CBCS Practice for NHA Exam/170
Answered Questions A+ Rated
Reinstated or recycled code - -The symbol "O" in the Current Procedural
Terminology reference is used to indicate what?
-Add-on codes - -In the anesthesia section of the CPT manual, what are
considered qualifying circumstances?
-Operative Report - -What is considered proper supportive documentation
for reporting CPT and ICD codes for surgical procedures?
-Guidelines prior to each section - -Where can unlisted codes be found in
the CPT manual.
-17b - -Where does the NPI number go on the CMS-1500 form?
-Electronic Data Interchange - -The transfer of electronic information in a
standard form.
-Explanation of Benefits (EOB) - -Describes the services rendered, payment
covered, and benefit limits and denials.
-Crossover Claim - -Claim submitted by people covered by a primary and
secondary insurance plan.
-Authorizes the release of medical information. - -By signing block 12 of
CMS-1500 form, a patient is doing what?
-Medicare Part A - -Provides hospitalization insurance to eligible individuals.
-Medicare Part B - -Voluntary supplemental medical insurance to help pay
for physicians' and other medical professionals' services, medical services,
and medical-surgical supplies not covered by Medicare Part A.
-Medicare Advantage (MA) - -Combined package of benefits under Medicare
Parts A and B that may offer extra coverage for services such as vision,
hearing, dental, health and wellness, or prescription drug coverage.
-Medicare Part D - -prescription drug coverage by Medicare
-Medigap - -A private health insurance that pays for most of the charges not
covered by Medicare Parts A and B.
, -PreAUTHORIZATION - -Approval from the health plan for an inpatient
hospital stay or surgery.
-PreCERTIFICATION - -A review that looks at whether the procedure could be
performed safely but less expensively in an outpatient setting.
-PreDETERMINATION - -A written request for a verification of benefits.
-Who is usually the Gatekeeper? - -The primary physician.
-Formulary - -A list of prescription drugs covered by an insurance plan.
-Tier 1 - -Providers and facilities in a PPO's network.
-Tier 2 - -Providers and facilities within a broader, contracted network of the
insurance company.
-Tier 3 - -Providers and facilities out of the network.
-Tier 4 - -Providers and facilities not on the formulary.
-Preferred Provider - -Tier 2 provider
-Charge Description Master (CDM) - -Information about health care services
that patients have received and financial transactions that have taken place.
-Balance Billing - -Billing patients for charges in excess of the Medicare fee
schedule.
-Batch - -A group of submitted claims.
-V Codes - -Codes used to classify visits when circumstances other than
disease or injury are the reason for the appointment.
-E Codes - -Codes used to classify environmental events, circumstances,
and conditions, such as the cause of injury, poisoning, and other adverse
events.
-Category 1 CPT Code - -Code that covers physicians' services and hospital
outpatient coding.
-Category 2 CPT Code - -Code designed to serve as supplemental tracking
codes that can be used for performance measurement.
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