REVIEW 1
For coding purposes, which of the following is not a level of patient history?
expanded detailed
An example of a Category II code is a code used for __________.
WEIGHT REDUCTION COUNSELING
What symbol appears next to a code that appears out of numerical sequence?
A POUND # SIGN
A medical provider bills separately for a comprehensive metabolic panel and a quantitative glucose test, which is normally included in the metabolic panel. This is an example of which of the following fraudulent coding and billing practices?
Billing separately for services that are bundled in a single procedure code.
Medical offices usually have a(n) __________ to help minimize the risk of fraud by discovering and correcting coding and billing problems.
COMPLIANCE PLAN
The Healthcare Common Procedure Coding System (HCPCS) was originally developed for use in coding services, such as durable medical equipment, for __________.
Medicare patients
The most frequently used CPT codes are the __________.
evaluation and management codes
To ensure reimbursement at the highest allowed level, CPT codes must __________.
include codes and modifiers that reflect the services performed
In ICD-10, in which chapter would a code for an injury diagnosis be found?
CHAPTER 19
In ICD-10, which chapter would include the diagnosis codes for congenital malformations, deformations, and chromosomal abnormalities?
17
All ICD-10 codes begin with a(n) __________ character.
ALPHABETIC
Eight-year-old Geri climbed the oak tree in her back yard to rescue her cat, who had climbed the tree but could not get back down. Unfortunately, Geri slipped and fell out of the tree and hurt her left arm. The lower arm is bent at an odd angle and the radius bone is visible. The physician diagnoses an open fracture and orders X-rays of the lower arm. Where will you locate the ICD-10 code for this?
S00–T88
Jenni is a healthy 24-year-old patient who is in the office today for routine obstetric care. Which chapter of the ICD-10 is used to code for pregnancy, childbirth, and the puerperium?
CHAPTER 15
Which convention is used in ICD-10 to indicate that an entry is not classified as part of the preceding code?
Excludes
Which of the following ICD-10-CM conventions is used in the Tabular List after an incomplete term that needs one of the terms that follow to make it assignable to a given category?
:
Which of the following ICD-10-CM conventions is used around synonyms, alternative wordings, or explanations?
[ ]
If providers submit a claim for a simple procedure when in fact a more complicated procedure was documented in the medical record, __________ may occur.
UNDERPAYMENT
Which of the following must be verbally discussed with a Medicare beneficiary to enable the beneficiary to consider options and make informed choices?
ABN
Which of the following is not part of the process for verifying workers' compensation coverage?
getting the name and policy number of the patient's personal health insurance policy
How should data in medical billing programs be entered?
enter information using capital letters
Which of the following best describes HCPS Level II codes?
The codes have five characters: numbers, letters, or a combination of both.
Nathan is in the medical office today complaining of a sore throat and fever. After ruling out strep throat, the practitioner diagnoses a common cold and tells Nathan to take over-the-counter medications for symptom relief. In which category does Nathan’s chief complaint fall?
self-limited complaint
Using a clearinghouse to transmit electronic media claims __________.
includes data elements that are transmitted in a computer file
One advantage of submitting claims electronically is __________.
electronic submissions are cost-efficient
In which program can enrollees who are aged 65 and older continue to obtain medical services at military hospitals and clinics as they did before they turned 65?
TRICARE FOR LIFE