -51 Multiple procedures C. -53 Discontinued procedure D. -76 Repeat procedure -26 Professional component
A computerized lifelong health care record for an individual that incorporates data from all sources is known as a(n) A. lifelong health care record (LHR). B. computerized health record (CHR). C. electronic health record (EHR). D. practice management program (PMP). electronic health record (EHR).
Which of the following provides an index of the disease descriptions? A. Tabular List B. Index to External Causes C. Alphabetic Index D. Neoplasm Table Alphabetic Index
An encounter is defined as a A. phone call between a provider and family of the patient. B. meeting between a clinician and a patient. C. face-to-face meeting between a provider and a patient. D. face-to-face meeting between an administrator and a patient. face-to-face meeting between a provider and a patient.
Where are Exclusion notes located in ICD-10-CM? A. Hypertension Table B. Neoplasm Table C. Tabular List D. Alphabetic Index Tabular List
What kind of medical services are annual physical examinations and routine screening procedures? A. noncovered B. surgical C. covered D. preventive preventive
What do payers issue when they approve a service? A. trace number B. self-referral C. prior authorization number D. referral waiver prior authorization number
If you are coding in the outpatient setting, the chief complaint is A. documented in the patient's words. B. listed as the secondary diagnosis. C. documented with medical terminology. D. listed as the primary diagnosis. documented in the patient's words.
Updates to ICD-10-CM are called A. supplements. B. additions. C. addenda. D. changes. addenda.
Which of the following acts contains additional provisions concerning the standards for electronic transmission of health care data? A. OCR B. HITECH C. TCS D. HIPAA HITECH
Created by: C to the C
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