Question 1

HCPCS was developed to achieve all of the following goals EXCEPT:

Accepted Answer

A) coordinating government programs by uniform application of Centers for Medicare and Medicaid Services (CMS) policies. 
B) ensuring the validity of profiles and fee schedules through standardized coding. 
C) allowing providers and suppliers to communicate their services in a consistent manner. 
D) implementing standard fee structures for all providers across all plans. 
A) coordinating government programs by uniform application of Centers for Medicare and Medicaid Services (CMS) policies. 
B) ensuring the validity of profiles and fee schedules through standardized coding. 
C) allowing providers and suppliers to communicate their services in a consistent manner. 
D) implementing standard fee structures for all providers across all plans.

Question 2

Procedure and diagnostic codes should be appropriate to the patient's:

Accepted Answer

A) age. 
B) gender. 
C) health condition. 
D) All of the above 
A) age. 
B) gender. 
C) health condition. 
D) All of the above

Question 3

HCPCS is organized by code number rather than by service or supply name.

Accepted Answer

A) True 
 B)False

Question 4

How is the GA modifier used?

Accepted Answer

The GA modifier is appended to

Question 5

Which organizations are represented on the HCPCS National Panel?

Accepted Answer

Representatives are from the B

Question 6

Individuals suspected of medical fraud and abuse can be investigated and prosecuted by all of the following EXCEPT the:

Accepted Answer

A) U.S. Department of Justice. 
B) Federal Bureau of Investigation (FBI). 
C) Office of Inspector General (OIG). 
D) Supreme Court. 
A) U.S. Department of Justice. 
B) Federal Bureau of Investigation (FBI). 
C) Office of Inspector General (OIG). 
D) Supreme Court.

Question 7

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

Accepted Answer

Physician self-referral is the

Question 8

The Current Procedural Terminology codes are considered HCPCS Level __________ codes.

Accepted Answer

The answer of The Current Procedural Terminology codes are considered...

Question 9

If the coder determines that the code checked off by the physician on the encounter form does NOT match the medical record, the coder should:

Accepted Answer

A) ignore the encounter form and bill based on the medical record. 
B) change the encounter form to match the medical record. 
C) inform the physician of the issue and determine the correct code. 
D) not bill for the questionable services. 
A) ignore the encounter form and bill based on the medical record. 
B) change the encounter form to match the medical record. 
C) inform the physician of the issue and determine the correct code. 
D) not bill for the questionable services.

Question 10

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

Accepted Answer

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

Question 11

Code linkage refers to the connection between the:

Accepted Answer

A) procedure and modifier. 
B) diagnosis and procedure. 
C) diagnosis and symptom. 
D) HCPCS Level I and Level II codes. 
A) procedure and modifier. 
B) diagnosis and procedure. 
C) diagnosis and symptom. 
D) HCPCS Level I and Level II codes.

Question 12

The federal government will protect and reward people involved in qui tam, or whistle-blower, cases to identify Medicare fraud.

Accepted Answer

A) True 
 B)False

Question 13

Medicare requires that all physician offices have a seven-part compliance plan in place.

Accepted Answer

A) True 
 B)False

Question 14

An advisory opinion from the CMS or OIG is considered legal advice on any question regarding healthcare business.

Accepted Answer

A) True 
 B)False

Question 15

State Medicaid agency codes are reported with what HCPCS code range?

Accepted Answer

A) C1300-C9899. 
B) G0008-G9156. 
C) T1000-T5999. 
D) V2020-V2799. 
A) C1300-C9899. 
B) G0008-G9156. 
C) T1000-T5999. 
D) V2020-V2799.

Question 16

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 17

The National Panel that maintains Level II HCPCS codes includes representatives from:

Accepted Answer

A) the Centers for Medicare and Medicaid Services (CMS). 
B) the Blue Cross/Blue Shield Association. 
C) the Health Insurance Association of America (HIA
A) . 
D) all of the above. 
A) the Centers for Medicare and Medicaid Services (CMS). 
B) the Blue Cross/Blue Shield Association. 
C) the Health Insurance Association of America (HIA
A) . 
D) all of the above.

Question 18

List seven consequences of inaccurate coding and incorrect billing.

Accepted Answer

Consequences include denied claims; dela

Question 19

What questions should a coder ask in checking a claim to make sure it is accurate and ready to submit?

Accepted Answer

Is the coded service billable? Are the c

Question 20

The Compliance Program Guidance suggests that a physician's office implement a plan that includes all of the following EXCEPT:

Accepted Answer

A) conducting internal monitoring and auditing of claims. 
B) developing open lines of communication. 
C) conducting appropriate training and education of staff. 
D) dismissing any employee who fails to understand the compliance plan. 
A) conducting internal monitoring and auditing of claims. 
B) developing open lines of communication. 
C) conducting appropriate training and education of staff. 
D) dismissing any employee who fails to understand the compliance plan.

HCPCS was developed to achieve all of the following goals EXCEPT:

Procedure and diagnostic codes should be appropriate to the patient's:

HCPCS is organized by code number rather than by service or supply name.

How is the GA modifier used?

Which organizations are represented on the HCPCS National Panel?

Individuals suspected of medical fraud and abuse can be investigated and prosecuted by all of the following EXCEPT the:

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

The Current Procedural Terminology codes are considered HCPCS Level __________ codes.

If the coder determines that the code checked off by the physician on the encounter form does NOT match the medical record, the coder should:

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

Code linkage refers to the connection between the:

The federal government will protect and reward people involved in qui tam, or whistle-blower, cases to identify Medicare fraud.

Medicare requires that all physician offices have a seven-part compliance plan in place.

An advisory opinion from the CMS or OIG is considered legal advice on any question regarding healthcare business.

State Medicaid agency codes are reported with what HCPCS code range?

HCPCS Level II national codes consist of:

The National Panel that maintains Level II HCPCS codes includes representatives from:

List seven consequences of inaccurate coding and incorrect billing.

What questions should a coder ask in checking a claim to make sure it is accurate and ready to submit?

The Compliance Program Guidance suggests that a physician's office implement a plan that includes all of the following EXCEPT:

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 was developed to achieve all of the following goals EXCEPT:

Procedure and diagnostic codes should be appropriate to the patient's:

HCPCS is organized by code number rather than by service or supply name.

How is the GA modifier used?

Which organizations are represented on the HCPCS National Panel?

Individuals suspected of medical fraud and abuse can be investigated and prosecuted by all of the following EXCEPT the:

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

The Current Procedural Terminology codes are considered HCPCS Level __________ codes.

If the coder determines that the code checked off by the physician on the encounter form does NOT match the medical record, the coder should:

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

Code linkage refers to the connection between the:

The federal government will protect and reward people involved in qui tam, or whistle-blower, cases to identify Medicare fraud.

Medicare requires that all physician offices have a seven-part compliance plan in place.

An advisory opinion from the CMS or OIG is considered legal advice on any question regarding healthcare business.

State Medicaid agency codes are reported with what HCPCS code range?

HCPCS Level II national codes consist of:

The National Panel that maintains Level II HCPCS codes includes representatives from:

List seven consequences of inaccurate coding and incorrect billing.

What questions should a coder ask in checking a claim to make sure it is accurate and ready to submit?

The Compliance Program Guidance suggests that a physician's office implement a plan that includes all of the following EXCEPT:

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