Quiz 18: Medical Insurance Coding

Delmars Administrative

Medicine
31
Questions
0
True/False
31
Choices
0
Essay
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Questions

Q1
Free

Why is it important for the medical assistant to understand medical insurance coding?

Multiple Choice
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A) Needed to transfer all information
B) Assists explanations to patients
C) Helps the patient file claims
D) Serves as basis for the information on the claim form
Answer:
D) Serves as basis for the information on the claim form
Q2
Free

What is necessary in order to authorize release of medical information to an insurance carrier?

Multiple Choice
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A) A verbal agreement between the patient and the doctor is necessary.
B) A medical release from the patient is needed.
C) A handshake between the patient and the doctor is all that is necessary.
D) Authorization is never required to release medical information.
E) Physicians never have to share medical information.
Answer:
B) A medical release from the patient is needed.
Q3
Free

Which of the following organizations developed ICD-9-CM?

Multiple Choice
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A) American Medical Association
B) Centers for Medicare and Medicaid Services
C) World Health Organization
D) Health Care Financing Administration
Answer:
C) World Health Organization
Q4

Which of the following applies to the coding book used for specifying services and procedures performed in the medical office?

Multiple Choice
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A) ICD-9-CM
B) RBRVS
C) CPT
D) EOB
Answer:

A) You need to subscribe to get the answer.

Q5

How many major sections are in the Current Procedural Terminology reference book?

Multiple Choice
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A) Four
B) Five
C) Six
D) Seven
Answer:

A) You need to subscribe to get the answer.

Q6

Which of the following is NOT included in the recommended procedure for researching CPT code numbers using the index?

Multiple Choice
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A) Search for the service or procedure in the alphabetic index.
B) Find a suggested number or range of numbers.
C) Search for the suggested number range in the tabular list.
D) Choose the correct code number for description.
E) Choose a modifier for all diagnoses and procedures.
Answer:

A) You need to subscribe to get the answer.

Q7

Which section of the CPT book includes coding of immunizations and chemotherapy?

Multiple Choice
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A) Medicine
B) Surgery
C) Pathology
D) Laboratory
Answer:

A) You need to subscribe to get the answer.

Q8

Which section of the CPT book includes coding of lacerations?

Multiple Choice
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A) Medicine
B) Surgery
C) Pathology
D) Laboratory
Answer:

A) You need to subscribe to get the answer.

Q9

Which of the following volumes is the alphabetic index of ICD-9-CM?

Multiple Choice
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A) Volume I
B) Volume II
C) Volume III
D) Volume IV
Answer:

A) You need to subscribe to get the answer.

Q10

Which of the following ICD-9-CM volumes is recommended as the first reference when coding diagnoses?

Multiple Choice
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A) Volume I
B) Volume II
C) Volume III
D) Volume IV
Answer:

A) You need to subscribe to get the answer.

Q11

Which of the following is a convention used when there is not enough information to find a more specific code?

Multiple Choice
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A) NEC
B) NOS
C) V codes
D) E codes
Answer:

A) You need to subscribe to get the answer.

Q12

Which of the following are codes applied to an injury or poisoning?

Multiple Choice
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A) Modifiers
B) V codes
C) E codes
D) Injury codes
Answer:

A) You need to subscribe to get the answer.

Q13

Which of the following best describes the purpose of a physician's fee profile?

Multiple Choice
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A) To analyze office fees
B) To reflect charges for services and reimbursement rates
C) To prevent downcoding
D) To subrogate monies
Answer:

A) You need to subscribe to get the answer.

Q14

Which of the following is NOT affected by coding accuracy?

Multiple Choice
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A) Ruling out a diagnosis
B) Physician reimbursement
C) Resubmissions
D) Medical records
Answer:

A) You need to subscribe to get the answer.

Q15

Which of the following is completed using data from the patient's electronic health record in most offices today?

Multiple Choice
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A) CMS 1490
B) UB92
C) CMS 1500
D) HCFA form
Answer:

A) You need to subscribe to get the answer.

Q16

Which of the following information is NOT included in coding?

Multiple Choice
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A) Visit complexity
B) Diagnosis for visit
C) Specific procedures
D) Counseling
Answer:

A) You need to subscribe to get the answer.

Q17

Which of the following should be used to check for patient eligibility?

Multiple Choice
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A) Point-of-service device
B) Claims register
C) Universal claim form
D) Explanation of benefits
Answer:

A) You need to subscribe to get the answer.

Q18

Which of the following is a record of claims sent to the insurance carrier?

Multiple Choice
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A) Point-of-service device
B) Claims register
C) Universal claim form
D) Explanation of benefits
Answer:

A) You need to subscribe to get the answer.

Q19

Which of the following is NOT included in the insurance carrier's role?

Multiple Choice
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A) Check to see that there are no pre-existing condition restrictions.
B) Ensure that the provider has a contract with the carrier.
C) Ensure that coverage was in force at the time of treatment.
D) Collect a co-payment from the physician.
E) Ensure that amounts meet usual and customary standards.
Answer:

A) You need to subscribe to get the answer.

Q20

On completion of the processing of the claim, the insurance company sends what to the insured person?

Multiple Choice
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A) POS
B) Claim remittance
C) EOB
D) 1490 form
Answer:

A) You need to subscribe to get the answer.

Q21

Which of the following is recommended to do first when a claim is not paid within 4-6 weeks?

Multiple Choice
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A) Allow the carrier 30 days more to pay the claim.
B) Check the carrier's regulations for payment.
C) Call the insurance carrier and ask about the delay.
D) Resubmit the claim.
Answer:

A) You need to subscribe to get the answer.

Q22

Which of the following occurs when the insurance carrier is deliberately billed a higher rate service than what was performed to order for the provider to obtain greater reimbursements?

Multiple Choice
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A) Upcoding
B) Bundling
C) Downcoding
D) Unbundling
Answer:

A) You need to subscribe to get the answer.

Q23

Which of the following applies to codes used as supplements to the basic CPT system and are required when reporting services and procedures to Medicare and Medicaid patients?

Multiple Choice
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A) HCPCS
B) M codes
C) E&M codes
D) DRGs
Answer:

A) You need to subscribe to get the answer.

Q24

Which of the following is the volume of the ICD-9-CM known as the tabular list?

Multiple Choice
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A) Volume I
B) Volume II
C) Volume III
D) Volume I-III
Answer:

A) You need to subscribe to get the answer.

Q25

Which of the following are diagnosis codes used primarily with cancer registries?

Multiple Choice
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A) V codes
B) E codes
C) DRG codes
D) M codes
Answer:

A) You need to subscribe to get the answer.

Q26

Which of the following is the claim form used for filing inpatient admissions claims?

Multiple Choice
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A) CMS 1500
B) UB-04
C) CMS 1490
D) HCFA 1500
Answer:

A) You need to subscribe to get the answer.

Q27

The ICD-CM 10th revision will utilize alphanumeric codes that will consist of up to how many characters?

Multiple Choice
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A) Five
B) Six
C) Seven
D) Eight
Answer:

A) You need to subscribe to get the answer.

Q28

How many diagnosis codes will the preceding scenario require?

Multiple Choice
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A) One
B) Two
C) Three
D) Four
E) Five
Answer:

A) You need to subscribe to get the answer.

Q29

How many procedure codes would apply to the preceding scenario?

Multiple Choice
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A) One
B) Two
C) Three
D) Four
E) Five
Answer:

A) You need to subscribe to get the answer.

Q30

Separating the components of a procedure and reporting them as billable codes with charges in order to increase reimbursement rates is known as what?

Multiple Choice
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A) Upcoding
B) Unbundling
C) Bundling
D) Downcoding
Answer:

A) You need to subscribe to get the answer.

Q31

The new CMS-1500 form is distinguishable from the old form in that the 1500 symbol and date are located where?

Multiple Choice
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A) Top right margin
B) Bottom right margin
C) Bottom left margin
D) Top left margin
Answer:

A) You need to subscribe to get the answer.

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