Exam (elaborations)
MEDICAL CODING MIDTERM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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MEDICAL CODING MIDTERM QUESTIONS AND ANSWERS WITH SOLUTIONS 2024
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MEDICAL CODING MIDTERMQUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
A major change took place in Medicare in ____ with the enactment of the Omnibus Budget
Reconciliation Act. - ANSWER 1989
CMS - ANSWER Centers for Medicare and Medicaid Services
CMS handles the daily operation of the Medicare program through the use of ____ ____ ____, formerly
Fiscal Intermediaries. - ANSWER Medicare Administrative Contractors
DHHS - ANSWER Department of Health and Human Services
For endoscopic procedures Medicare allows the full value of the highest valued endoscopy, plus the
difference between the next highest endoscopy and the ____________________ endoscopy. - ANSWER
Highest
Fraud is an intentional deception or misrepresentation that an individual knows to be false or does not
believe to be true and makes knowing that the deception could result in some unauthorized benefit to
himself/herself or some other person. T/F - ANSWER True
If a QIO provider renders a covered service that costs $100 and bills Medicare for the service and
Medicare allowed $58, the provider would bill this amount to the patient. - ANSWER $0
If a surgeon performs more than one procedure on the same patient on the same day, and discounts
were made on all subsequent procedures, Medicare would pay what percentages for the first, second,
third, fourth, and fifth procedures? - ANSWER 100%, 50%, 50%, 50%, 50%
In the role as a medical coder, it is your responsibility to ensure that you code ____________________
and ____________________ to optimize reimbursement for services provided. (Separate your answers
with a comma and a space.) - ANSWER accurately, completely
, Kickbacks from patients are allowed under certain circumstances according to Medicare guidelines. T/F -
ANSWER False
List the three components of the relative value unit. - ANSWER 1. Work
2. Overhead
3. Malpractice
List the three goals of the Physician Payment Reform. - ANSWER 1. Decrease Medicare expenditures
2. Redistribute physicians' payments more equitably
3. Ensure quality health care at a reasonable rate
List the three types of persons eligible for Medicare. - ANSWER 1. People 65 or older
2. People who are eligible for disability benefits from Social Security
3. Patients experiencing end-stage renal disease
MAAC - ANSWER Maximum Actual Allowable Charge
Match the Medicare part(s) with the coverage.
Part A, Part A, Part C, or Part D
1) Hospice care
2) Prescription drug
3) Physician visits
4) Automatic coverage when age 65 - ANSWER 1) Part A
2) Part D
3) Part B
4) Part A
Medicare Part A pays for - ANSWER hospital/facility care
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