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Billing
Billing UB-04
| Question | Answer |
|---|---|
| 2- Which payer action can be appealed | A ( Claim denial) |
| 3- Which payer action calls for corrected and resubmitted claim? | B ( Claim rejection) |
| 4- Physician must submit electronic 837P claims for Medicare Part B unless: | B They have less than 10 full-time or equivalent employees and never send any kind of electronic health care transaction |
| 5- How many unlabeled form locators does the UB-04 have? | D (11) |
| 6-Which of the following is not an advantage of EDI claim transmittal? | D ( More expensive because requires higher level of personnel to process claims |
| 7-Which of the following is not a common reason for a claim not to pass the clean claim requirements? | C ( Incorrect provider address) |
| 8- THe data element E8888 on the UB-04 is an example of which type of format? | D ( Alphanumeric) |
| 9- The second digit in the type of bill code represents the | A ( Type of facility) |
| 10- The third digit in the type of bill code represent the | C ( Type of service) |
| 11- The fourth digit in the type of bill code represents the | B ( Bill frequency) |
| 12- To correctly report the date of service in FL6, the MMDDYY format is required. Which of the following is an example of a correct entry? | B ( 01022006) |
| 13- Number assigned to a patient that is used for multiple episodes of care at the facility | C (Medical record number) |
| 14- A type of bill code has how many digits | C ( Four) |
| 15- The number 1 as the second digit in the TOB code represents what place of service | A ( Hospital) |
| 16- The number 1 as the third digit in the TOB code represent what type of service | D ( Inpatient (including Medicare Part A) |
| 17- The number 3 as the third digit in the TOB code represent what type of service | B ( Outpatient) |
| 18- Which of the following is not a basic category of patient dischare status | A ( Nonroutine discharge) |
| 19- If a patient's date of birth is March 8, 1951, is should be entered in FL10 as | C ( 03081951) |
| 20- In which type of admission is the patient admitted to the first available suitable accommodation | B ( Urgent) |
| 21- which type of admission indicates the patient's condition is sever, life threatening or potentially disabling | C ( Emergency) |
| 22- In which type of admission is the healh of the patient not in jeopardy | A ( Elective) |
| 23- Which of the following types of information is not part of the patient information section on the UB-04 claim form? | C (Patients medical record number) |
| 24- If an admission date is June 4, 2010, is should be entered in the FL 12 as | B ( 060410) |
| 25- In FL 8, which is the correct format for entering a patient's name that is hyphenated, such as Sanchez-Jones | C ( Sanchez-Jones) |
| 26- In FL 8, which is the correct format for entering a patient's name that has an apostrophe, such as O'Connor? | B ( OConnor) |
| 27- In FL: 8. which is the correct format for entering a patient's name that has a prefix, such as Van Buren? | A ( VanBuren) |
| 28- If the cold in FL14 (Type of Admission or Visit) is 4 (newborn) what Point of Origin for Admission of Visit code would be entered if the newborn was born outside of the hospital submitting the claim | C (6) |
| 29- FL 15 (Point of Orgin for Admission or Visit) has two coding structures, each with it own set of codes. What type of admission has its own set of codes? | D (Newborn) |
| 30-Conditon code 01 (military service related) is an example of which group of condition codes? | A (insurance) |
| 31- Condition code 36 (General Care Patient in a Special Unit) is an example of which group of condition codes | B ( Patient Condition codes) |
| 32- Conditin code E0 ( Change in Patien Discharge Status) is an example of which group of condition codes | D ( Claim change reason code) |
| 33- Condition code 18 (Maiden Name Retained ) is an exapmple of which group of condition codes | B ( Patient condition codes) |
| 34- Condition code 22 (patient on multiple drug regimen) is an example of which group of condition codes | B ( Patient condition codes) |
| 35- Condition code D2 (Changes in Revenue Code?HCPCS/HIPPS Rate Code) is an example of which group of conditions codes | D ( Claim change reason codes) |
| 36- Conditons code 39 (Private Room Medically Necessary) is an example of which group of condition codes | C ( Room Codes) |
| 37- Condition code 31 ((patient is a student - full time day) is an example of which group of condition codes. | B ( Patient condition codes) |
| 38- Whien either condition code 20 (Beneficiary requested billing) or 21 ( billing for denial notice) is reported, the services are known by the provider to be non-covered or exluded by medicare and the patient should have been issued a(n) | B ( ABN) (Advanced beneficiary Notice) |
| 39- On a claim form, the date on which an accident occureed is reported using | C ( Occurrence code) |
| 40- On a claim form, the period of skeilled nursing care that occurs druing aninpatient acute hospital stay is reported using | B ( Occurrence code span) |
| 41- Occurrence code 02 (no-fault insurance involved) is an expample of which type of occurrence code | A ( An accident-related code) |
| 42- Occurence code 40 ( scheduled date of admission) is an example of which type of Occurence code | D ( A service related code) |
| 43- Occurence code 16 ( date of lat threapy ) is an example of which type of Occurence code | D ( A service related code) |
| 44- A payment requested from medicare before a primary payer's payment is received, when medicare is the secondary payer and the provider believes that the primary payer will not pay within 120 days is call a | A ( Conditional payment) |
| 45- when an Occurence code is reported on a claim, what must also be reported | C ( Date) |
| 46- Occurence code 11 (Onset of Symptoms/Illness) is ofter used with which of the following codes | D ( Date treatment Started for Physical Therapy) |
| 47 _ Medicare coinsurance amount in the first calendar year is billing period is a description of | B ( Value code) |
| 48- Working Aged Beneficiary/Spouse with an EGHP is a description of a | D ( MSP value code) |
| 49- Value code A1 (Deductible Payer A) is used to report the amount to be applied by the provider to the patient's deductible for the indicated | B ( payer) |
| 50- Which of the following is an MSP value code | D ( 47 Any liability insurance) |
| 51- For hospitals, the total number of covered days reported with value code 80 (Covered Days) will not exceed | A (150) |
| 52- Value code 50 (Physical Therapy Visits) indicates | C ( The number of PT visits provided from the onset of tx through the billing period) |
| 53- If an accident occurred at 3:45 in the morning, how would this time be entered for value code 45 (Accident hour) | C (03.00) |
| 54 - In addition to value code 45 (Accident Hor), what other type of code must be entered to report the date of accident | B ( Occurrence code) |
| 55- When value code 02 (Hospital Has Noemiprivate rooms) is used, what amount is entered | A (0.00) |
| 56- The most commonly used revenue code for room charges is | C ( 012X, Room and Board-Semiprivate(two-Beds) |
| 57- Revenue code 0292 9 Purchase of new DME) is an example of | B ( An Ancillary service code) |
| 58- Revenue code 0352 (CT-body scan) is an example of | B ( An Ancillary service code) |
| 59- Which of the following subcatergory describtions is not included in revenue code series 063X (Pharmacy - Extension of 025X) | A ( Drugs incident to other diagnostic services) |
| 60- Which revenue code range represents accommodation revenue codes | C ( 01X-021X) |
| 61- Revenue code 0171 (Nursery, Newborn - level 1) is an example of | A ( An accommodation code) |
| 62- Revenue code 0201 (Intensive Care, Surgical) is an example of | D ( An accommodation code) |
| 63- Medicare does not require a detailed revenue code for | A (General pharmacy charges) |
| 64- On the UB-04 claim form, with the exception of revenue code 0001, revenue codes shold be listed in what order | B ( Ascending numeric order by date of service) |
| 65- Revenue code series 18X (Leave of Absence) is an example of | D ( An accommodation code) |
| 66- Which of the follwoing is a subcategory description uner revenue code 026X (IV Therapy) | A ( IV therapy/supplies) |
| 67- Ememergency room charges (045X) can be billed on | A ( Both inpatient and outpatient claims) |
| 68- A revenue code for physical, occupational or speech therapy is also reported with | C ( A value code and an occurrence code) |
| 69- Which of the following is a subcatergory description under revenue code 032X (Radiology-Diagnostic) | D ( Chest X-ray) |
| 70- FL 44 on an inpatient claim contains | A A HCPCS/CPT code |
| For claims other than medicare, which field contains the covered and noncovered charges for each revenue code? | c. FL 47 |
| 72- In FL 50 (payer name), which line is used to report the primary payer | A ( Line A) |
| 73- The code chices to complete FL 52 (release of information certification indicator) are | C Y(yes), I informed consent |
| 74- To indicate that the patient has refused to assign benefits, what code is reported in FL 53 (Assignment of Beneficts Certification Indicator) | B ( W not applicable) |
| 75- Code 01 (spouse) is a choice for which of these form locators | B ( FL 59 patient relationship to insured) |
| 76- The health insurance claim number is entered in whihc of thes form locators | C ( FL 60 insured unique identifier) |
| 77- In FL 58, the name Geller-Brown should be entered using the following format | A (Geller-Brown) |
| 78- WHich of the following types of provider data contained in the NPI database is not considered disclosable under the Freedom of Information Act | A ( Social Security Number) |
| 79- Which of the following codes is used in FL 59 (Patients Relationship to Insured) to identify a child of the insured | C (19) |
| 80- Which of the following is not an accurate description of a change from the UB-92 to the UB-04 claim form | A decreased number of fields for secondarty diagnoses |
| 81- the correct format on the UB - 04 form for diagnosis code 425.4 | C - 4254 |
| 82- In which of the following encounters wold it not be appropriate to use a V Code | b. patient being evaluated postoperatively |
| 83 which type of codes are liste first highet priority amoung the other secondary diagnosis codes on a claim | b. comorbidities and complications |
| 84- The CMS-assigned UPIN had how many alphanumeric characters? | c- six |
| 85- Fl 78-79 Other proveders names and identifiers are used to report which of the followin | d. a physician other thena the attending and operating physician who treated the patiednt |
| 86- Which of the following is not a qualifier code used in the Code-Code field? | a. R1 (Overflow Revenue Codes) |
| 87- In physician billing taxonomy codes are used to indicate | a. the providers specialty |
| 88In hospital billing, taxonomy codes are used to indicate | a. the type of hospital that is submitting the claim |
| 89- The letter U in UB-04 stands for uniform | |
| 90 - The I in the 837I stands for inpatient | false |
| 91- THe paper claim used by physician is the CMS-1450 | false |
| 92- When a continuing claim is submitted, the provider expects that subsequent bills will be sent | TRUE |
| 93- A continuing claim is the first in a series of claims to be submitted | FALSE |
| 94- TOB is the abbreviation for type of bill | TRUE |
| 95- The principle diagnosis and principle proceduer must be locigally linked | TRUE |
| 96- Admitting diagnosis and principle diagnosis are always the same | False |
| 97- Only one procedure code can be reported | False |
| 98- Providers number are assigned by the payer | True |
| 99- DCN and INC serve as two different purposes | False |
| 100 NPI is the abbreviaton for nation provider identifier | True |
| 1- The NUBC is coordinated through | A ( American Hospital Association) |
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