Question 1

The Federal Civil False Claims Act prohibits submitting a(n) ________ claim.

Accepted Answer

The answer of The Federal Civil False Claims Act prohibits...

Question 2

The connection between the diagnostic and the procedural information on a claim is referred to as ________.

Accepted Answer

The answer of The connection between the diagnostic and the...

Question 3

Match the following
-Billing for procedures or services that were NOT necessary

Accepted Answer

A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice 
A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice

Question 4

An appliance, apparatus, or product intended for use in assisting or treating a patient is sometimes covered by insurance and is billed as:

Accepted Answer

A)  durable medical equipment (DM
E) . 
B)  pharmaceuticals. 
C)  office supplies. 
D)  surgical supplies. 
A)  durable medical equipment (DM
E) . 
B)  pharmaceuticals. 
C)  office supplies. 
D)  surgical supplies.

Question 5

What are the levels of HCPCS codes?

Accepted Answer

Level I-CPT codes an

Question 6

Match the following
-Intentional acts of deception used to take advantage of another person or entity

Accepted Answer

A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice 
A)  fraud 
B)  assumption coding 
C)  upcoding 
D)  mutually exclusive 
E)  HCPCS Level II codes
F) abuse
G) unbundling
H) HCPCS Level I codes
I) HCPCS modifier
J) advance beneficiary notice

Question 7

Medicare's policy on proper and accurate coding is called the National Correct Coding Initiative (NCCI).

Accepted Answer

A) True 
 B)False

Question 8

Under civil law, the maximum penalty for medical fraud is:

Accepted Answer

A)  10 years in jail. 
B)  exclusion from the American Medical Association. 
C)  $10,000. 
D)  loss of professional license. 
A)  10 years in jail. 
B)  exclusion from the American Medical Association. 
C)  $10,000. 
D)  loss of professional license.

Question 9

What document lists the year's planned projects for sampling types of billing to see if there are any problems?

Accepted Answer

A)  OIG fraud alert 
B)  Federal Register 
C)  Medical Carrier's Manual 
D)  OIG work plan 
A)  OIG fraud alert 
B)  Federal Register 
C)  Medical Carrier's Manual 
D)  OIG work plan

Question 10

HCPCS Level II national codes consist of:

Accepted Answer

A)  five digits. 
B)  one alphabetic character and four digits. 
C)  two alphabetic characters and two digits. 
D)  one alphabetic character and five digits. 
A)  five digits. 
B)  one alphabetic character and four digits. 
C)  two alphabetic characters and two digits. 
D)  one alphabetic character and five digits.

Question 11

An action that misuses money the government has allocated is considered:

Accepted Answer

A)  fraud. 
B)  abuse. 
C)  an error. 
D)  a mistake. 
A)  fraud. 
B)  abuse. 
C)  an error. 
D)  a mistake.

Question 12

What is physician self-referral as regulated by the Stark Law?

Accepted Answer

Physician self-referral is the

Question 13

To identify that a procedure was performed on the thumb of the left hand, the coder would select the modifier:

Accepted Answer

A)  L1. 
B)  LA. 
C)  F1. 
D)  FA. 
A)  L1. 
B)  LA. 
C)  F1. 
D)  FA.

Question 14

HCPCS Level II codes in the range J0120-J9999 would be used for:

Accepted Answer

A)  durable medical equipment (DM
E) . 
B)  dental procedures. 
C)  diagnostic radiology services. 
D)  drugs administered other than oral method. 
A)  durable medical equipment (DM
E) . 
B)  dental procedures. 
C)  diagnostic radiology services. 
D)  drugs administered other than oral method.

Question 15

A compliance program in a physician's office should include a process for conducting internal monitoring and auditing of claims.

Accepted Answer

A) True 
 B)False

Question 16

Two codes that could NOT have both been reasonably performed during a single patient encounter are referred to as:

Accepted Answer

A)  mutually exclusive codes. 
B)  not medically necessary codes. 
C)  comprehensive codes. 
D)  component codes. 
A)  mutually exclusive codes. 
B)  not medically necessary codes. 
C)  comprehensive codes. 
D)  component codes.

Question 17

The five-digit CPT codes used to report services and procedures performed by healthcare providers are also known as:

Accepted Answer

A)  Level I HCPCS. 
B)  Level II HCPCS. 
C)  Level III HCPCS. 
D)  They are not considered HCPCS codes. 
A)  Level I HCPCS. 
B)  Level II HCPCS. 
C)  Level III HCPCS. 
D)  They are not considered HCPCS codes.

Question 18

HCPCS modifiers consist of:

Accepted Answer

A)  two digits. 
B)  two letters. 
C)  two letters or two numbers. 
D)  two letters or one letter and one number. 
A)  two digits. 
B)  two letters. 
C)  two letters or two numbers. 
D)  two letters or one letter and one number.

Question 19

A coder can obtain information about coding and governmental regulations from:

Accepted Answer

A)  American Medical Association (AM
A) . 
B)  national specialty medical societies. 
C)  insurance carriers. 
D)  all of the above. 
A)  American Medical Association (AM
A) . 
B)  national specialty medical societies. 
C)  insurance carriers. 
D)  all of the above.

Question 20

HCPCS is the acronym for the:

Accepted Answer

A)  Healthcare Current Procedures Coding System. 
B)  Health Coding for Procedures and Claim Sets. 
C)  Healthcare Common Procedure Coding System. 
D)  Healthcare Coding for Procedures and Claims Systems. 
A)  Healthcare Current Procedures Coding System. 
B)  Health Coding for Procedures and Claim Sets. 
C)  Healthcare Common Procedure Coding System. 
D)  Healthcare Coding for Procedures and Claims Systems.

The Federal Civil False Claims Act prohibits submitting a(n) ________ claim.

The connection between the diagnostic and the procedural information on a claim is referred to as ________.

Match the following -Billing for procedures or services that were NOT necessary

An appliance, apparatus, or product intended for use in assisting or treating a patient is sometimes covered by insurance and is billed as:

What are the levels of HCPCS codes?

Match the following -Intentional acts of deception used to take advantage of another person or entity

Medicare's policy on proper and accurate coding is called the National Correct Coding Initiative (NCCI).

Under civil law, the maximum penalty for medical fraud is:

What document lists the year's planned projects for sampling types of billing to see if there are any problems?

HCPCS Level II national codes consist of:

An action that misuses money the government has allocated is considered:

What is physician self-referral as regulated by the Stark Law?

To identify that a procedure was performed on the thumb of the left hand, the coder would select the modifier:

HCPCS Level II codes in the range J0120-J9999 would be used for:

A compliance program in a physician's office should include a process for conducting internal monitoring and auditing of claims.

Two codes that could NOT have both been reasonably performed during a single patient encounter are referred to as:

The five-digit CPT codes used to report services and procedures performed by healthcare providers are also known as:

HCPCS modifiers consist of:

A coder can obtain information about coding and governmental regulations from:

HCPCS is the acronym for the:

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

Auditing

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 8: Hcpcs Coding and Compliance

The Federal Civil False Claims Act prohibits submitting a(n) ________ claim.

The connection between the diagnostic and the procedural information on a claim is referred to as ________.

Match the following -Billing for procedures or services that were NOT necessary

An appliance, apparatus, or product intended for use in assisting or treating a patient is sometimes covered by insurance and is billed as:

What are the levels of HCPCS codes?

Match the following -Intentional acts of deception used to take advantage of another person or entity

Medicare's policy on proper and accurate coding is called the National Correct Coding Initiative (NCCI).

Under civil law, the maximum penalty for medical fraud is:

What document lists the year's planned projects for sampling types of billing to see if there are any problems?

HCPCS Level II national codes consist of:

An action that misuses money the government has allocated is considered:

What is physician self-referral as regulated by the Stark Law?

To identify that a procedure was performed on the thumb of the left hand, the coder would select the modifier:

HCPCS Level II codes in the range J0120-J9999 would be used for:

A compliance program in a physician's office should include a process for conducting internal monitoring and auditing of claims.

Two codes that could NOT have both been reasonably performed during a single patient encounter are referred to as:

The five-digit CPT codes used to report services and procedures performed by healthcare providers are also known as:

HCPCS modifiers consist of:

A coder can obtain information about coding and governmental regulations from:

HCPCS is the acronym for the:

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

Auditing

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