Coding
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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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| show | block 21
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| which block of cms-1500 form is additional claim information entered? block 18 | show 🗑
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| on cms-1500 claim form, blocks 14 - 33 contain what information? patients condition and provider's information | show 🗑
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| the EOB states the amount billed was $80. the amount allowed is $60, and the patient is required to pay a $20 copayment. what insurance check amount should be posted? $40 | show 🗑
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| what should a billing and coding specialist use to submit a claim with supporting documents? claim attachment | show 🗑
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| what medicare policy determines if a particular item or service is covered by medicare? National Coverage Determination (NCD) | 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? follow up with the patient to determine the current name, address, and carrier for resubmission | show 🗑
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| show | is required in block 33a of cms-1500 claim form? billing provider
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| what reason a claim would be denied? incorrectly linked codes | show 🗑
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| what term is used to describe the location of the stomach, spleen, part of pancreas, part of liver, and part of the small & large intestines? LUQ | show 🗑
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| when coding a front torso burn, what percentage should be coded? 18% | show 🗑
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| which statement is true regarding Medicaid eligibility? patient eligibility is determined monthly | show 🗑
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| what organization fights waste, fraud, and abuse in medicare and Medicaid? OIG - Office of the Inspector General | show 🗑
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| medicare part D prescription services | show 🗑
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| what part of medicare insurance program is managed by private, third-party insurance providers approved by medicare? medicare part C | 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? denied | show 🗑
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| what describes an insurance carrier that pays the provider who rendered services to a patient? third-party payer | show 🗑
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| for non-crossover claims, the billing and coding specialist should prepare a copy of what form? primary insurance card | show 🗑
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| a billing and coding specialist can ensure insurance coverage for an outpatient procedure by using what process? precertification | show 🗑
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| in the anesthesia section of CPT manual, what is considered a qualifying circumstance? add-on codes | 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? $2000 | show 🗑
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| what HMO managed care services requires a referral? DME | show 🗑
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| show | ? block 17b
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| transverse horizontal plan divides the body into top & bottom sections | show 🗑
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| sagittal vertical plane divides body into right and left sides | show 🗑
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| anterior, ventral front of body | show 🗑
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| posterior, dorsal back of body | show 🗑
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| superior above | show 🗑
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| proximal near or towards the origin, closer | show 🗑
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| medial middle of body | show 🗑
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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? attach remittance advice from primary insurance along w/ medicaid claim | show 🗑
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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 | show 🗑
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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? the provider | show 🗑
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| which block of cms-1500 claims form is the report modifiers section? 24d | show 🗑
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| what best describes medical ethics? medical standard of conduct | show 🗑
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