MDA121 Clinical Aspects of Billing and Coding

Question 1

Obtaining pre-certification will guarantee payment.

Accepted Answer

False

Question 2

What description best describes a level of care that involves multiple systems or complex involvement of a system?

Accepted Answer

comprehensive

Question 3

Level I CPT codes are 5-digit codes reporting services provided.

Accepted Answer

True

Question 4

Which is an Evaluation and Management (E/M) code?

Accepted Answer

99200

Question 5

Which component is not considered when determining appropriate level of E/M?

Accepted Answer

All the above

Question 6

When billing for immunizations during a well-child visit, which coding book would you use?

Accepted Answer

ICD-10-CM

Question 7

ICD-10-CM and CPT have the same codes.

Accepted Answer

False

Question 8

Assignment of benefits means you are informing the patient in advance that Medicare may not pay for a procedure.

Accepted Answer

False

Question 9

Assignment of benefits means that the patient has benefits.

Accepted Answer

False

Question 10

ICD-10 codes are

Accepted Answer

3-7 characters in length

Question 11

CPT Level I and HCPCS Level II can be used interchangeably.

Accepted Answer

False

Question 12

Which is the amount paid to an insurance company for health benefits?

Accepted Answer

Premium

Question 13

HCPCS codes are for medical, surgical and diagnostic codes, related to Medicare.

Accepted Answer

True

Question 14

The word part -rrhexis means flow.

Accepted Answer

True

Question 15

A code set is data used to document reasons patients are seen for exams.

Accepted Answer

True

Question 16

Which of the following is an ICD code?

Accepted Answer

981.02

Question 17

Stand alone codes, stand alone with the full description of the procedure.

Accepted Answer

True

Question 18

Which is a reason a claim would be denied?

Accepted Answer

All of the above

Question 19

A default code is the ICD-10 code most commonly associate with the main term.

Accepted Answer

True

Question 20

What is the term for the amount of money at patient must pay before insurance benefits pay?

Accepted Answer

Deductible

Question 21

Which is true about ICD-10-CM codes?

Accepted Answer

The first character is a letter

Question 22

Modifying terms are descriptive words under main terms to provide further descriptions of procedure.

Accepted Answer

True

Question 23

Patients enrolled in Medicare Part A

Accepted Answer

Usually do not pay premiums for Part A

Question 24

The 'Birthday Rule' determines who's plan will cover the children?

Accepted Answer

The spouse whose birthday falls first in the year

Question 25

Which part of Medicare pays for provider fees, diagnostic tests and medical equipment?

Accepted Answer

Part B

Question 26

Instructional notes guide you to find the most appropriate diagnosis code.

Accepted Answer

True

Question 27

An ABN on file insures the insurance will pay for the procedure.

Accepted Answer

False

Question 28

A main term is the identifying word that helps you find the correct diagnosis code.

Accepted Answer

True

Question 29

Which is a CPT code?

Accepted Answer

88130

Question 30

In the Tabular List of Diseases, ICD-10-CM codes in Chapter 1 begin with A00.

Accepted Answer

True

Question 31

A covered entity refers to anyone/any business exposed to patients' care/medical records.

Accepted Answer

True

Question 32

There are incentives through Medicare and Medicaid programs for billers to use EHR technology when billing.

Accepted Answer

True

Question 33

What is MOST important to have on file before billing a standard medical insurance?

Accepted Answer

Authorization to release medical information

Question 34

When a patient has coverage from more than one insurance, the primary insurance is

Accepted Answer

billed first

Question 35

E/M codes are CPT codes NOT used for

Accepted Answer

procedures

Question 36

Nonavailability means services are not available.

Accepted Answer

True

Question 37

What is the allowable charge?

Accepted Answer

The maximum an insurer will pay a provider

MDA121 Clinical Aspects of Billing and Coding

Questions 37

MDA121 Clinical Aspects of Billing and Coding

Questions 37