Study Guide

Question 1

Although eligibility for medicare part B is automatic for people entitled to medicare part A

Answer 1

Part B coverage is not automatic

Question 2

A colon is used in the tabular list after an incomplete term that needs one of the terms that follows

Answer 2

The colon to make it assignable to a given category

Question 3

In the alphabetic index, the word see refers you to

Answer 3

A different main term for the condition

Question 4

Leaning back in a chair or away from a person and folding your arms across your chest is a

Answer 4

Closed posture that may convey to patients that you are not totally receptive to what they are saying

Question 5

The insurance claim would be denied as a billing error because the treatment was not

Answer 5

Medically necessary based on the diagnosis code and there’s no evidence of code linkage

Question 6

Workers of any age who have chronic kidney disease requiring dialysis or end stage renal disease (ESRD) requiring transplant are eligible for

Answer 6

Medicare

Question 7

Liability insurance covers

Answer 7

Injuries caused by the insured or that occurred on the insurance property

Question 8

Parentheses are used in both ICD - 9 and ICD - 10 around descriptions and alphabetic index that

Answer 8

Do not affect the code that is, those that are non essential or supplementary terms that may assist you in choosing the correct code

Question 9

Medicaid is a health cost assistance program designed for

Answer 9

Low income, blind, or disabled patients it is not an insurance program

Question 10

“Excludes” indicates that an entry is not classified as part of the proceeding code and may also

Answer 10

Give the correct location of the excluded condition to help you find the correct code

Question 11

The ICD code are updated

Answer 11

Every year on October 1st

Question 12

The source sends the message to a receiver (1)

Answer 12

The receiver is missing in this figure

Question 13

It is fraudulent for people to

Answer 13

Misrepresent their credentials

Question 14

Code linkage is the analysis of the connection between The diagnostic and procedural information on a claim and is done by

Answer 14

Insurance companies to evaluate the medical necessity of the reported charges

Question 15

Billing for a moderate level evaluation and management service went only a minimal exam BP check and injection were performed is an example of

Answer 15

Reporting services at a higher level than was carried out

Question 16

During communication, posture can usually be described as

Answer 16

Open (receptive or friendly) or closed (unreceptive angry)

Question 17

Billing separately for items that are bundled in a single procedure code is referred to as

Answer 17

Unbundling

Question 18

A friendly but professional approach, a pleasant greeting, and a smile are

Answer 18

Interpersonal skills that help a patient feel relaxed

Question 19

Fraud is an act of deception used to

Answer 19

Take advantage of another person or entity

Question 20

Medicare part a is

Answer 20

A hospital benefit for patients who are admitted as in patients for up to the 90 day benefit period

Question 21

The alphabetic index contains

Answer 21

And alphabetic listing of diagnosis descriptions

Question 22

The diseases, conditions, and injuries in the tabular list are

Answer 22

Organized into chapters according to the source or body system

Question 23

Therese says she’s OK with having surgery, but her closed posture, avoidance of eye contact, and facial expression imply that

Answer 23

She may not mean what she says

Question 24

A friendly but professional approach, a pleasant greeting, and a smile are

Answer 24

Interpersonal skills that help a patient feel relaxed

Question 25

After receiving the message from the source

Answer 25

The receiver sends feedback to the source

Question 26

Never allow yourself to make Value judgments or

Answer 26

Stereotype a patient, culture, or ethnic group

Question 27

To avoid the risk of fraud, medical offices have a compliance plan to

Answer 27

Uncover compliance problems and correct them

Question 28

Forgetting common courtesy’s, such as saying please and thank you, is a form of

Answer 28

Negative communication

Question 29

When a compliance plan is in place, in demonstrates To payers like medicare that

Answer 29

Honest on going attempts have been made to find and fix weak areas of compliance with regulations

Question 30

In a typical medical practice, claims are transmitted within

Answer 30

A few business days after the date of service

Question 31

Procedures that are not related to the patient’s current condition are considered

Answer 31

Not medically necessary

Question 32

HCPCS was originally developed by the centers for medicare and medicaid services for use in

Answer 32

Coding services for medicare patients such as durable medical equipment (DME)

Question 33

In the review for allowable benefits, the claims department compares the fees the physician has charged with

Answer 33

The benefits provided by the patient’s health insurance policy to determine the amount of deductible or coinsurance patient owes

Question 34

A copayment is

Answer 34

A small fixed fee collected at the time of The Visit from patients who belong to a managed care health plan

Question 35

It is considered unethical and fraudulent to intentionally

Answer 35

Unbundle procedures into compartment codes when a bundle procedure code is available

Question 36

The brace encloses a series of terms, each of which is modified by

Answer 36

The statement that appears to the right of the brace

Question 37

Brackets are used around

Answer 37

Synonyms, alternative wordings, or explanations in ICD - 9 - CM

Question 38

Body language is an example of

Answer 38

Non verbal communication

Question 39

The total amount the patient owes the practice, including coinsurance, copayment, deductible, and non covered services is known as

Answer 39

Patient liability

Question 40

The entries following the term “includes” further define

Answer 40

The content of a preceding entry