Place of Service - Billing and coding specialists should first divide the E & M Code by
Privacy Officer - Compliant with HIPPA the following position should be assigned in each office
Principal Diagnosis - Coding on the UB-04 Form, must sequence the diagnosis code. Which is the first listed d...
NHA Medical Coding and billing exam
complete solution 2022
Place of Service - Billing and coding specialists should first divide the E & M Code by
Privacy Officer - Compliant with HIPPA the following position should be assigned in
each office
Principal Diagnosis - Coding on the UB-04 Form, must sequence the diagnosis code.
Which is the first listed diagnosis?
Urethratresia - Obstruction of the urethra is
UB04 Forms - Ambulatory surgery centers, home health center, and hospice use what
form?
Encounter forms - Form that contains of DOS, CPT, ICD codes, fees and copay
information is called
Add on Codes - Anesthesia section of CPT manual which are considered qualifying
circumstances
Title 11 - Patient presents with chest pain & shortness of breath with abnormal ECG
provider call a cardiologist. What portion of the HIPPA allows this
Code set standards pertain to all providers - HIPPA compliance guideline affecting EHR
Red - Color formats on CMS 1500 form acceptable
Patient Ledger account - Financial record generated by a provider office
Coding Compliance Plan - Which of the following includes procedures and best
practices for correct coding
Sagittal - Which of the following planes divides the body into left and right
Claim adjudication:( The term used in the industry to refer to the process of paying
claims submitted on denying them after comparing claims to the benefit or coverage
requirements) - 3rd Party payer validates a claim which takes place next
NCCI ( National Correct Coding Initiative) - Developed to reduced Medicare Program
expenditure by detecting in appropriate codes & eliminating improper coding
, 0% - Beneficiary of Medicaid/ Medicare crossover claim is responsible for the
percentage
Internal monitoring and auditing - Which of the following steps would be part of a
physicians practice compliance program
HIPPA - Which of the following acts applies to the administrative simplification
guidelines?
Accounts recievable - Patient charges that have not been paid will appear in which of
the following
adjudication - Which of the following is considered the final determination of the issues
involving settlement of an insurance claim
A billing worksheet from the patient account - A prospective billing account audit
prevents fraud by reviewing & comparing a completed claim for with which of the
following documents
Lymphatic system - Which of the following parts of the body system regulates immunity
Billing using 2- digit CPT Modifiers to indicate a procedure as preformed differs from its
usual 5 digit code - Which of the following is allowed when billing procedural codes
Direct Data entry - A biller will electronically submit a claim to the carrier via which of the
following?
A Providers office with fewer than 10 fulltime employees - Medicare enforces mandatory
submission of electronic claims for most providers. Which of the providers is allowed to
submit paper claims to Medicare?
(RAC) Recovery audit Contractor - Which of the following organizations identifies
improper payments made on CMS claims
Bone and bone marrow - IF a patient has osteomyelitis he has problems with which of
the following areas?
Preauthorization form - Which of the following is a requirement of some third-party
payers before a procedure is performed?
Precertification - Ensure appropriate insurance coverage for an outpatient procedure by
first using the following process
History - Key component if an evaluation and management service
837 - Format used to submit electronic claims and 3rd Party payer
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