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MBG101 review Flashcards | StudBud
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MBG101 review
MBG101 review
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Flashcards
53 cards
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Questions
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Answers
1
Texas is part of Medicare Jurisdiction
F
H
G
E
2
EDI submits claims ______.
via fax
Electronically
On paper
via email
3
The paper claim form currently in use is the
ABN
CMS-1500 (02-12)
UB-04
CMS-1500 (08-05)
4
The ____ is the main reason for the visit.
objective opinion
referring doctor's order
chief complaint
signs/symptoms
5
The ICD-10-CM book as _____ chapters.
21
20
10
6
6
What is an HMO?
Health Maintenance Organization
Health Management Organization
Historical Maintenance Operation
Health Management Operation
7
When 2 diagnoses are classified with a single code, that code is referred to as a
All codes need to be listed separately.
Z code
A combination code
An accident code
8
The time limit for filing insurance claims to a commercial carrier range from
60 days to 18 months from the date of service.
30 days to 1 year from the date of service
10 days to 1 year from the date of service.
There is no timely filing limit.
9
An insurance uses an ____ to directly deposit money into the provider's account.
a paper check.
EFT.
ACH.
credit card payment.
10
A request for a claim review after the claim has been denied is known as
an appeal.
a tracer.
a demand for payment.
an inquiry.
11
Modifier for professional services only
26
25
TC
51
12
Modifier for multiple procedures
11
52
51
25
13
What is NPI?
Normal Procedural Investigation
Not Particularly Identifiable
National Provider Identifier
Notice of Privacy Information
14
Laterality
is a surgery.
is a modifier.
refers to the side of the body being treated.
is a person's first name.
15
An ICD-10 code for a "history of disease" would start with the letter
A
Z
E
S
16
What is NOS?
Nitrus Oxide Systems
Not Elsewhere Classified
Northern Operational Systems
Not Otherwise Specified
17
The most important part of a practice management system is the
the schedule.
the patient portal.
checkbook register.
Accounts Receivable.
18
An independent organization that receives claims and disburses them to insurance companies is a
the software vendor.
a blog.
an mass email.
clearinghouse.
19
What is an ABN?
Advanced Beneficiary Notice
Alabama Board of Nursing
American Business Number
Additional Benefit Notification
20
What is EDI?
Emergency Data Institute
Electronic Data Interchange
Emergency Data Information
Electronic Digital Imaging
21
What is E/M?
Evaluation and Management
Everyday Management
Extra Maintenance
Evaluation and Maintenance
22
A fee schedule
is another name for the patient's statement.
Is how the insurance bases their payment for procedures.
is the aging report.
is the checkbook register.
23
The account receivable report that shows outstanding balances is known as
the patient roster.
the index.
the aging.
the check register.
24
The visits before & after surgery, the surgery, the supplies, and follow up for up to 90 days
is billed by many different providers.
is the global period.
should be unbundled and billed separately.
is the surgical package.
25
What is DME?
Duration of Medical Experiment
Durable Medical Equipment
Durable Medical Energy
Drug and Medicine Explanations
26
The _____ is a 10 digit number that follows the provider for life.
Tax identification number
taxonomy code
UPIN
NPI
27
The 6 sections of the CPT book are: E/M, Anesthesia, Surgery, Radiology, Path/Lab, and _____.
DME
Medicine
Medications
Diagnostic Ultrasound
28
The Medicare EOB is now called the
the EOB
Medicare Summary Notice
remittance advice
EOMB
29
What is an EOB?
Expert on Benefits
Everyday Operational Book
Explanation of Benefits
Explanation owed to Beneficiary
30
What is POS?
Place of Service
Point of Service
Path of Service
Part of Service
31
What is HCPCS?
Healthcare Common Procedural Coding System
Health Codes Pharmacy Codes and Services
Health Codes Procedure Correction System
Healthcare Correct Procedure Coding Service
32
Modifier for reduced services is
52
11
51
25
33
A provider can release medical records
To the family, even without consent.
for treatment, payment, or operations (TPO).
Whenever he wants to.
Never.
34
What is ICD-10?
International Coding of Diagnoses
Information for Correct Diagnoses
International Classification of Disease
Internet Coding of Disease
35
what is HIPAA?
Privacy Law
Health Information Portability & Accountability Act
Health Insurance Portability and Accountability Act
Security Law for PHI
36
Modifier for an office add on
52
51
25
TC
37
A signature stamp is not acceptable on paper claims.
False
True
38
When was ICD-10 first published?
2007
1992
1990
2015
39
What is NEC?
Not Otherwise Specified
Non Exceptional Code
National Electrical Code
Not Elsewhere Classified
40
Under HIPAA privacy regulations, patients have the right to their psychotherapy notes.
False
True
41
What is a PPO?
Precise Privacy Operations
Preferred Provider Organization
Planned Practice Operations
Preferred Provider Operations
42
What is PHI?
Personal History Information
Preferred Health Insurance
Protected Health information
43
What is CMS?
Correct Management System
Center for Medicare and Medicaid Services
Center for Management Services
Center for Medicaid and Medicare Services
44
Critical care can be rendered to a patient
Only in the office setting.
In areas other than the ICU if it may be life-threatening.
Only in the emergency room.
Only in the ICU.
45
A person can remain on their parent's insurance until they are ____ years old.
21
19
26
24
46
an EMR system
Is a computer program to write checks for the business
is an electronic way to manage the billing for the practice.
an electronic way to store medical records.
is for large hospital practices.
47
Office place of service
11
TC
25
26
48
A provider can bill Medicare with a paper claim if he has fewer than ___ full time employees.
5
20
10
50
49
Medicare paients can only be billed when their claims deny if there is a signed ABN on file.
True
False
50
A new patient is one who hasn't been seen by anyone in the practice for _____ years.
7
5
1
3
51
The current CMS-1500 form has space for _____ diagnosis codes.
16
8
4
12
52
The HCPCS book has codes for _____.
Office visits.
Procedures.
DME and medications.
Diagnoses.
53
What is CPT?
Correspondence Procedural Terminology
Current Procedural Terminology
Correct Protocol Terms
Correct Procedural Technology
