Legal and Ethical Issues
Insurance and Billing
Diagnostic Coding
Procedural Coding
Patient Collections and Financial Management
100
  • What are the elements of a contract?

✅ Agreement, consideration, legal subject, capacity

100
  • What is Medicaid?

✅ Government insurance for low-income individuals

100
  • What are external cause codes used for?

✅ Identifying injury causes

100
  • What is Block 21 on CMS-1500?

✅ Diagnosis codes

100
  • What is the purpose of establishing collection procedures?

✅ To ensure consistent and legal handling of patient payments

200
  • What is risk management used for?

✅ Preventing malpractice claims

200
  • What does RA stand for?

✅ Remittance Advice

200
  • When are ICD codes updated?

✅ Annually in January

200
  • What does a plus sign in CPT mean?

✅ Add-on code

200
  • What does ECOA stand for?

✅ Equal Credit Opportunity Act

300
  • What does HIPAA stand for?

✅ Health Insurance Portability and Accountability Act

300
  • What does EOP stand for?

✅ Explanation of Payment

300
  • Where is the Alphabetic Index in ICD-10?

✅ At the front of the manual

300
  • Why are add-on codes important?

✅ Show additional procedures

300
  • What does FCRA stand for?

✅ Fair Credit Reporting Act

400
  • What does the FDA regulate?

✅ Drugs, food, and medical devices

400
  • What percentage does Original Medicare pay?

✅ 80%

400
  • What do brackets in ICD-10 mean?

✅ Enclose synonyms or alternate words

400
  • What are E/M codes used for?

✅ Evaluation and management services

400
  • What does TILA (or TLA) stand for?

✅ Truth in Lending Act

500
  • What is expressed consent?

✅ Verbal or written permission

500
  • What percentage does the patient pay under Original Medicare?

✅ 20%

500
  • What does NOS mean?

✅ Not Otherwise Specified

500
  • What does modifier -22 indicate?

✅ Increased procedural services

500
  • What does the Telephone Consumer Protection Act regulate?

✅ Telemarketing and automated calls

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