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CBCS BILLING AND CODING NEWEST EXAM AND STUDY GUIDE ACTUAL EXAM WITH 450 UPDATED QUESTIONS AND ANSWERS (VERIFIED ANSWERS) [ALREADY GRADED A+]$19.99
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CBCS BILLING AND CODING NEWEST EXAM AND STUDY GUIDE ACTUAL EXAM WITH 450 UPDATED QUESTIONS AND ANSWERS (VERIFIED ANSWERS) [ALREADY GRADED A+]
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Course
CBCS BILLING AND CODING
Institution
CBCS BILLING AND CODING
CBCS BILLING AND CODING NEWEST EXAM AND
STUDY GUIDE ACTUAL EXAM WITH 450
UPDATED QUESTIONS AND ANSWERS (VERIFIED
ANSWERS) [ALREADY GRADED A+]
How are payments determined under Medicare's RBRVS? - by multiplying
a code's relative value by constant dollar amount called the conversion
fact...
How are payments determined under Medicare's RBRVS? - by multiplying
a code's relative value by constant dollar amount called the conversion
factor (multiplier). The conversion factors are determined annually by the
CMS in cooperation with congress. The conversion factor varies according
to the type of service provided such as medical, surgical, non-surgical
How are services paid to physicians associated w/ Medicare Part B? -
services are paid according to a fee schedule which is based on the
relative value multiplied by the geographical adjustment and conversion
factors. All dr's in a given area are paid the same for same service
regardless of specialization. However, non par's are paid 5% less for
assigned claims. Non PAR's, not accepting assignment, can charge no
more than 115% of the participating allowance w/o facing possible
Medicare fines and penalties.
,2|Page
How do individuals that are not eligible for Social Security Obtain Medicare
Part A? - By paying a premium and they must enroll in Part B this is
however limited to applicants 65+ and US resident. A deductible is req for
each episode of illness and a co-insurance applies for hospitalizations of
more than 60 days
How do you know if an update has been made to the CPT manual? - **A
triangle- represents a change in the code description since the last edition.
The change may be minor or significant and it could be an addition,
deletion, or revision
**2 triangle symbols-represent changes in the text or definition between the
triangles
**A bullet-represents a new procedure or service code added since the
previous addition of the manual
**A plus sign-indicates add-on codes
**A circle w/ a line through it- represents exemption from use of modifier
,3|Page
How is a fee schedule determined? - UCR method, the usual, customary,
and reasonable- the carrier compare *the dr's most frequent charge for a
given service (the usual) *the average charge of all providers of similar
training/experience in a given geographical area (the customary) *the
actual charge submitted on a claim (must be reasonable to the provider)
*****the lowest amount is used as the basis for payment (the allowed
charge)
How is eligibility for Medicaid classified? - divided into 2 classifications
A) Categorically Needy: 1) families, pregnant women & children 2) Aged
and disabled persons 3) Persons receiving institutional or other long-term
care in nursing facilities (NF's) and intermediate care facilities (ICF's)
B) Medically Needy: 1) medically indigent low-income and families 2)low-
income persons losing employer health ins coverage (Medicaid purchase of
COBRA purchase)
How many chapters does the Tabular List(Volume 1) contain? - 17; based
on either body system or cause or type of disease
, 4|Page
How many edits does NCCI include? - 2: 1)Column 1/Column 2 (prev
called Comprehensive/Component) Edits
How many layers to the skin? - 3;1) Epidermis (thin, cellular membrane
layer that contains keratin)
2) Dermis (dense, fibrous, connective tissue that contains collagen)
3) Subcutaneous layer (thicker & fatter tissue)
How many parts to CPT Manual? - 3; the main text, the appendices and the
alphabetic index and is divided into 6 sections; these sections are
subdivided into
How many sections to the CPT Manual? - 8; each section begins w/
guidelines that provide specific coding rules for that section. Guidelines at
the beginning of the section are applicable to all codes in the section, while
notes that pertain to specific codes appear before or after such codes.
Guidelines usually contain definitions of terms, applicable modifiers,
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