Question 1

For a presenting problem without an established diagnosis, the clinical impression may be stated as a "possible" or "rule-out" diagnosis.

Accepted Answer

A) True 
 B)False  True

Question 2

In documenting a medical examination, all of the following are recognized body areas EXCEPT the:
A)neck.
B)abdomen.
C)back.
D)skin.

Accepted Answer

skin.

Question 3

If Medicare determines that an evaluation and management (E/M) service exceeds the patient's documented need, Medicare could:
A)unbundle the service.
B)upcode the service.
C)pay the service as billed.
D)deny payment.

Accepted Answer

deny payment.

Question 4

An examination that documents a limited examination of the affected body area or organ system and any other symptomatic or related body areas would be considered a(n):
A)problem-focused exam.
B)expanded problem-focused exam.
C)detailed exam.
D)comprehensive exam.

Accepted Answer

expanded p

Question 5

An independent medical record review completed after payment is received from an insurance carrier is a(n) __________ audit.

Accepted Answer

The answer of An independent medical record review completed after...

Question 6

What are the key components for selecting evaluation and management (E/M) codes?

Accepted Answer

The key components for assigni

Question 7

If a physician documents that an exam included the measurement of a patient's blood pressure, the system examined would be the:
A)cardiovascular system.
B)respiratory system.
C)neurological system.
D)musculoskeletal system.

Accepted Answer

cardiovasc

Question 8

What are the three types of audits?

Accepted Answer

The three types are

Question 9

Which of the following is a disadvantage of a prospective internal audit?
A)It delays insurance payment.
B)It decreases the workload of the medical office specialist.
C)It ensures compliance.
D)It increases the risk of errors.

Accepted Answer

It delays

Question 10

If a physician documents that a patient had breast cancer 4 years ago, he or she would be documenting the patient's __________ history.

Accepted Answer

The answer of If a physician documents that a patient...

Question 11

If a medical office specialist does NOT agree with the payment determination made by an insurance company, the decision can be appealed.

Accepted Answer

A) True 
 B)False

Question 12

A retrospective audit is conducted before sending claims to an insurance company.

Accepted Answer

A) True 
 B)False

Question 13

If a PFSH includes a review of the patient's past, family, and social history, it would be considered:
A)pertinent.
B)complete.
C)comprehensive.
D)detailed.

Accepted Answer

The answer of If a PFSH includes a review of...

Question 14

A review of systems (ROS) is considered part of the physical examination.

Accepted Answer

A) True 
 B)False

Question 15

If documentation in the patient chart supports a lower level of service than that coded, the error would be called:
A)upcoding.
B)downcoding.
C)bundling.
D)unbundling.

Accepted Answer

The answer of If documentation in the patient chart supports...

Question 16

The extent of information that the physician gathers for a medical history is based on rules set up by Medicare.

Accepted Answer

A) True 
 B)False

Question 17

If a patient presents with one self-limited or minor problem, the level of risk involved with the medical decision making would be considered:
A)minimal.
B)low.
C)moderate.
D)high.

Accepted Answer

The answer of If a patient presents with one self-limited...

Question 18

When documentation supports a higher level of service than the code assigned, this practice is known as __________ .

Accepted Answer

The answer of When documentation supports a higher level of...

Question 19

If a patient complains of an aching pain in the chest, the complaint would be considered part of the past, family, and social history (PFSH).

Accepted Answer

A) True 
 B)False

Question 20

The most widely used CPT codes are:
A)evaluation and management (E/M).
B)surgery.
C)radiology.
D)medicine.

Accepted Answer

evaluation

For a presenting problem without an established diagnosis, the clinical impression may be stated as a "possible" or "rule-out" diagnosis.

In documenting a medical examination, all of the following are recognized body areas EXCEPT the: A)neck. B)abdomen. C)back. D)skin.

If Medicare determines that an evaluation and management (E/M) service exceeds the patient's documented need, Medicare could: A)unbundle the service. B)upcode the service. C)pay the service as billed. D)deny payment.

An examination that documents a limited examination of the affected body area or organ system and any other symptomatic or related body areas would be considered a(n): A)problem-focused exam. B)expanded problem-focused exam. C)detailed exam. D)comprehensive exam.

An independent medical record review completed after payment is received from an insurance carrier is a(n) __________ audit.

What are the key components for selecting evaluation and management (E/M) codes?

If a physician documents that an exam included the measurement of a patient's blood pressure, the system examined would be the: A)cardiovascular system. B)respiratory system. C)neurological system. D)musculoskeletal system.

What are the three types of audits?

Which of the following is a disadvantage of a prospective internal audit? A)It delays insurance payment. B)It decreases the workload of the medical office specialist. C)It ensures compliance. D)It increases the risk of errors.

If a physician documents that a patient had breast cancer 4 years ago, he or she would be documenting the patient's __________ history.

If a medical office specialist does NOT agree with the payment determination made by an insurance company, the decision can be appealed.

A retrospective audit is conducted before sending claims to an insurance company.

If a PFSH includes a review of the patient's past, family, and social history, it would be considered: A)pertinent. B)complete. C)comprehensive. D)detailed.

A review of systems (ROS) is considered part of the physical examination.

If documentation in the patient chart supports a lower level of service than that coded, the error would be called: A)upcoding. B)downcoding. C)bundling. D)unbundling.

The extent of information that the physician gathers for a medical history is based on rules set up by Medicare.

If a patient presents with one self-limited or minor problem, the level of risk involved with the medical decision making would be considered: A)minimal. B)low. C)moderate. D)high.

When documentation supports a higher level of service than the code assigned, this practice is known as __________ .

If a patient complains of an aching pain in the chest, the complaint would be considered part of the past, family, and social history (PFSH).

The most widely used CPT codes are: A)evaluation and management (E/M). B)surgery. C)radiology. D)medicine.

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

Hcpcs and Coding Compliance

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 10: Auditing

For a presenting problem without an established diagnosis, the clinical impression may be stated as a "possible" or "rule-out" diagnosis.

In documenting a medical examination, all of the following are recognized body areas EXCEPT the: A)neck. B)abdomen. C)back. D)skin.

If Medicare determines that an evaluation and management (E/M) service exceeds the patient's documented need, Medicare could: A)unbundle the service. B)upcode the service. C)pay the service as billed. D)deny payment.

An examination that documents a limited examination of the affected body area or organ system and any other symptomatic or related body areas would be considered a(n): A)problem-focused exam. B)expanded problem-focused exam. C)detailed exam. D)comprehensive exam.

An independent medical record review completed after payment is received from an insurance carrier is a(n) __________ audit.

What are the key components for selecting evaluation and management (E/M) codes?

If a physician documents that an exam included the measurement of a patient's blood pressure, the system examined would be the: A)cardiovascular system. B)respiratory system. C)neurological system. D)musculoskeletal system.

What are the three types of audits?

Which of the following is a disadvantage of a prospective internal audit? A)It delays insurance payment. B)It decreases the workload of the medical office specialist. C)It ensures compliance. D)It increases the risk of errors.

If a physician documents that a patient had breast cancer 4 years ago, he or she would be documenting the patient's __________ history.

If a medical office specialist does NOT agree with the payment determination made by an insurance company, the decision can be appealed.

A retrospective audit is conducted before sending claims to an insurance company.

If a PFSH includes a review of the patient's past, family, and social history, it would be considered: A)pertinent. B)complete. C)comprehensive. D)detailed.

A review of systems (ROS) is considered part of the physical examination.

If documentation in the patient chart supports a lower level of service than that coded, the error would be called: A)upcoding. B)downcoding. C)bundling. D)unbundling.

The extent of information that the physician gathers for a medical history is based on rules set up by Medicare.

If a patient presents with one self-limited or minor problem, the level of risk involved with the medical decision making would be considered: A)minimal. B)low. C)moderate. D)high.

When documentation supports a higher level of service than the code assigned, this practice is known as __________ .

If a patient complains of an aching pain in the chest, the complaint would be considered part of the past, family, and social history (PFSH).

The most widely used CPT codes are: A)evaluation and management (E/M). B)surgery. C)radiology. D)medicine.

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

Hcpcs and Coding Compliance

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