1
What is necessary in order to authorize release of medical information to an insurance carrier?
A medical release from the patient is needed.
A handshake between the patient and the doctor is all that is necessary.
Physicians never have to share medical information.
A verbal agreement between the patient and the doctor is necessary.
Authorization is never required to release medical information.
A medical release from the patient is needed.
Which of the following are codes applied to an injury or poisoning?
S00-T88
V codes
P00-P96
Modifiers
S00-T88
Which of the following is NOT a section of the CPT coding system?
Psychiatry
Evaluation and Management
Anesthesiology
Medicine
Psychiatry
Patrick fell from a tree, hurt his arm, and his face was cut. His mother took him to the physician’s office where a greenstick fracture of the wrist was put in a splint. A laceration was repaired on his cheek. He was given a tetanus injection.
How many diagnosis codes will the preceding scenario require?
Five
Three
Four
Two
One
Three
Which of the following is a convention used when there is not enough information to find a more specific code?
NOS
V codes
NEC
E codes
NEC
Which of the following is the claim form used for filing inpatient admissions claims?
CMS 1500
CMS 1490
HCFA 1500
UB-04
UB-04
Which of the following is completed using data from the patient’s electronic health record in most offices today?
CMS 1490
CMS 1500
UB92
HCFA form
CMS 1500
How many procedure codes would apply to the preceding scenario?
Five
Three
Four
Two
One
Three
Which of the following applies to codes used as supplements to the basic CPT system and are required when reporting services and procedures to Medicare patients?
DRGs
E&M codes
M codes
HCPCS
HCPCS
Who is responsible for maintaining the procedure codes for the ICD-10-CM?
CMS
AMA
FDA
WHO
CMS
Which of the following is NOT included in the insurance carrier’s role?
Ensure that amounts meet usual and customary standards.
Ensure that the provider has a contract with the carrier.
Collect a co-payment from the physician.
Ensure that coverage was in force at the time of treatment.
Check to see that there are no pre-existing condition restrictions.
Collect a co-payment from the physician
Which of the following is a record of claims sent to the insurance carrier?
Explanation of benefits
Universal claim form
Point-of-service device
Claims register
Claims register
The HCPCS code range for mental health services is:
M codes
D codes
P2028-P9615
H0001-H2037
H0001-H2037
The new CMS-1500 form is distinguishable from the old form in that the 1500 symbol and date are located where?
Top left margin
Bottom left margin
Bottom right margin
Top right margin
Top left margin
Which of the following best describes the purpose of a physician’s fee profile?
To prevent downcoding
To reflect charges for services and reimbursement rates
To subrogate monies
To analyze office fees
To reflect charges for services and reimbursement rates
Separating the components of a procedure and reporting them as billable codes with charges in order to increase reimbursement rates is known as what?
Bundling
Upcoding
Downcoding
Unbundling
Unbundling
Why is it important for the medical assistant to understand medical insurance coding?
Needed to transfer all information
Serves as basis for the information on the claim form
Helps the patient file claims
Assists explanations to patients
Serves as basis for the information on the claim form
Which of the following is NOT affected by coding accuracy?
Medical records
Ruling out a diagnosis
Physician reimbursement
Resubmissions
Resubmissions
Which section of the CPT book includes coding of lacerations?
Pathology
Medicine
Laboratory
Surgery
Surgery
On completion of the processing of the claim, the insurance company sends what to the insured person?
1490 form
EOB
Claim remittance
POS
EOB
Which of the following information is NOT included in coding?
Diagnosis for visit
Counseling
Specific procedures
Visit complexity
Counseling
Which of the following is NOT included in the recommended procedure for researching CPT code numbers using the index?
Find a suggested number or range of numbers.
Choose the correct code number for description.
Search for the service or procedure in the alphabetic index.
Search for the suggested number range in the tabular list.
Choose a modifier for all diagnoses and procedures.
Choose a modifier for all diagnoses and procedures
The ICD-10-PCS codes have how many alphanumeric characters?
4
7
9
3
7
Which of the following applies to the coding book used for specifying services and procedures performed in the medical office?
CPT
RBRVS
ICD-9-CM
EOB
CPT
Which of the following should be used to check for patient eligibility?
Point-of-service device
Universal claim form
Explanation of benefits
Claims register
Point-of-service device