Question 1

In order for a medical practice to demonstrate that it is making good-faith efforts to prevent fraud and abuse, it should develop a(n) __________ plan.

Accepted Answer

The answer of In order for a medical practice to...

Question 2

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 3

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 4

Services can be denied for all of the following reasons EXCEPT when:

Accepted Answer

A) the patient has a physical examination within 6 months of becoming a Medicare Part B subscriber. 
B) the procedure is considered experimental. 
C) there is a cap on the number of services allowed. 
D) the service was not performed at an appropriate location. 
A) the patient has a physical examination within 6 months of becoming a Medicare Part B subscriber. 
B) the procedure is considered experimental. 
C) there is a cap on the number of services allowed. 
D) the service was not performed at an appropriate location.

Question 5

HCPCS Level I codes were developed 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 6

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 7

HCPCS modifiers are required on all health insurance forms filed for private insurance patients.

Accepted Answer

A) True 
 B)False

Question 8

The types of edits for National Correct Coding Initiative (NCCI) errors include all of the following EXCEPT:

Accepted Answer

A) modifier indicators. 
B) diagnostic and procedure code linkages. 
C) mutually exclusive edits. 
D) comprehensive versus component edits. 
A) modifier indicators. 
B) diagnostic and procedure code linkages. 
C) mutually exclusive edits. 
D) comprehensive versus component edits.

Question 9

Each year a specific area of billing is audited for billing and coding accuracy by the Office of __________ .

Accepted Answer

The answer of Each year a specific area of billing...

Question 10

To bill for a procedure that was NOT performed is considered:

Accepted Answer

A) fraud. 
B) abuse. 
C) unbundling. 
D) upcoding. 
A) fraud. 
B) abuse. 
C) unbundling. 
D) upcoding.

Question 11

When the services of two codes could NOT have both been reasonably done in a single encounter, the codes are considered __________ .

Accepted Answer

The answer of When the services of two codes could...

In order for a medical practice to demonstrate that it is making good-faith efforts to prevent fraud and abuse, it should develop a(n) __________ plan.

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

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

Services can be denied for all of the following reasons EXCEPT when:

HCPCS Level I codes were developed by the:

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

HCPCS modifiers are required on all health insurance forms filed for private insurance patients.

The types of edits for National Correct Coding Initiative (NCCI) errors include all of the following EXCEPT:

Each year a specific area of billing is audited for billing and coding accuracy by the Office of __________ .

To bill for a procedure that was NOT performed is considered:

When the services of two codes could NOT have both been reasonably done in a single encounter, the codes are considered __________ .

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

In order for a medical practice to demonstrate that it is making good-faith efforts to prevent fraud and abuse, it should develop a(n) __________ plan.

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

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

Services can be denied for all of the following reasons EXCEPT when:

HCPCS Level I codes were developed by the:

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

HCPCS modifiers are required on all health insurance forms filed for private insurance patients.

The types of edits for National Correct Coding Initiative (NCCI) errors include all of the following EXCEPT:

Each year a specific area of billing is audited for billing and coding accuracy by the Office of __________ .

To bill for a procedure that was NOT performed is considered:

When the services of two codes could NOT have both been reasonably done in a single encounter, the codes are considered __________ .

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