Question 1

HCPCS Level II codes are assigned and maintained by individual state Medicare carriers.

Accepted Answer

A) True 
 B)False

Question 2

Misusing Medicare funds is considered:

Accepted Answer

A) abuse and illegal. 
B) abuse but not illegal. 
C) fraud and illegal. 
D) fraud but not illegal. 
A) abuse and illegal. 
B) abuse but not illegal. 
C) fraud and illegal. 
D) fraud but not illegal.

Question 3

When two or more codes can be combined and billed as a single code, they are referred to as mutually exclusive.

Accepted Answer

A) True 
 B)False

Question 4

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 5

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

Accepted Answer

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

Question 6

Billing the parts of a bundled procedure as separate procedures for higher reimbursement is referred to as:

Accepted Answer

A) bundling. 
B) unbundling. 
C) upcoding. 
D) downcoding. 
A) bundling. 
B) unbundling. 
C) upcoding. 
D) downcoding.

Question 7

HCPCS Level II national codes are used in claims submitted to:

Accepted Answer

A) public insurers only. 
B) private insurers only. 
C) public and private insurers. 
D) self-funded plans only. 
A) public insurers only. 
B) private insurers only. 
C) public and private insurers. 
D) self-funded plans only.

Question 8

In physical therapy cases, if a coder bills for supervised attendance:

Accepted Answer

A) the therapist must be in constant attendance with the patient. 
B) the therapist must be supervised by a physician. 
C) one-on-one direct contact by the therapist is not required. 
D) one-on-one direct contact by the therapist is required. 
A) the therapist must be in constant attendance with the patient. 
B) the therapist must be supervised by a physician. 
C) one-on-one direct contact by the therapist is not required. 
D) one-on-one direct contact by the therapist is required.

Question 9

If a provider requests an advisory opinion and fails to follow the advice of the Office of Inspector General (OIG), the provider:

Accepted Answer

A) would be treated leniently for asking the question. 
B) could claim "not knowing." 
C) could be prosecuted. 
D) should not change its practices. 
A) would be treated leniently for asking the question. 
B) could claim "not knowing." 
C) could be prosecuted. 
D) should not change its practices.

Question 10

Match between columns
                        Premises: Billing for procedures or services that were NOT necessary
The notice that alerts a Medicare beneficiary that a service may NOT be medically necessary and is, therefore, NOT covered
The practice of billing the parts of a bundled procedure as separate procedures
Reporting items or services that are NOT actually documented in the medical record but that the coder believes were performed
The codes used to report vision and hearing services
Two codes that could NOT have both reasonably been performed during a single patient encounter
Intentional acts of deception used to take advantage of another person or entity
The two-character code used with all levels of HCPCS codes to provide additional detail on services reported on Medicare claims
The use of a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided
The codes found in the Current Procedural Terminology (CPT) code book

Accepted Answer

The Answer of abuse and assumption coding and HCPCS Level is...

Question 11

Those found guilty of medical fraud can receive jail sentences as well as fines.

Accepted Answer

A) True 
 B)False

Question 12

When each reported service is connected to a diagnosis that supports the procedure as medically necessary, the claim is referred to as:

Accepted Answer

A) accurate. 
B) clean. 
C) complete. 
D) authorized. 
A) accurate. 
B) clean. 
C) complete. 
D) authorized.

Question 13

The Healthcare Fraud and Abuse Control Program was created by the:

Accepted Answer

A) Health Insurance Portability and Accountability Act (HIPA
A) . 
B) Social Security Act. 
C) Federal Civil False Claims Act. 
D) Centers for Medicare and Medicaid Services (CMS). 
A) Health Insurance Portability and Accountability Act (HIPA
A) . 
B) Social Security Act. 
C) Federal Civil False Claims Act. 
D) Centers for Medicare and Medicaid Services (CMS).

Question 14

Abuse against Medicare is considered illegal because taxpayer dollars have been misspent.

Accepted Answer

A) True 
 B)False

Question 15

If a person pretends to be a physician and treats patients without a valid medical license, it is considered abuse.

Accepted Answer

A) True 
 B)False

Question 16

The code for durable medical equipment (DME) would be found in the:

Accepted Answer

A) Level I HCPCS code book. 
B) Level II HCPCS code book. 
C) Level III HCPCS code book. 
D) This is not considered a HCPCS code. 
A) Level I HCPCS code book. 
B) Level II HCPCS code book. 
C) Level III HCPCS code book. 
D) This is not considered a HCPCS code.

Question 17

A coder who needs to find the codes for prosthetic devices and related procedures would find it in the:

Accepted Answer

A) Level I HCPCS code book. 
B) Level II HCPCS code book. 
C) Level III HCPCS code book. 
D) This is not considered an HCPCS code. 
A) Level I HCPCS code book. 
B) Level II HCPCS code book. 
C) Level III HCPCS code book. 
D) This is not considered an HCPCS code.

Question 18

The Stark Law was enacted to govern the practice of:

Accepted Answer

A) physician referrals to other providers such as physical and occupational therapists. 
B) physician referrals of Medicare and Medicaid patients to facilities in which he or she has a financial interest. 
C) medical office coding practices. 
D) utilization of controlled substances in medical facilities. 
A) physician referrals to other providers such as physical and occupational therapists. 
B) physician referrals of Medicare and Medicaid patients to facilities in which he or she has a financial interest. 
C) medical office coding practices. 
D) utilization of controlled substances in medical facilities.

Question 19

Compliance Program Guidance for Individual and Small Group Physician Practices can be found in the:

Accepted Answer

A) Health Insurance Portability and Accountability Act (HIPA
A) . 
B) Office of Inspector General's Fraud Alerts. 
C) Federal Register. 
D) National Correct Coding Initiative (NCCI). 
A) Health Insurance Portability and Accountability Act (HIPA
A) . 
B) Office of Inspector General's Fraud Alerts. 
C) Federal Register. 
D) National Correct Coding Initiative (NCCI).

Question 20

HCPCS Level II codes would include all of the following EXCEPT codes for:

Accepted Answer

A) vision and hearing services. 
B) surgical services. 
C) ambulance services. 
D) medical and surgical supplies. 
A) vision and hearing services. 
B) surgical services. 
C) ambulance services. 
D) medical and surgical supplies.

HCPCS Level II codes are assigned and maintained by individual state Medicare carriers.

Misusing Medicare funds is considered:

When two or more codes can be combined and billed as a single code, they are referred to as mutually exclusive.

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

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

Billing the parts of a bundled procedure as separate procedures for higher reimbursement is referred to as:

HCPCS Level II national codes are used in claims submitted to:

In physical therapy cases, if a coder bills for supervised attendance:

If a provider requests an advisory opinion and fails to follow the advice of the Office of Inspector General (OIG), the provider:

Those found guilty of medical fraud can receive jail sentences as well as fines.

When each reported service is connected to a diagnosis that supports the procedure as medically necessary, the claim is referred to as:

The Healthcare Fraud and Abuse Control Program was created by the:

Abuse against Medicare is considered illegal because taxpayer dollars have been misspent.

If a person pretends to be a physician and treats patients without a valid medical license, it is considered abuse.

The code for durable medical equipment (DME) would be found in the:

A coder who needs to find the codes for prosthetic devices and related procedures would find it in the:

The Stark Law was enacted to govern the practice of:

Compliance Program Guidance for Individual and Small Group Physician Practices can be found in the:

HCPCS Level II codes would include all of the following EXCEPT codes for:

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Hipaa: Health Insurance Portability and Accountability Act of 1996

ICD-9-CM Medical Coding

ICD-10-CM Medical Coding

Introduction to Cpt and Place of Service Coding

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

Electronic Medical Claims Processing

Filters

Exam 9: Hcpcs and Coding Compliance

HCPCS Level II codes are assigned and maintained by individual state Medicare carriers.

Misusing Medicare funds is considered:

When two or more codes can be combined and billed as a single code, they are referred to as mutually exclusive.

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

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

Billing the parts of a bundled procedure as separate procedures for higher reimbursement is referred to as:

HCPCS Level II national codes are used in claims submitted to:

In physical therapy cases, if a coder bills for supervised attendance:

If a provider requests an advisory opinion and fails to follow the advice of the Office of Inspector General (OIG), the provider:

Those found guilty of medical fraud can receive jail sentences as well as fines.

When each reported service is connected to a diagnosis that supports the procedure as medically necessary, the claim is referred to as:

The Healthcare Fraud and Abuse Control Program was created by the:

Abuse against Medicare is considered illegal because taxpayer dollars have been misspent.

If a person pretends to be a physician and treats patients without a valid medical license, it is considered abuse.

The code for durable medical equipment (DME) would be found in the:

A coder who needs to find the codes for prosthetic devices and related procedures would find it in the:

The Stark Law was enacted to govern the practice of:

Compliance Program Guidance for Individual and Small Group Physician Practices can be found in the:

HCPCS Level II codes would include all of the following EXCEPT codes for:

Introduction to Professional Billing and Coding Careers

Understanding Managed Care: Insurance Plans

Understanding Managed Care: Medical Contracts and Ethics

Hipaa: Health Insurance Portability and Accountability Act of 1996

ICD-9-CM Medical Coding

ICD-10-CM Medical Coding

Introduction to Cpt and Place of Service Coding

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

Electronic Medical Claims Processing

Filters