Question 1

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 2

Durable medical eDurable medical equipment (DME) is billed using Levelquipment (DME) is billed using Level __________ HCPCS codes.

Accepted Answer

The answer of Durable medical eDurable medical equipment (DME) is...

Question 3

Inaccurate coding and incorrect billing can result in:

Accepted Answer

A) delays in receiving payments. 
B) prison sentences. 
C) loss of the provider's license to practice medicine. 
D) all of the above. 
A) delays in receiving payments. 
B) prison sentences. 
C) loss of the provider's license to practice medicine. 
D) all of the above.

Question 4

The written notification that must be signed by a patient with Medicare coverage to acknowledge that he or she understands that a service may NOT be considered medically necessary and therefore may not be paid by Medicare is a(n):

Accepted Answer

A) advance beneficiary notice. 
B) medical necessary authorization. 
C) denial of payment notice. 
D) liability for potential payment notice. 
A) advance beneficiary notice. 
B) medical necessary authorization. 
C) denial of payment notice. 
D) liability for potential payment notice.

Question 5

What are four benefits of a compliance plan?

Accepted Answer

Benefits are speeding and optimizing pro

Question 6

The legislation that prohibits submitting a fraudulent claim or making a false statement in connection with a claim is called the:

Accepted Answer

A) Health Insurance Portability and Accountability Act. 
B) Social Security Act. 
C) Federal Civil False Claims Act. 
D) American Civil Liberties Act. 
A) Health Insurance Portability and Accountability Act. 
B) Social Security Act. 
C) Federal Civil False Claims Act. 
D) American Civil Liberties Act.

Question 7

The HCPCS modifier GA indicates:

Accepted Answer

A) a waiver of liability statement is on file. 
B) an advance beneficiary notice has been signed by the patient. 
C) the procedure billed may be denied by Medicare as "not medically necessary." 
D) all of the above. 
A) a waiver of liability statement is on file. 
B) an advance beneficiary notice has been signed by the patient. 
C) the procedure billed may be denied by Medicare as "not medically necessary." 
D) all of the above.

Question 8

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.

Question 9

HCPCS is the acronym for Healthcare Coding Procedures in a Common System.

Accepted Answer

A) True 
 B)False

Question 10

What are the levels of HCPCS codes?

Accepted Answer

Level I-CPT codes an

Question 11

HCPCS Level II codes are updated annually by the:

Accepted Answer

A) Centers for Medicare and Medicaid Services (CMS). 
B) American Dental Association (AD
A) . 
C) American Medical Association (AM
A) . 
D) World Health Organization (WHO). 
A) Centers for Medicare and Medicaid Services (CMS). 
B) American Dental Association (AD
A) . 
C) American Medical Association (AM
A) . 
D) World Health Organization (WHO).

Question 12

Which type of coding error involves reporting items or services that are NOT documented in the medical record?

Accepted Answer

A) Unbundling 
B) Reporting services provided by unlicensed or unqualified personnel 
C) Assumption coding 
D) Upcoding 
A) Unbundling 
B) Reporting services provided by unlicensed or unqualified personnel 
C) Assumption coding 
D) Upcoding

Question 13

Inaccurate coding and incorrect billing could result in fines and other sanctions.

Accepted Answer

A) True 
 B)False

Question 14

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 15

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

Accepted Answer

A) True 
 B)False

Question 16

For Medicare patients, to indicate that a procedure was performed on the left side of the body, the modifier LT should be used.

Accepted Answer

A) True 
 B)False

Question 17

Codes for drugs administered other than by oral method would be found in HCPCS Level II.

Accepted Answer

A) True 
 B)False

Question 18

Benefits of a voluntary compliance plan include:

Accepted Answer

A) minimizing billing mistakes. 
B) reducing the chances that an audit will be conducted by the CMS or OIG. 
C) avoiding conflicts with the self-referral and anti-kickback statutes. 
D) all of the above. 
A) minimizing billing mistakes. 
B) reducing the chances that an audit will be conducted by the CMS or OIG. 
C) avoiding conflicts with the self-referral and anti-kickback statutes. 
D) all of the above.

Question 19

Coding __________ is part of the overall effort of medical practices and facilities to comply with regulations, including those related to the confidentiality of patients' personal and health information.

Accepted Answer

The answer of Coding __________ is part of the overall...

Question 20

A compliance plan for a physician's office is:

Accepted Answer

A) not mandatory but suggested. 
B) now mandatory. 
C) required by 2015. 
D) not necessary or practical. 
A) not mandatory but suggested. 
B) now mandatory. 
C) required by 2015. 
D) not necessary or practical.

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

Durable medical eDurable medical equipment (DME) is billed using Levelquipment (DME) is billed using Level __________ HCPCS codes.

Inaccurate coding and incorrect billing can result in:

The written notification that must be signed by a patient with Medicare coverage to acknowledge that he or she understands that a service may NOT be considered medically necessary and therefore may not be paid by Medicare is a(n):

What are four benefits of a compliance plan?

The legislation that prohibits submitting a fraudulent claim or making a false statement in connection with a claim is called the:

The HCPCS modifier GA indicates:

HCPCS is the acronym for the:

HCPCS is the acronym for Healthcare Coding Procedures in a Common System.

What are the levels of HCPCS codes?

HCPCS Level II codes are updated annually by the:

Which type of coding error involves reporting items or services that are NOT documented in the medical record?

Inaccurate coding and incorrect billing could result in fines and other sanctions.

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

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

For Medicare patients, to indicate that a procedure was performed on the left side of the body, the modifier LT should be used.

Codes for drugs administered other than by oral method would be found in HCPCS Level II.

Benefits of a voluntary compliance plan include:

Coding __________ is part of the overall effort of medical practices and facilities to comply with regulations, including those related to the confidentiality of patients' personal and health information.

A compliance plan for a physician's office is:

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

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

Durable medical eDurable medical equipment (DME) is billed using Levelquipment (DME) is billed using Level __________ HCPCS codes.

Inaccurate coding and incorrect billing can result in:

The written notification that must be signed by a patient with Medicare coverage to acknowledge that he or she understands that a service may NOT be considered medically necessary and therefore may not be paid by Medicare is a(n):

What are four benefits of a compliance plan?

The legislation that prohibits submitting a fraudulent claim or making a false statement in connection with a claim is called the:

The HCPCS modifier GA indicates:

HCPCS is the acronym for the:

HCPCS is the acronym for Healthcare Coding Procedures in a Common System.

What are the levels of HCPCS codes?

HCPCS Level II codes are updated annually by the:

Which type of coding error involves reporting items or services that are NOT documented in the medical record?

Inaccurate coding and incorrect billing could result in fines and other sanctions.

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

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

For Medicare patients, to indicate that a procedure was performed on the left side of the body, the modifier LT should be used.

Codes for drugs administered other than by oral method would be found in HCPCS Level II.

Benefits of a voluntary compliance plan include:

Coding __________ is part of the overall effort of medical practices and facilities to comply with regulations, including those related to the confidentiality of patients' personal and health information.

A compliance plan for a physician's office is:

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