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NHA - Certified Billing and Coding Specialist (CBCS) Study Guide Exam/153 Q’s and A’s
NHA - Certified Billing and Coding Specialist (CBCS) Study Guide Exam/153 Q’s and A’s
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NHA - Certified Billing and Coding Specialist(CBCS) Study Guide Exam/153 Q’s and A’s
The symbol "O" in the Current Procedural Terminology reference is used to
indicate what? - -Reinstated or recycled code
-In the anesthesia section of the CPT manual, what are considered qualifying
circumstances? - -Add-on codes
-As of April 1, 2014 what is the maximum number of diagnoses that can be
reported on the CMS-1500 claim form before a further claim is required? - -
12
-What is considered proper supportive documentation for reporting CPT and
ICD codes for surgical procedures? - -Operative report
-What action should be taken first when reviewing a delinquent claim? - -
Verify the age of the account
-A claim can be denied or rejected for which of the following reasons? - -
Block 24D contains the diagnosis code
-A coroner's autopsy is comprised of what examinations? - -Gross
Examination
-Medigap coverage is offered to Medicare beneficiaries by whom? - -Private
third-party payers
-What part of Medicare covers prescriptions? - -Part C
-What plane divides the body into left and right? - -Sagittal
-Where can unlisted codes be found in the CPT manual? - -Guidelines prior
to each section
-Ambulatory surgery centers, home health care, and hospice organizations
use which form to submit claims? - -UB-04 Claim Form
-What color format is acceptable on the CMS-1500 claim form? - -Red
-Who is responsible to pay the deductible? - -Patient
-A patient's health plan is referred to as the "payer of last resort." What is
the name of that health plan? - -Medicaid
, -Informed Consent - -Providers explain medical or diagnostic procedures,
surgical interventions, and the benefits and risks involved, giving patients an
opportunity to ask questions before medical intervention is provided.
-Implied Consent - -A patient presents for treatment, such as extending an
arm to allow a venipuncture to be performed.
-Clearinghouse - -Agency that converts claims into standardized electronic
format, looks for errors, and formats them according to HIPAA and insurance
standards.
-Individually Identifiable - -Documents that identify the person or provide
enough information so that the person can be identified.
-De-identified Information - -Information that does not identify an individual
because unique and personal characteristics have been removed.
-Consent - -A patient's permission evidenced by signature.
-Authorizations - -Permission granted by the patient or the patient's
representative to release information for reasons other than treatment,
payment, or health care operations.
-Reimbursement - -Payment for services rendered from a third-party payer.
-Auditing - -Review of claims for accuracy and completeness.
-Fraud - -Making false statements of representations of material facts to
obtain some benefit or payment for which no entitlement would otherwise
exist.
-Upcoding - -Assigning a diagnosis or procedure code at a higher level than
the documentation supports, such as coding bronchitis as pneumonia.
-Unbundling - -Using multiple codes that describe different components of a
treatment instead of using a single code that describes all steps of the
procedure.
-Abuse - -Practices that directly or indirectly result in unnecessary costs to
the Medicare program.
-Business Associate (BA) - -Individuals, groups, or organizations who are not
members of a covered entity's workforce that perform functions or activities
on behalf of or for a covered entity.
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