Practice Exam for Medical Coding and Billing
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| show | EOB
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| show | When contained in the individual policy.
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| show | Check that demographics are complete.
Make sure that the patient's name matches the insurance card.
Make sure the registration form is signed and dated.
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| show | Patient's date of birth.
Patient's name.
Patient's insurance ID number.
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| The patient needs to have a tubal litigation performed. Which of the following is needed in order for the third party payer to cover the procedure? | show 🗑
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| show | Deductible
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| A patient arrives at the physician's office and the specialist notes the patient has a HMO plan. After the appointment, the physician wants the patient to meet with a general surgeon. Which of the following should be the next step for the specialist? | show 🗑
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| When using the EHR to schedule a patient visit, which of the following screens should be used to complete the scheduling process? | show 🗑
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| show | Resubmit the claim with an attachment explaining the error.
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| A patient has called to schedule an appointment for an office visit tomorrow. It is discovered during the scheduling process that the insurance policy on file has been cancelled. Which of the following should the insuance and coding specialis do next? | show 🗑
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| show | Preauthorization
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| When using an EHR system to enter CPT codes on a CMS 1500 claim form for electronic submission, which of the following should be entered on the claim form first? | show 🗑
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| show | $20
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| show | Part A
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| show | Fair Debt Collections Practices Act.
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| show | When the items may be denied and prior to performing the service.
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| show | Poverty level.
Amount of the bill.
Number of dependents.
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| show | Aging.
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| An insurance and coding specialist is reviewing Appendix B in the CPT book. Which of the following tasks is she most likely performing? | show 🗑
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| show | Account number.
Credit card number.
Security Code.
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| Which of the following reports is used to follow up on outstanding claims to third party payers? | show 🗑
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| Which of the following information is necessary to post payments from the RA/EOB? (select the three correct answers) | show 🗑
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| show | Capitation.
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| An established patient is being seen by the physician today. The patient owes $25.00 for the visit. The amount collected for the office visit is called the | show 🗑
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| show | Hidden,
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| Providers may receive payment directly from the insurance carrier by accepting an | show 🗑
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| Which of the following fees posted to the patient's account is an example of "usual, customary, and reasonable"? | show 🗑
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| A patient was seen in the office. Charges were recorded and submitted to the patient's insurance, and an EOB was received y the office with a payment of $70.89. These transactions should be recorded in the | show 🗑
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| show | "Do you have any questions about the cost of today's visit? I will be glad to answer them."
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| in order to have claims paid as quickly as possible, the insurance specialist must be familiar with which of the following? | show 🗑
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| show | Physician's office fee.
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| show | Monthly prepayment amount.
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| HIPAA allows a health care provider to communicate with a patient's family, friends, or other persons who are involved in the patient's care regarding their mental health status providing | show 🗑
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| Which of the following are necessary to complete the CMS 1500 form? (select the three correct answers) | show 🗑
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| show | Clean claim.
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| show | Query the physician.
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| show | Adjustment column.
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| show | Patient's claim number.
Physician's NPL.
Patient's insurance ID number.
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| show | Statute of limitations.
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| show | The husband's insurance.
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| When receiving the charges for a patient's procedure using computer assisted coding software (CAC), the insurance and coding specialist should first | show 🗑
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| show | Payment is misplaced.
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| show | Collect fees at the time of service.
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| show | HIPAA
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| show | Insurance allowed amount
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| show | She will be able to keep her current medical insurance from her previous job through COBRA.
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| show | When the patient calls to schedule an appointment.
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| Based on the CMS manual system, when updating or maintaining the billing code database, which of the following does the "R" denote? | show 🗑
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| show | An authorization to release form.
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| Which of the following regulations prohibits the submission of a fraudulent claim or making a false statement or representation in connection with a claim? | show 🗑
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| show | Accepting gifts in place of payment from patients.
Referring patients to facilities where the provider has a financial interest.
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| show | CMS-1500
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| Which of the following are needed to submit a prior authorization request for medical equipment? | show 🗑
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| Which of the following is the correct procedure for keeping a Workers' Compensation patient's financial and health records when the same physician is also seeing the patient as a private patient? | show 🗑
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| show | OIG
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| The Fair Debt Collection Practices Act restricts debt collectors from engaging in conduct that includes | show 🗑
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| When the patient has signed the assignment of benefits form, the payment for services should be sent to the provider unless the provider is | show 🗑
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| show | Schedule an appointment using both his insurance benefits and his wife's insurance benefits.
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| show | 99283
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| A patient presents to the ED with multiple stab wounds to the arms and chest. On examination there are 3 deep lacerations to the arms measuring 1.2 cm, 1.4 cm and 2.1 cm requiring complex closure and 2 superficial wounds measuring 1.3 cm and 2.4 cm reauir | show 🗑
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| An established patient comes into the ENT office where the physician performs an irrigation on the right ear. Which of the following CPT codes should be assigned? | show 🗑
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| The patient presents for excision of the nail and nail matrix, complete of the left great toe. Which of the following is the appropriate CPT code assignment? | show 🗑
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| The patient returned to the operative suite 10 days postoperative for an I&D due to a postoperative infection. The final lab results discover the organism is pseudomonas mallei. Which of the following is the appropriate ICD-10-CM coding? | show 🗑
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| The patient suffers from atherosclerotic heart disease caused by plaque deposits in a grafted internal mammary artery. The patient underwent arterial bypass graft four months ago. Which of the following ICD-10-CM codes should be assigned? | show 🗑
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| A physician uses cryotherapy for correction of trychiasis. Which of the following CPT codes should be assigned? | show 🗑
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| show | M43.17
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| A 32-year old patient required an urgent vaginal hysterectomy following delivery of her third child. Which of the following anesthesia codes should be assigned? | show 🗑
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| show | 45385, 45384-59
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| A patient is seen in the office for a candidal paronychia nail abcess was incised and drained. Which of the following is the correct CPT code assignment | show 🗑
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| show | A6262, A6219
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| show | -79
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| show | 53210-53
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| show | R10.31, R50.9
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| show | R10.0, K59.00
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| The patient presents today for upper gastrointestinal (GI) endoscopy and biopsy of the stomach. Which of the following is the correct CPT code assignment? | show 🗑
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| show | 24
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| show | 12002
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| show | 43235-53
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| A patient was diagnosed with cancer of both breasts and was prepped for surgery today. A simple bilateral mastectomy was performed. Which of the following is the correct CPT code assignment? | show 🗑
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| A 57-year old patient with severe systemic disease is having surgery to remove an integumentary mass from his neck. Which of the following is the correct CPT code assignment for the | show 🗑
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| Which of the following is the correct CPT code assignment for mediastinal and region lymphadenectomy with a RT video-assisted thoracic (VATS) lobectomy? | show 🗑
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| show | -78
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| show | E11.351
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| show | 99396, Z00.00, I10, E11.9
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| The patient's diagnosis is vesicoureteral reflux with nephropathy (without hydroureter) and chronic obstructive pyelonephritis due to E-coli infection. Which of the following ICD-10-CM codes should be assigned? | show 🗑
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| A 45-year old with ESRD receives a unilateral cadaver kidney transplant. The surgeon performs the bench work in addition to the transplant. Which of the following CPT codes should be assigned? | show 🗑
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| show | 99213-25, 20553
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| show | 10160-78
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| A 70-year old patient was admitted for coronary ASHD. Cardiac catheterization performed showed numerous native vessels to be 70% to 100% blocked. The patient was taken to the operating room. A CABG was performed using five venous grafts and four arterial | show 🗑
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| A 72-year old patient is undergoing a corneal transplant. An anesthesiologist is personally performing monitored anesthesia care. Which of the following modifiers should be reported for the anesthesia? | show 🗑
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| The patient is hospitalized for diabetes. Upon release the patient consults with a registered dietician. Which of the following Level II HCPCS modifiers should be assigned? | show 🗑
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| show | J06.9
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| A patient presents for a right sided hip injection. The provider used palpitation for guidance. Which of the following is the appropriate CPT code? | show 🗑
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| When filing an electronic insurance claim, the insurance and coding specialist processes which o the following forms? | show 🗑
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| A patient presents for excision his arm. The lesion was 3 cm with 0.5 cm margins. it was a full thickness removal and the pathology proved it toe be a benign lesion. The closure was simple. Which of the following is the correct CPT code assignment? | show 🗑
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| show | K70.31, F10.21
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| The patient presents to the physician's office for an initial encounter of a crushing injury to the middle finger. Which of the following ICD-10-CM codes should be assigned? | show 🗑
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| show | R10.11
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Created by:
garces
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