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Answer-Integrated Exam HMAP 163 Midterm 2024/2025 CA$19.17
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Answer-Integrated Exam HMAP 163 Midterm 2024/2025

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Form used to withhold federal taxes Answer: W-4 Form New patient Answer: One who has not received face-to-face services within last 3 years. Importance of pre certification, pre authorization, pre determine Answer: Make sure we can file a claim and the physician receiv...

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  • August 28, 2024
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  • 2024/2025
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Answer-Integrated Exam HMAP 163
Midterm 2024/2025

Form used to withhold federal taxes Answer: W-4 Form



New patient Answer: One who has not received face-to-face services within last 3 years.



Importance of pre certification, pre authorization, pre determine Answer: Make sure we can file a
claim and the physician receives payment.



established patient Answer: One who has received face-to-face services within the last 3 years



HIPAA to coding Answer: establishes guidelines to protect patient information



Insurance fraud examples Answer: upcoding, downcoding, unbundling



Methods to file a claim Answer: Mail or electronic



CPT Answer: Current Procedural Terminology



What is the ICD - 10 book for? Answer: Coding diagnosis



What is the CPT book for? Answer: Coding procedures



What are 2 things needed for E/M? Answer: time and medical decision making

, ICD-10-CM Answer: International Classification of Diseases, 10th Revision, Clinical Modification



Memorize an E/M code Answer: 99222



Memorize a CPT code Answer: 11055



Memorize a ICD code Answer: J45.901



Memorize a modifier Answer: -50



Not Elsewhere Classifiable (NEC) Answer: Physician documented specific information which there is
no code specific for



Not Otherwise Specified (NOS) Answer: No specific information was documented by physician to
code more specific



What goes on line 12 and 13 on coding forms? Answer: Signature on file (SOF)



What are the two most common claim forms? Answer: CMS-1500 and CMS-1450



CMS-1500 form Answer: used to file claims for outpatient services



What is another name for the CMS-1450 Answer: UB-04



HCPCS Answer: Healthcare Common Procedure Coding System

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