Prep Exam items
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| show | remittance advice
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| the authorization number for a service approved before service was rendered is indicated in which block on cms-1500 claim form? | show 🗑
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| show | block 25
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| which block of cms-1500 form indicates an ICD diagnosis code? | show 🗑
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| which block of cms-1500 form is additional claim information entered? | show 🗑
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| what standardized format is used in the electronic filing of claims? | show 🗑
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| which block of cms-1500 form is used to accept assignment of benefit? | show 🗑
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| on cms-1500 claim form, blocks 14 - 33 contain what information? | show 🗑
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| show | $40
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| show | claim attachment
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| show | National Coverage Determination (NCD)
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| show | contractual allowance
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| what form should a billing and coding specialist transmit to the insurance carrier for reimbursement of inpatient hospital services? | show 🗑
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| a claim is denied due to termination of coverage (TOC). what action should the billing and coding specialist take next? | show 🗑
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| what NPI # is required in block 33a of cms-1500 claim form? | show 🗑
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| what reason a claim would be denied? | show 🗑
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| show | ensure the proper payment has been made
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| show | LUQ
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| show | 18%
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| show | patient eligibility is determined monthly
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| which of the following describes a key component of E/M service? | show 🗑
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| show | a billing and coding specialist unbundles a code to receive higher reimbursement
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| which of the following is an example of medicare abuse? | show 🗑
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| what organization fights waste, fraud, and abuse in medicare and Medicaid? | show 🗑
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| show | hospital services
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| medicare part B | show 🗑
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| medicare part C | show 🗑
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| show | prescription services
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| what part of medicare insurance program is managed by private, third-party insurance providers approved by medicare? | show 🗑
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| a patient's employer has not submitted a premium payment. what claim status should the provider receive from third-party payer? | show 🗑
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| show | block 24d
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| what describes an insurance carrier that pays the provider who rendered services to a patient? | show 🗑
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| what format is used to submit electronic claims to a third-party payer? | show 🗑
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| show | OIG
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| what causes a claim to be suspended? | show 🗑
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| a medicare non-participating (non-PAR) provider's approved payment amount is $200 for a lobectomy and deductible has been met. what amount is the limiting charge for this procedure? | show 🗑
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| show | primary insurance card
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| a billing and coding specialist can ensure insurance coverage for an outpatient procedure by using what process? | show 🗑
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| when a third-party payer requests copies of patient information related to claim, billing and coding specialist must include what document from patient's file? | show 🗑
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| in the anesthesia section of CPT manual, what is considered a qualifying circumstance? | show 🗑
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| show | when insurance company transfers data to allow (COB) coordination of benefits of a claim
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| show | arthroscopy
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| show | $2000
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| show | $70
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| show | adjustment
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| show | procedure descriptors
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| what HIPAA compliance guideline affects electronic health records? | show 🗑
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| what describes a code that would be denied? | show 🗑
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| what section of SOAP note indicates a patient's level of pain to a provider? | show 🗑
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| show | DME
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| what explains why medicare will deny a service / procedure? | show 🗑
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| show | block 17b
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| coronal, frontal | show 🗑
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| transverse | show 🗑
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| show | vertical plane divides body into right and left sides
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| anterior, ventral | show 🗑
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| show | back of body
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| show | above
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| show | near or towards the origin, closer
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| show | far / away form origin
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| inferior | show 🗑
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| show | side
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| bilateral | show 🗑
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| show | middle of body
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| show | attach remittance advice from primary insurance along w/ medicaid claim
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| show | claim adjustment codes
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| two surgeon successfully performed closure of a vaginal fistiula thru patient's abdomen. for both providers' claims, the billing & coding specialist should use what cpt codes & modifiers? | show 🗑
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| in 1996, cms implemented which entity to detect inappropriate & improper codes? | show 🗑
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| show | sagittal
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| show | 24j
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| on a remittance advice form, who is responsible for writing off difference between amount billed and the amount allowed by agreement? | show 🗑
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| show | prevent multiple insurers from paying benefits covered by other policies
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| which block of cms-1500 claims form is the report modifiers section? | show 🗑
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| show | 12
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| what best describes medical ethics? | show 🗑
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| a patient has AARP as secondary insurance. what block on cms-1500 claim form should enter information? | show 🗑
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