Chapter 14,15,17 final

Question 1

When a prov. does not accept assignment from Medicare, the most that can be charged to thept is

Accepted Answer

115%

Question 2

All these statements are True about ICD-10-CM, except:

Accepted Answer

United states Will be only nation using ICD-10-CM

Question 3

national codes are approved and maintained jointly by all but which of these Organizations?

Accepted Answer

National hospital association

Question 4

Medicare pays __ of the approved medical bill Amount once the deductible is satisfied

Accepted Answer

80%

Question 5

Which of the following is not an advantage of using an electronic claims tracking system

Accepted Answer

All claims are guaranteed to be paid if the forms are crrect

Question 6

Which carriers will except physicians typed name and credentials as their signature

Accepted Answer

All carriers

Question 7

The CMS 1500 form is excepted by:

Accepted Answer

Both Medicare and Medicaid

Question 8

Pathology and lab cpt

Accepted Answer

80047-89398

Question 9

When following up on a delinqentclaim if the carrier tells you that it is in process you should

Accepted Answer

Request an anticipated date of payment

Question 10

In which of the icd-9-cm will you find the classification of drugs by American hospital form

Accepted Answer

Volume 1

Question 11

Amount of time physician spent

Accepted Answer

Contributory factor

Question 12

Assigning CPT procedural codes othat do not match patient doc. For increased reimbursment is:

Accepted Answer

Upcoding

Question 13

As a result of Medicare modernization act of 2004, codes must be implemented every year on:

Accepted Answer

January 1

Question 14

In a ___ plan, pt’s are able to see specialists without having to obtain referrals

Accepted Answer

Indemnity-type insurance

Question 15

How many digits are in the national provider identifier number?

Accepted Answer

10

Question 16

Medicaid cards are issued to recipients on a ___ basis

Accepted Answer

Monthly

Question 17

Medicine cpt

Accepted Answer

90281-99199, 99500-99607

Question 18

When coding, primary reason for the office visit is listed first, other reason are listed in:

Accepted Answer

Order of importance

Question 19

Once pt is ready to leave the hospital __ is used to ensure that the pt is being discharged

Accepted Answer

Discharge planning

Question 20

Blue cross was originally set up to pay for:

Accepted Answer

Hospital expenses

Question 21

Counseling

Accepted Answer

Contributory factor

Question 22

The term __ refers to discover if max amount of money that carrier will pay for primary surgery

Accepted Answer

Predetermination

Question 23

Part __ of medicare was created to provide coverage for both generic and brand name drugs

Accepted Answer

D

Question 24

Level of examination performed

Accepted Answer

Key Component

Question 25

Which level of healthcare common procedural coding system (HCPCS) includes national codes

Accepted Answer

Level 2

Question 26

When coding, you isolate the main term from the providers statement and then look it up in the:

Accepted Answer

Index

Question 27

Tools Known as crosswalk or __ will be used to help convert an ICD 9PCS code to ICD 10 PCS code

Accepted Answer

General equivalent mappings

Question 28

Who publishes current procedural terminolgy (CPT)

Accepted Answer

American Medical Association

Question 29

When a third-party payer identifies an error on the claim form the claim is :

Accepted Answer

Rejected with a request to resubmit the form with correction

Question 30

Under the birthday rule, if the parents divorce and retain their plans, parent with_ is primary

Accepted Answer

Custody

Question 31

Most physician offices utilize the version of ICD 9 manual that has only which two volumes?

Accepted Answer

1 & 2

Question 32

When records are reviewed by third-party payers if a procedure is not documented it:

Accepted Answer

Is considered to have never been performed

Question 33

Which section of volume 2 ICD 9 manual includes index to external causes of injuries and poison

Accepted Answer

Section 3

Question 34

The ICD-9-CM will remain in use in the US until October first of what year?

Accepted Answer

2013

Question 35

Radiology cpt

Accepted Answer

70010-79999

Question 36

When pt arrived at office, you should copy __ of the insurance card(s)

Accepted Answer

Both sides

Question 37

When pt’s w/out health insurance are seen in the medical practice they are classified as __ pt

Accepted Answer

Self-pay

Question 38

What is the first step in completing a claim form

Accepted Answer

Check for photocopy of the patient’s insurance card

Question 39

Coordination of care

Accepted Answer

contributory factor

Question 40

The only practitioners that can currently bill Medicare’s with the hard copy cms are those with

Accepted Answer

Less than 10 full-time employees, including physicians

Question 41

Nature of presenting problem

Accepted Answer

Key components

Question 42

Which of the following is not a fee usually charge by clearinghouse

Accepted Answer

Customer service fee

Question 43

Anesthesiology cpt

Accepted Answer

00100-01999, 99100-99140

Question 44

Level of history obtained

Accepted Answer

Key components

Question 45

Because a pcp in an hmo makes referrals and approves addition care he or she is known as the:

Accepted Answer

Gatekeeper

Question 46

The ICD-9-CM:

Accepted Answer

Ian running out of capacity

Question 47

Part __ of medicare is for payment of medical expenses such as office visits,x-ray, and labs

Accepted Answer

B

Question 48

A provider may not charge A pt for:

Accepted Answer

amount reimbursed after after excepting assignment

Question 49

ICD codes are descriptive Of the:

Accepted Answer

Presenting disease or condition

Question 50

Under workers comp. A pt who has an industrial injury is billed:

Accepted Answer

If treatment was given without authorization

Question 51

_ was coined to indicate payment of services rendered by someone other than the patient

Accepted Answer

Third-party reimbursement

Question 52

Which form is also known as the UB – 40 form

Accepted Answer

CM—1450

Question 53

Surgery cpt

Accepted Answer

10021-69990

Question 54

A __ is used to inform third-party payers that a particular code has been altered

Accepted Answer

Modifier

Question 55

The remittance advice form is used when payment is being made from

Accepted Answer

Medicare

Question 56

Person in medical office is designated as the _ and is expected to maintain currency w/ insurer

Accepted Answer

Claims filer

Question 57

Health insurance offered to person eligible for Medicare benefits, designed to supplement

Accepted Answer

Medigap

Question 58

Since 2005 providers have urged to:

Accepted Answer

Send claims electronically

Question 59

Which type of HMO is composed of providers who practice in their own office

Accepted Answer

Independent practice association

Question 60

Degree of medical decision making making involved

Accepted Answer

Key components

Question 61

Services performed in the office are generally marked on a Pt’s encounter form by:

Accepted Answer

Provider

Question 62

Physicians who treat pt’s under workers comp. Plans are usually Required to register with wcb

Accepted Answer

On an annual basis

Question 63

E/m cpt

Accepted Answer

99201-99499

Question 64

Which HCPCS level 2 codes are temporary codes for procedures, services, ad supplies

Accepted Answer

G codes

Chapter 14,15,17 final

Questions 68

Chapter 14,15,17 final

Questions 68