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NHA - Certified Billing and Coding Specialist (CBCS) Study Guide 2022 with complete solutions €8,62   In winkelwagen

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NHA - Certified Billing and Coding Specialist (CBCS) Study Guide 2022 with complete solutions

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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 diag...

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NHA - Certified Billing and Coding
Specialist (CBCS) Study Guide
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.

, NHA - Certified Billing and Coding
Specialist (CBCS) Study Guide
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.

What is the main job of the Office of the Inspector General (OIG)? - ANSWER The OIG
protects Medicare and other HHS programs from fraud and abuse by conducting audits,
investigations , and inspections.

Medicare - ANSWER Federally funded health insurance provided to people age 65 or older, and
people 65 and younger with certain disabilities.

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