The attending physician
A nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning?
The patients condition and the providers informa...
NHA Billing and Coding practice test
(CBCS)
The attending physician - ANSWERA nurse is reviewing a patients lab results prior to
discharge and discovers an elevated glucose level. Which of the following health care
providers should be altered before the nurse can proceed with discharge planning?
The patients condition and the providers information - ANSWEROn the CMS-1500
Claims for, blocks 14 through 33 contain information about which of the following?
Problem focused examination - ANSWERA provider performs an examination of a
patient's throat during an office visit. Which of the following describes the level of the
examination?
Reinstated or recycled code - ANSWERThe symbol "O" in the Current Procedural
Terminology reference is used to indicate which of the following?
Coinsurance - ANSWERWhich of the following is the portion of the account balance the
patient must pay after services are rendered and the annual deductible is met?
Place of service - ANSWERThe billing and coding specialist should divide the
evaluation and management code by which of the following?
Cardiovascular system - ANSWERThe standard medical abbreviation "ECG" refers to a
test used to access which of the following body systems?
add on codes - ANSWERIn the anesthesia section of the CPT manual, which of the
following are considered qualifying circumstances?
12 - ANSWERAs of April 1st 2014, what is the maximum number of diagnosis that can
be reported on the CMS-1500 claim form before a further claim is required?
Nephrolithiasis - ANSWERWhen submitting a clean claim with a diagnosis of kidney
stones, which of the following procedure names is correct?
Verifying that the medical records and the billing record match - ANSWERWhich of the
following is one of the purposes of an internal auditing program in a physician's office?
The DOB is entered incorrectly - ANSWERPatient: Jane Austin; Social Security # 555-
22-1111; Medicare ID: 555-33-2222A; DOB: 05/22/1945. Claim information entered:
Austin, Jane; Social Security #.: 555-22-1111; Medicare ID No.: 555-33-2222A; DOB:
052245. Which of the following is a reason this claim was rejected?
Operative report - ANSWERWhich of the following options is considered proper
supportive documentation for reporting CPT and ICD codes for surgical procedures?
,NHA Billing and Coding practice test
(CBCS)
Verify the age of the account - ANSWERWhich of the following actions should be taken
first when reviewing delinquent claims?
Claim control number - ANSWERWhich of the following components of an explanation
of benefits expedites the process of a phone appeal?
Bloc 24D contains the diagnosis code - ANSWERA claim can be denied or rejected for
which of the following reasons?
Privacy officer - ANSWERTo be compliant with HIPAA, which of the following positions
should be assigned in each office?
encrypted - ANSWERAll e-mail correspondence to a third party payer containing
patients' protected health information (PHI) should be
patient ledger account - ANSWERA billing and coding specialist should understand that
the financial record source that is generated by a provider's office is called a
Coding compliance plan - ANSWERWhich of the following includes procedures and
best practices for correct coding?
Health care clearinghouses - ANSWERHIPAA transaction standards apply to which of
the following entities?
Appeal the decision with a provider's report - ANSWERWhich of the following actions
should be taken if an insurance company denies a service as not medically necessary?
Accommodate the request and send the records - ANSWERA patient with a past due
balance requests that his records be sent to another provider. Which of the following
actions should be taken?
$48 - ANSWERA participating BlueCross/ BlueShield (BC/BS) provider receives an
explanation of benefits for a patient account. The charged amount was $100. BC/BS
allowed $40 to the patients annual deductible. BC/BS paid the balance at 80%. How
much should the patient expect to pay?
Deductible - ANSWERThe physician bills $500 to a patient. After submitting the claim to
the insurance company, the claim is sent back with no payment. The patient still owes
$500 for this year.
International Classification of Disease (ICD) - ANSWERWhich of the following is used to
code diseases, injuries, impairments, and other health related problems?
, NHA Billing and Coding practice test
(CBCS)
Ureters - ANSWERUrine moves from the kidneys to the bladder through which of the
following parts of the body?
Angioplasty - ANSWERThreading a catheter with a balloon into a coronary artery and
expanding it to repair arteries describes which of the following procedures?
To ensure the patient understands his portion of the bill - ANSWERA patient's portion of
the bill should be discussed with the patient before a procedure is performed for which
of the following reasons?
Performing periodic audits - ANSWERWhich of the following actions by the billing and
coding specialists prevents fraud?
Name and address of guarantor - ANSWERWhich of the following information is
required on a patient account record?
Invalid - ANSWERA claim is submitted with a transposed insurance member ID number
and returned to the provider. Which of the following describes the status that should be
assigned to the claim by the carrier?
CMS-1500 claim form - ANSWERWhich of the following should the billing and coding
specialist complete to be reimbursed for the provider's services?
The electronic transmission and code set standards require every provider to use the
healthcare transactions, code sets, and identifiers. - ANSWERWhich of the following is
HIPAA compliance guideline affecting electronic health records?
Verification of coverage. - ANSWERWhich of the following is the purpose of
precertification
The entity to whom the information is to be released - ANSWERWhich of the following
should the billing and coding specialist include in an authorization to release
information?
Report the incident to a supervisor - ANSWERWhich of the following actions should the
billing and coding specialist take if he observes a colleague in an unethical situation?
Patient's responsibility - ANSWERWhen posting payment accurately, which of the
following items should the billing and coding specialist include?
The parent whose birthdate comes first in the calendar year - ANSWERA dependent
child whose parents both have insurance coverage comes to the clinic. The billing and
coding specialist uses the birthday rule to determine which insurance policy is primary.
Which of the following describes the birthday rule?
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