CBCS NHA Prep Exam Questions And Answers

CBCS NHA Prep Exam Questions And Answers abuse - ANSWER- charging excessively for services and supplies subscriber, member, policyholder - ANSWER- in health insurance, the insured is known as also patient information form - ANSWER- the first document obtained in the initial patient visit superbill - ANSWER- the source document for insurance claim data supporting documentation in the electronic health record - ANSWER- the key to substantiating procedure and diagnostic code selections for proper reimbursement right lower quadrant - ANSWER- parts of the small and large intestines, right ovary, right uterine tube, appendix, and right ureter x character - ANSWER- a placeholder for future code expansion in the ICD-10-CM Table of Drugs and Chemicals - ANSWER- table that contains a classification of substances for identifying poisoning states and external causes of adverse effects Annually - ANSWER- the CPT publication is updated and revised optical scanning - ANSWER- in 2012 the CMS-1500 claim form was revised to version 02-12 to accommodate leave the space blank - ANSWER- when completing a claim form, is any question is unanswerable consecutive, uses the same procedure code, and results in the same fee. - ANSWER- office visits may be grouped on the insurance claim form if each visit 2 weeks or less - ANSWER- usually paid insurance claims transmitted electronically ICD-10-CM/PCS codes - ANSWER- ASC X12 Version 5010 allows providers to submit claims Denied - ANSWER- an insurance claim for which prior approval was not obtained would be appeal the decision with a statement from the physician - ANSWER- should be done if an insurance claim denial is received because a billed service was not a program benefit redetermination - ANSWER- the first level of appeal in the Medicare program Tertiary care - ANSWER- referral of a patient recommended by one specialist to another specialist Diagnostic tests - ANSWER- part B of Medicare covers 1 year at a time - ANSWER- enrollment in TRICARE prime is within 1 year from the date - ANSWER- The time limit within which a TRICARE outpatient claim from which a service is provided occupational illness - ANSWER- an abnormal condition caused by exposure to environmental factors associated with employment Medicaid - ANSWER- Health insurance for low income Medicare - ANSWER- Health insurance for elderly over 65 Primary diagnosis - ANSWER- the diagnosis listed first in submitting insurance claims for patients seen in a physician's office is the Disease and injury - ANSWER- In locating a diagnosis, look up the main term, which is the nonessential modifiers - ANSWER- terms enclosed in parentheses following the main term are referred to as uncertain behavior - ANSWER- for a tumor that has not been diagnosed as benign or malignant by the pathologist, use the codes in the column labeled: when a definitive diagnosis has not been established - ANSWER- codes that describe symptoms and signs are acceptable for reporting purposes to show cause of injury - ANSWER- external cause codes are used they can be reported as stand-alone codes - ANSWER- all of the following are correct regarding add-on codes except pre-existing condition - ANSWER- an illness or condition present before insurance coverage begins Medicaid - ANSWER- insurance policy is never primary when the insured has more than one policy Triangle in front of a code in the updated CPT manual - ANSWER- the description for the code has been changed CPT coding system - ANSWER- service & procedure based durable medical equipment - ANSWER- a respirator used by a medicare patient; example medical ethics - ANSWER- standards of conduct correct an error on a patient's medical record - ANSWER- to cross out the incorrect data with a single line and write in the correct information followed by initials and date Cardiomegaly - ANSWER- enlargement of the heart 282.60 - ANSWER- following example of a SUBCLASSIFICATION code in the ICD-9-CM -58 - ANSWER- staged or related procedure or service by the same physician during the postoperative period Itemized statement - ANSWER- document that contains dates of service, list of detailed charges, co-payments and deductibles paid, date insurance was filed, adjustments and account balances ICD-9-CM - ANSWER- international Classification of Diseases, 9th revision, Clinical Modification 3 years - ANSWER- an established patient is defined as one who has received professional services from the physician of another physician of the same specialty in the same group within the past ______ years