Exam (elaborations)
NHA - Certified Billing and Coding Specialist (CBCS) Study Guide latest updated
- Course
- Institution
NHA - Certified Billing and Coding Specialist (CBCS) Study Guide latest updated
[Show more]
Content preview
NHA - Certified Billing and Coding Specialist (CBCS) Study Guide latest updatedThe 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.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller mereka. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
76449 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now