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CBCS
NHA 3
| Question | Answer |
|---|---|
| Which of the following provisions ensures that an insureds benefits from all insurance companies do not exceedd 100% of the allowable medical expenses? | Coordination of Benefits |
| On the CMS 1500 claim form, which of the following information should the billing and coding specalist enter into block 32? | Service facility location information |
| the >< symbol is used to indicate new and revised text other than which of the following? | Procedure descriptors |
| Which of the following pieces of guarantor information is required when establishing a patients financial record? | Phone number |
| Which of the following national provider identifier (NPI) is required in Block 33a of the CMS 1500 form? | Billing provider |
| Which of the following accurately describe code symbols found in the CPT manual | A product pending FDA approval is indicated as a lightning bolt symbol |
| Which of the following symbols indicates a revised code? | Triangle |
| Which of the following standardized formats are used in the electronic filing of claims? | HIPAA standard transaction |
| Which of the following describes an insurance carrier that pays the provider who rendered services to a patient? | third party payor |
| In anesthesia section of the cpt manual, which of the following are considered qualifying circumstances? | add on codes |
| Which of the following options is considered proper supportive documentation for reporting CPT and ICD codes for surgical procedures? | Operative report |
| Which of the following actions should the billing and coding specalist take when submitting a claim to medicaid for a patient who has primary and secondary insurance coverage? | Attach the remittance advice from the primary insurance along with the medicaid claim |
| A medicare non participating providers approved payment amount is @200 for a lobectomy and the deductible has been met. which one of the following amounts is the limiting charge for this procedure? | $230. |
| The billing and coding specalist should follow the guidelines in the CPT manual for which of the following reasons? | The guidelines define items that are necessary to accurately code |
| which of the following causes a claim to be suspended? | services require additional information |
| For non crossover claims, the billing and coding specalist should prepare an additional claim for the secondary payer and send it with a copy of which of the following? | Remittance Advice |
| Which best describes medical ethics | Medical standard of conduct |
| Which of the following explains why medcicare will deny a particular service or procedure | Advance Beneficary Notice |
| Which of the following is included in the release of patient information | date of the last disclosure |
| Which of the following electronic forms is used to post payments? | Electronic remittancfe advice |
| Which of the following is an example of a remark code from an explanation of benefits document? | Contractual allowance |
| Which of the following describes a two digit cpt code used to indicate that the provider supervised and interpreted a radiology procedure? | Professional component |
| A billing and coding specalist is preparing a claim form for a provider from a group practice. the billing and coding specalist hsould enter the rendering providers identifier into which of the following blocks on the 1500 form? | 24J |
| A billing and coding specalist has four past due charges: $400-10 weeks past due. $800 - 6 weeks past due. $1000 - 4 weeks past due. $2000 - 8 weeks past due. Which will be sent to collections first? | $2,000. largest gets sent to collections first |
| Which is an example of medicare abuse | charging excessive fees |
| Which of the following is a reason a claim would be denied? | incorrectly linked codes |
| Which of the following would result in a claim being denied | an italicized code used as the first listed diagnosis |
| Which of the folloeing terms is used to describe the location of the stomach, spleen, pancreas, liver, and small and large intestines? | Upper left quadrant |
| Which of the following forms does a third party payer require for physcican services? | CMS 1500 |
| Which of the following HMO managed care service requires a referral? | Durable Medical Equipment |
| Which of the following entities define the essential element of the comprehensive compliance program | office of inspector general |
| Which of the following describes a key component of an evaluation and managemtnservice | history |
| when reviewing an established patients insurnace card, specalist notice a minor change from existing card on file, which of the following actions should the billing and coding specalist take? | Photocopy both sides of the new card |
| a billing and coding specalist can ensure apropriate insurance coverage for an outpatient procedure by first using which of the followng processes? | precertification |
| Which is a federal government health insurnace program/ | tricare |
Created by:
mzamazal23