Question 1

An internal audit will NOT be able to help a practice discover lost revenue.

Accepted Answer

A) True 
 B)False  False

Question 2

A postpayment audit would verify all of the following EXCEPT:

Accepted Answer

A)  the coder's skill and knowledge. 
B)  billing records. 
C)  patient progress notes. 
D)  laboratory results. 
A)  the coder's skill and knowledge. 
B)  billing records. 
C)  patient progress notes. 
D)  laboratory results. A

Question 3

List the body areas recognized by the CPT book for reporting the level of exams.

Accepted Answer

Body areas include head, neck, chest, abdomen, genitalia, groin, buttocks, back, and each extremity.

Question 4

A retrospective audit is conducted before sending claims to an insurance company.

Accepted Answer

A) True 
 B)False

Question 5

If a patient complains of an aching pain in the chest, the complaint would be considered part of the PFSH.

Accepted Answer

A) True 
 B)False

Question 6

If a patient presents with one self-limited or minor problem, the level of risk involved with the medical decision making would be considered:

Accepted Answer

A)  minimal. 
B)  low. 
C)  moderate. 
D)  high. 
A)  minimal. 
B)  low. 
C)  moderate. 
D)  high.

Question 7

An ROS is considered part of the physical examination.

Accepted Answer

A) True 
 B)False

Question 8

If a patient states that the pain he or she is experiencing is in the right arm, the element he or she would be describing is the:

Accepted Answer

A)  location. 
B)  severity. 
C)  context. 
D)  quality. 
A)  location. 
B)  severity. 
C)  context. 
D)  quality.

Question 9

When auditing a medical chart, the auditor should verify that all documentation is initialed or signed by:

Accepted Answer

A)  the provider and the office manager. 
B)  the provider. 
C)  the office manager. 
D)  all office staff. 
A)  the provider and the office manager. 
B)  the provider. 
C)  the office manager. 
D)  all office staff.

Question 10

The two types of HPI are ________ and ________.

Accepted Answer

The answer of The two types of HPI are ________...

Question 11

Name three top coding and documentation errors.

Accepted Answer

Answers will vary but may include: The c

Question 12

If a medical record note documents that the patient has smoked two packs of cigarettes every day for the past 10 years, it would be an example of the patient's:

Accepted Answer

A)  past history. 
B)  family history. 
C)  social history. 
D)  HPI. 
A)  past history. 
B)  family history. 
C)  social history. 
D)  HPI.

Question 13

In documenting a medical examination, all of the following are recognized body areas EXCEPT the:

Accepted Answer

A)  neck. 
B)  abdomen. 
C)  back. 
D)  skin. 
A)  neck. 
B)  abdomen. 
C)  back. 
D)  skin.

Question 14

The risk of significant complication, morbidity, and/or mortality is based on the risks of:

Accepted Answer

A)  the presenting problems. 
B)  the diagnostic procedures. 
C)  the possible management options. 
D)  all of the above. 
A)  the presenting problems. 
B)  the diagnostic procedures. 
C)  the possible management options. 
D)  all of the above.

Question 15

Which of following questions should be asked and answered yes before coding as a consultation?

Accepted Answer

A)  Does the documentation of the service clearly demonstrate who made the request and the nature of the opinion requested? 
B)  Has the provider provided a written report of his or her opinion/advice to the referring physician? 
C)  Although the referring physician may have asked for a "consultation," should the E/M service truly be reported as a consultation? 
D)  all of the above. 
A)  Does the documentation of the service clearly demonstrate who made the request and the nature of the opinion requested? 
B)  Has the provider provided a written report of his or her opinion/advice to the referring physician? 
C)  Although the referring physician may have asked for a "consultation," should the E/M service truly be reported as a consultation? 
D)  all of the above.

Question 16

A postpayment audit would verify:

Accepted Answer

A)  date of service. 
B)  patient insurance identification number. 
C)  sign-in sheets and appointment scheduling practices. 
D)  patient insurance eligibility. 
A)  date of service. 
B)  patient insurance identification number. 
C)  sign-in sheets and appointment scheduling practices. 
D)  patient insurance eligibility.

Question 17

The extent of information that the physician gathers for a medical history is based on rules set up by Medicare.

Accepted Answer

A) True 
 B)False

Question 18

If a PFSH includes a review of the patient's past, family, and social history, it would be considered:

Accepted Answer

A)  pertinent. 
B)  complete. 
C)  comprehensive. 
D)  detailed. 
A)  pertinent. 
B)  complete. 
C)  comprehensive. 
D)  detailed.

Question 19

Match the following
-The type of audit performed after payment is received from an insurance carrier.

Accepted Answer

A)  downcoded 
B)  retrospective 
C)  internal 
D)  prospective 
E)  complete review of systems
F) upcoded
G) external
H) code edits
I) extended review of systems
J) problem-pertinent review of systems 
A)  downcoded 
B)  retrospective 
C)  internal 
D)  prospective 
E)  complete review of systems
F) upcoded
G) external
H) code edits
I) extended review of systems
J) problem-pertinent review of systems

Question 20

Match the following
-The type of ROS that inquires about the system directly related to the problem identified in the HPI and two to nine additional systems.

Accepted Answer

A)  downcoded 
B)  retrospective 
C)  internal 
D)  prospective 
E)  complete review of systems
F) upcoded
G) external
H) code edits
I) extended review of systems
J) problem-pertinent review of systems 
A)  downcoded 
B)  retrospective 
C)  internal 
D)  prospective 
E)  complete review of systems
F) upcoded
G) external
H) code edits
I) extended review of systems
J) problem-pertinent review of systems

An internal audit will NOT be able to help a practice discover lost revenue.

A postpayment audit would verify all of the following EXCEPT:

List the body areas recognized by the CPT book for reporting the level of exams.

A retrospective audit is conducted before sending claims to an insurance company.

If a patient complains of an aching pain in the chest, the complaint would be considered part of the PFSH.

If a patient presents with one self-limited or minor problem, the level of risk involved with the medical decision making would be considered:

An ROS is considered part of the physical examination.

If a patient states that the pain he or she is experiencing is in the right arm, the element he or she would be describing is the:

When auditing a medical chart, the auditor should verify that all documentation is initialed or signed by:

The two types of HPI are and .

Name three top coding and documentation errors.

If a medical record note documents that the patient has smoked two packs of cigarettes every day for the past 10 years, it would be an example of the patient's:

In documenting a medical examination, all of the following are recognized body areas EXCEPT the:

The risk of significant complication, morbidity, and/or mortality is based on the risks of:

Which of following questions should be asked and answered yes before coding as a consultation?

A postpayment audit would verify:

The extent of information that the physician gathers for a medical history is based on rules set up by Medicare.

If a PFSH includes a review of the patient's past, family, and social history, it would be considered:

Match the following -The type of audit performed after payment is received from an insurance carrier.

Match the following -The type of ROS that inquires about the system directly related to the problem identified in the HPI and two to nine additional systems.

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters

Exam 9: Auditing

An internal audit will NOT be able to help a practice discover lost revenue.

A postpayment audit would verify all of the following EXCEPT:

List the body areas recognized by the CPT book for reporting the level of exams.

A retrospective audit is conducted before sending claims to an insurance company.

If a patient complains of an aching pain in the chest, the complaint would be considered part of the PFSH.

If a patient presents with one self-limited or minor problem, the level of risk involved with the medical decision making would be considered:

An ROS is considered part of the physical examination.

If a patient states that the pain he or she is experiencing is in the right arm, the element he or she would be describing is the:

When auditing a medical chart, the auditor should verify that all documentation is initialed or signed by:

The two types of HPI are ________ and ________.

Name three top coding and documentation errors.

If a medical record note documents that the patient has smoked two packs of cigarettes every day for the past 10 years, it would be an example of the patient's:

In documenting a medical examination, all of the following are recognized body areas EXCEPT the:

The risk of significant complication, morbidity, and/or mortality is based on the risks of:

Which of following questions should be asked and answered yes before coding as a consultation?

A postpayment audit would verify:

The extent of information that the physician gathers for a medical history is based on rules set up by Medicare.

If a PFSH includes a review of the patient's past, family, and social history, it would be considered:

Match the following -The type of audit performed after payment is received from an insurance carrier.

Match the following -The type of ROS that inquires about the system directly related to the problem identified in the HPI and two to nine additional systems.

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Introduction to the Health Insurance Portability and Accountability Act Hipaa

ICD-10 Cm Medical Coding

Introduction to CPT and Place of Coding Services

Coding Procedures and Services

Hcpcs Coding and Compliance

Physician Medical Billing

Hospital Medical Billing

Medicare Medical Billing

Medicaid Medical Billing

Tricare Medical Billing

Explanation of Benefits and Payment Adjudication

Refunds and Appeals

Workers Compensation

Filters

The two types of HPI are and .