Which of the following sections of the medical record is used to determine the correct evaluation and
management code used for billing and coding? - Answer -history and physical
A billing and coding specialist is reviewing a CMS-1500 claim form. The "assignment of benefits" box has
been checked "yes." The checked box indicates which of the following? - Answer -The provider receives
payment directly from the payer
Which of the following do physicians use to electronically submit a claim? - Answer -Clearinghouse
Which of the following should the billing and coding specialist include in an authorization to release
information? - Answer -The entity to whom the information is to be released
Which of the following describes the content of a medical practice aging report? - Answer -An overview
of the practice's outstanding claims
HIPAA transaction standards apply to which of the following entities? - Answer -Health care
clearinghouses
When a physician documents a patient's response to symptoms and various body systems, the results
are documented as which of the following? - Answer -Review of systems
Which part of Medicare covers prescriptions? - Answer -Part D
,Which of the following indicates a claim should be submitted on paper instead of electronically? -
Answer -The claim requires an attachment
Medicare enforces mandatory submission of electronic claims for most providers. Which of the
following providers is allowed to submit paper claims to Medicare? - Answer -A provider's office with
fewer than 10 full-time employees
Which of the following is the correct term for an amount that has been determined to be uncollectible?
- Answer -Bad debt
Which of the following statements are correct regarding a deductible? - Answer -The deductible is the
patient's responsibility
Which of the following statements is true regarding the release of patient records? - Answer -Patient
access to psychotherapy notes may be restricted
Why does correct claim processing rely on accurately completed encounter forms? - Answer -They
streamline patient billing by summarizing the services rendered for a given date of service
When posting payment accurately. Which of the following items should the billing and coding specialist
include? - Answer -Patient's responsibility
A dependent child whose parents both have insurance coverage come to the clinic. The billing and
coding specialist uses the birthday rule determine which insurance policy is primary. Which of the
following describes the birthday rule? - Answer -The patient whose birthday comes first in the calendar
year
Which of the following actions should the billing and coding specialist take to effectively manage
accounts receivable? - Answer -Collect copayment from the patient at the time of service
If a patient has osteomyelitis, he has problems with which of the following areas? - Answer -bones, bone
marrow
, Which of the following are used by providers to remove errors from claims before they are submitted to
third-party payers? - Answer -Clearinghouse
A provider receives a reimbursement from a third-party payer accompanied by which of the following
documents? - Answer -explanation of benefits
Which of the following is the appropriate diagnosis for a patient who has an abnormal accumulation of
fluid in her lower leg that has resulted in swelling? - Answer -Edema
Which of the following blocks on the CMS-1500 claim form is used to bill ICD codes? - Answer -Block 21
Patient charges that have not been paid to appear in which of the following? - Answer -Accounts
receivable
A physician is contracted with an insurance company to accept the allowed amount. The insurance
company allows $80 of a $120 billed amount, And $50 of the deductible has not been met. How much
should the physician write off the patient's record? - Answer -$40
This is the difference between the amount billed and allowed amount. The physician should write off
$40.
A provider performs an examination of a patient sore throat during an office visit. Which of the following
describes the level of the examination? - Answer -Problem-focused examination
When building a secondary insurance company, which block should be billing and coding specialist fill
out on the CMS-1500 claim form? - Answer -9a
Which of the following forms must be patient or representative sign to allow the release of protected
health information? - Answer -An Authorization
What is the maximum number of ICD codes that can be entered on a CMS-1500 claim form as of
February 2012? - Answer -12
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