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 informat...
NHA Billing and Coding practice test
(CBCS) complete solution 2022 verified
correctly
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 information - On the CMS-1500 Claims for,
blocks 14 through 33 contain information about which of the following?
Problem focused examination - A 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 - The symbol "O" in the Current Procedural Terminology
reference is used to indicate which of the following?
Coinsurance - Which 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 - The billing and coding specialist should divide the evaluation and
management code by which of the following?
Cardiovascular system - The standard medical abbreviation "ECG" refers to a test used
to access which of the following body systems?
add on codes - In the anesthesia section of the CPT manual, which of the following are
considered qualifying circumstances?
12 - As 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 - When 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 - Which of the following
is one of the purposes of an internal auditing program in a physician's office?
The DOB is entered incorrectly - Patient: 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 - Which of the following options is considered proper supportive
documentation for reporting CPT and ICD codes for surgical procedures?
Verify the age of the account - Which of the following actions should be taken first when
reviewing delinquent claims?
Claim control number - Which of the following components of an explanation of benefits
expedites the process of a phone appeal?
Bloc 24D contains the diagnosis code - A claim can be denied or rejected for which of
the following reasons?
Privacy officer - To be compliant with HIPAA, which of the following positions should be
assigned in each office?
encrypted - All e-mail correspondence to a third party payer containing patients'
protected health information (PHI) should be
patient ledger account - A 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 - Which of the following includes procedures and best practices
for correct coding?
Health care clearinghouses - HIPAA transaction standards apply to which of the
following entities?
Appeal the decision with a provider's report - Which 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 - A patient with a past due balance
requests that his records be sent to another provider. Which of the following actions
should be taken?
$48 - A 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 - The 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) - Which of the following is used to code
diseases, injuries, impairments, and other health related problems?
, Ureters - Urine moves from the kidneys to the bladder through which of the following
parts of the body?
Angioplasty - Threading 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 - A 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 - Which of the following actions by the billing and coding
specialists prevents fraud?
Name and address of guarantor - Which of the following information is required on a
patient account record?
Invalid - A 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 - Which 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. - Which of the following is HIPAA
compliance guideline affecting electronic health records?
Verification of coverage. - Which of the following is the purpose of precertification
The entity to whom the information is to be released - Which of the following should the
billing and coding specialist include in an authorization to release information?
Report the incident to a supervisor - Which of the following actions should the billing and
coding specialist take if he observes a colleague in an unethical situation?
Patient's responsibility - When 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 - A 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?
Patient access to psychotherapy notes may be restricted - Which of the following
statements is true regarding the release of patient records?
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