Exam (elaborations)
Medical Coding Certification Exam Preparation 2nd Edition By Stewart - Exam Bank
- Course
- Institution
Medical Coding Certification Exam Preparation 2nd Edition By Stewart - Exam Bank
[Show more]
Seller
Follow
evileye251
Reviews received
Content preview
,Medical Coding, 2e (Stewart)Chapter 1 The Certified Professional Coder
1) A clean claim:
A) Guarantees the provider will receive payment
B) Slows the reimbursement process
C) Results in accurate and timely reimbursement
D) Releases the payer from the contractual adjudication time frame
Answer: C
Explanation: A clean claim results in accurate and timely reimbursement for services provided
to the patient and the resources used to provide those services.
Difficulty: 1 Easy
Topic: The CPCs Role in Reimbursement and Compliance
Learning Objective: 01.02 Determine the many roles a coder plays in the reimbursement and
compliance process.
Bloom's: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system; IX.C.2
Describe how to use the most current diagnostic coding classification system
ABHES: 7.d Process insurance claims
2) Accounts receivable, denials, and modifiers are examples of ________ language.
A) Provider
B) Payer
C) Compliance
D) Billing
Answer: D
Explanation: Billing language includes terms such as accounts receivable (A/R), clean claims,
denials, modifiers, and advanced beneficiary notices (ABNs).
Difficulty: 1 Easy
Topic: Differentiation of Various Languages In Medical Coding
Learning Objective: 01.01 Differentiate between the various languages used in medical coding.
Bloom's: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system; IX.C.2
Describe how to use the most current diagnostic coding classification system; VII.C.1 Define the
following bookkeeping terms; VII.C.1.c accounts receivable; VII.C.1.a. charges; VII.C.1.b.
payments; VII.C.1.d. accounts payable; VII.C.1.e. adjustments
ABHES: 7.d Process insurance claims
1
Copyright 2019 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
,3) Compliance language includes:
A) Services, procedures, and medical terminology
B) Unbundling, fraud, and abuse
C) Noncovered services, medical necessity, and unbundling
D) Denials, modifiers, and advanced beneficiary notices
Answer: B
Explanation: Compliance language brings terms such as unbundling, fraud, false claim, and
abuse into the translation.
Difficulty: 1 Easy
Topic: Differentiation of Various Languages In Medical Coding
Learning Objective: 01.01 Differentiate between the various languages used in medical coding.
Bloom's: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system; IX.C.2
Describe how to use the most current diagnostic coding classification system; VII.C.1 Define the
following bookkeeping terms; VII.C.1.c accounts receivable; VII.C.1.a. charges; VII.C.1.b.
payments; VII.C.1.d. accounts payable; VII.C.1.e. adjustments
ABHES: 7.d Process insurance claims
4) An ICD-10-CM (tenth revision) code represents:
A) the demographics
B) the procedure
C) the service
D) the diagnosis
Answer: D
Explanation: The appropriate ICD-10 (tenth revision) code for the diagnosis or condition must
be linked to the appropriate service or procedure provided.
Difficulty: 1 Easy
Topic: The CPCs Role in Reimbursement and Compliance
Learning Objective: 01.02 Determine the many roles a coder plays in the reimbursement and
compliance process.
Bloom's: Remember
CAAHEP: IX.C.2 Describe how to use the most current diagnostic coding classification system
ABHES: 7.d Process insurance claims
2
Copyright 2019 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
, 5) The following coding habit would be most likely to trigger a payer audit:
A) Consistently billing the same, low level E/M service code
B) Billing an even distribution of low and high level E/M service codes
C) Consistently billing the same, high level E/M service code
D) Consistently billing the same, low level E/M service code and consistently billing the same,
high level E/M service code
Answer: D
Explanation: Consistent use of the same level of evaluation and management codes are some of
the areas being audited.
Difficulty: 2 Medium
Topic: Medical Coding Credentials and the AAPC
Learning Objective: 01.03 Recognize the benefits of obtaining medical coding credentials and
the importance of AAPC to the medical coder.
Bloom's: Understand
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
ABHES: 7.d Process insurance claims
6) The acronym AAPC stands for:
A) American Academy of Professional Coders
B) Academy of American Physician Coders
C) American Academy of Physician Coders
D) Academy of Auditors and Physician Coders
Answer: A
Explanation: The American Academy of Professional Coders (AAPC) is a credentialing
organization of more than 100,000 members.
Difficulty: 1 Easy
Topic: Medical Coding Credentials and the AAPC
Learning Objective: 01.03 Recognize the benefits of obtaining medical coding credentials and
the importance of AAPC to the medical coder.
Bloom's: Remember
CAAHEP: X.C.5 Discuss licensure and certification as they apply to healthcare providers
ABHES: 1.b Compare and contrast the allied health professions and understand their relation to
medical assisting
3
Copyright 2019 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller evileye251. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $26.73. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75759 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now