NHA - Certified Billing and Coding
Specialist (CBCS) Study Guide
The symbol "O" within the Current Procedural Terminology reference is used to indicate
what? - ANSReinstated or recycled code
In the anesthesia segment of the CPT guide, what are taken into consideration qualifying
circumstances? - ANSAdd-on codes
As of April 1, 2014 what's the most variety of diagnoses that may be suggested at the
CMS-1500 declare shape earlier than a in addition declare is needed? - ANS12
What is considered right supportive documentation for reporting CPT and ICD codes for
surgical approaches? - ANSOperative document
What motion have to be taken first whilst reviewing a antisocial declare? - ANSVerify the age
of the account
A claim can be denied or rejected for which of the following motives? - ANSBlock 24D
carries the diagnosis code
A coroner's autopsy is produced from what examinations? - ANSGross Examination
Medigap insurance is obtainable to Medicare beneficiaries by using whom? - ANSPrivate
1/3-birthday celebration payers
What a part of Medicare covers prescriptions? - ANSPart C
What plane divides the body into left and proper? - ANSSagittal
Where can unlisted codes be discovered in the CPT guide? - ANSGuidelines prior to each
section
Ambulatory surgical procedure centers, home health care, and hospice groups use which
form to post claims? - ANSUB-04 Claim Form
What coloration layout is suitable at the CMS-1500 declare shape? - ANSRed
Who is accountable to pay the deductible? - ANSPatient
A affected person's fitness plan is called the "payer of ultimate lodge." What is the name of
that fitness plan? - ANSMedicaid
, Informed Consent - ANSProviders give an explanation for clinical or diagnostic tactics,
surgical interventions, and the blessings and risks involved, giving patients an opportunity to
ask questions earlier than scientific intervention is supplied.
Implied Consent - ANSA patient affords for remedy, including extending an arm to permit a
venipuncture to be carried out.
Clearinghouse - ANSAgency that converts claims into standardized digital layout, looks for
mistakes, and codecs them according to HIPAA and insurance requirements.
Individually Identifiable - ANSDocuments that identify the character or provide sufficient facts
so that the man or woman can be diagnosed.
De-diagnosed Information - ANSInformation that doesn't pick out an man or woman because
precise and personal characteristics had been removed.
Consent - ANSA patient's permission evidenced via signature.
Authorizations - ANSPermission granted by the affected person or the affected person's
consultant to launch statistics for motives other than remedy, payment, or health care
operations.
Reimbursement - ANSPayment for offerings rendered from a third-birthday celebration
payer.
Auditing - ANSReview of claims for accuracy and completeness.
Fraud - ANSMaking false statements of representations of cloth records to gain a few gain or
charge for which no entitlement might in any other case exist.
Upcoding - ANSAssigning a diagnosis or system code at a higher degree than the
documentation helps, such as coding bronchitis as pneumonia.
Unbundling - ANSUsing multiple codes that describe distinct additives of a remedy as
opposed to the usage of a single code that describes all steps of the method.
Abuse - ANSPractices that at once or circuitously result in pointless costs to the Medicare
program.
Business Associate (BA) - ANSIndividuals, organizations, or companies who aren't members
of a protected entity's staff that perform features or activities on behalf of or for a included
entity.
What is the main process of the Office of the Inspector General (OIG)? - ANSThe OIG
protects Medicare and other HHS packages from fraud and abuse with the aid of carrying
out audits, investigations , and inspections.
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