Prep Exam items
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| what form used to post payments? | show 🗑
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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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| show | block 18
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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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| what should a billing and coding specialist use to submit a claim with supporting documents? | show 🗑
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| show | National Coverage Determination (NCD)
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| what is an example of a remark code from EOB document? | show 🗑
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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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| which statement is true regarding Medicaid eligibility? | show 🗑
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| show | history
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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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| show | OIG - Office of the Inspector General
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| show | hospital services
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| show | provides insurance for outpatient and physician services
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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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| show | third-party payer
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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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| show | services required additional information
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| show | $230
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| show | primary insurance card
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| show | precertification
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| show | signed release of information form
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| show | add-on codes
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| show | when insurance company transfers data to allow (COB) coordination of benefits of a claim
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| a provider performs an examination of patient's knee joint via small incisions and optical device. what term describes this procedure? | show 🗑
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| a billing and coding specialist has 4 past-due charges: $400 - 10 weeks past due; $800 - 6 weeks past due; $1,000 - weeks past due; and $2,000 - 8 weeks past due. what charge should be sent to collections first? | show 🗑
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| the EOB states the amount billed was $170. The allowed amount is $150. The patient has an unmet deductible of $50 and a copayment of $20. what dollar amount is the patient responsible for? | show 🗑
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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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| which block of cms-1500 form should a billing & coding speacialist enter the referring provider's NPI# ? | show 🗑
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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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| superior | show 🗑
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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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| show | both sides
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| show | middle of body
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| what action should billing & coding specialist take when submitting a claim to medicaid for a patient that has primary & secondary insurance coverage? | show 🗑
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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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| show | National Correct Code Initiative (NCCI)
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| show | sagittal
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| a billing & coding specialist is preparing a claim form for a provider from a group practice. the billing & coding specialist should enter the rendering providers NPI# in which block on cms-1500 form? | show 🗑
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| show | the provider
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| what is the purpose o coordination of benefits (COB)? | show 🗑
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| show | 24d
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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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