Certified Billing and Coding Specialist (CBCS) Study Guide
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Module
Certified Billing and Coding Specialist Stu
Institution
Certified Billing And Coding Specialist Stu
Certified Billing and Coding Specialist (CBCS) Study Guide
Which of the following accurately describes the difference between informed and implied consent?
A) Informed consent is required after a procedure, while implied consent is required before a procedure.
B) Informed consent only refers...
Certified Billing and Coding Specialist
(CBCS) Study Guide
Which of the following accurately describes the difference between informed and implied consent?
A) Informed consent is required after a procedure, while implied consent is required before a procedure.
B) Informed consent only refers to electronic documents, while implied consent refers to written and
electronic documents.
C) Informed consent is required in writing after explanation of a procedure, with time to ask questions,
while implied consent is assumed.
D) Informed consent applies to hospitals, while implied consent applies to physicians'' offices. - ANSWER-
C) Informed consent is required in writing after explanation of a procedure, with time to ask questions,
while implies consent is assumed.
The correct distinction between informed consent, which requires the patients' signature, and implied
consent
What is documentation? - ANSWER-Documentation is a complete, accurate, up-to-date record of care a
patient receives at a health care facility.
Disclosure refers to the way health information is:
A) Handled by doctors
B) Given to an outside person or organization
C) Stored
D) Organized - ANSWER-B) Given to an outside person or Organization
Disclosure refers to the dissemination of personal health information, which is covered by the HIPAA
Privacy Rule
What is the difference between consent and authorization? - ANSWER-Authorization: Permission
granted by the patient or the patient's representative to release information for reasons other than
treatment, payment, or health care operations
, Consent: Is used only when the permission is for treatment, payment, or health care operations
True or False: Physicians have the option to decide whether to explain privacy rules to their patients. -
ANSWER-False
Physicians are legally obligated to explain privacy rules to their patients
Auditing refers to which of the following?
A) Writing claims
B) Signing off on claims
C) Sending claims to third-party payers
D) Reviewing claims for accuracy and completeness - ANSWER-D) Reviewing claims for accuracy and
completeness
Many facilities have internal auditing systems to review claims for accuracy and completeness. One of
the main things an audit looks for is nonspecific or inaccurate use of diagnosis and procedure codes.
True or False: Fraud is intentional misrepresentation of information for the purposes of receiving higher
payments, while abuse happens unintentionally, often because of poor business practices. - ANSWER-
True
An example of fraud is knowingly billing for services or supplies that were not provided. Abuse includes
any practice that is not consistent with the goals of providing patients with services that are medically
necessary, meet professionally recognized standards, and are fairly priced.
Which of the following accurately defines upcoding?
A) Assigning a code that will deliberately result in a higher payment
B) Using a shorthand code system
C) Including more than one procedure in one code
D) Using multiple codes when a comprehensive code is available - ANSWER-A) Assigning a code that will
deliberately result in a higher payment
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