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