Procedural Coding Basics

To examine claims for accuracy and completeness before they are submitted is to _________ the claims.

Category ll codes can be used to help measure performance measurements?

It is acceptable to code from the Alphabetic Index

In medical terms, a medical diagnosis or procedure named for the person who discovered it is called

Dirty claims cannot be resubmitted

Durable medical equipment are HCPCS _____-codes.

Medical records used for procedural coding can include which of the following?

The Tabular List is divided into _____ sections, with codes listed in numeric order in each section.

If the ICD-10-CM codes and the CPT/HCPCS codes do not match the claim will not show __________.

What information is not part of the patient’s required information listed on the CMS-1500 about the insured?

Claims that have errors or omissions must be corrected and resubmitted to receive reimbursement are:

Patient care approached from a holistic approach defines

Who is directly contracted with the insurance company and the person’s information is found in Section 2 of CMS-1500?

Durable medical equipment are HCPCS A-codes

What is correct regarding CPT codes?

Which of the following steps to medical billing should be performed prior to rendering medical services?

When both parents have coverage for their children, how is the primary policy identified?

Downcoding and upcoding are illegal practices, and medical assistants can be prosecuted for either practice

What information is required in Block 9 on the CMS-1500?

Patients sign an __________ of benefits form so that the physician will receive payment for services directly

What is correct regarding HCPCS codes?

An eponym will be used in which of the following CPT divisions?

Claims sent to the wrong insurance plan are the reason why many claims are rejected

Hepatitis B vaccine, adult dosage (3 dose schedule) for IM use (vaccine code only)

The radiology sections uses the code range between 70010 and 79999?

Qualitative and quantitative codes for drug testing are found in which of the following CPT sections?

The first step in filing a claim with a third-party is:

When searching the Alphabetic Index, “humerus” is an example of which of the following?

Downcoding can increase reimbursements

These modifiers indicate a professional component used when a tech performs a service & a provider makes an accurate Dx

The process of determining if a procedure/service is covered by the insurance plan and reimbursement for that procedure:

Measles, mumps, rubella, and varicella vaccine (MMRV), live, subcutaneous use (vaccine code only)

Which of the following is typically documented in the explanation of benefits (EOB)?

Annie’s mom, Sue was born in 1/5/1997 and her dad Tim was born 3/19/1995. Both parents carry ins. but which is primary?

A deductible is a set dollar amount that the patient must pay for each office visit

The patient billing record includes the insurance billing information

Medical and surgical supplies are HCPCS _____-codes

Four diagnoses can be reported on the CMS-1500

Claims submitted to a(n) clearinghouse are forwarded to individual insurance carriers.

Electronic data interchange is

Hepatitis B vaccine, adult dosage (3 dose schedule) for IM use (vaccine code only)

The place of service never changes for physician billing

New patient, medically appropriate history, exam, straightforward medical decision making, 15-29 minutes. CPT code?

A set dollar amount that the policyholder must pay before the insurance company starts to pay for services is the:

Block 1 of the CMS-1500 contains the patient's name