NHA - Certified Billing and Coding Specialist (CBCS) Study Guide
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The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Ans-Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered quali...
NHA - Certified Billing and Coding
Specialist (CBCS) Study Guide
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Ans-
Reinstated or recycled code
In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - Ans-
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? - Ans-12
What is considered proper supportive documentation for reporting CPT and ICD codes for surgical
procedures? - Ans-Operative report
What action should be taken first when reviewing a delinquent claim? - Ans-Verify the age of the
account
A claim can be denied or rejected for which of the following reasons? - Ans-Block 24D contains the
diagnosis code
A coroner's autopsy is comprised of what examinations? - Ans-Gross Examination
Medigap coverage is offered to Medicare beneficiaries by whom? - Ans-Private third-party payers
What part of Medicare covers prescriptions? - Ans-Part C
What plane divides the body into left and right? - Ans-Sagittal
, Where can unlisted codes be found in the CPT manual? - Ans-Guidelines prior to each section
Ambulatory surgery centers, home health care, and hospice organizations use which form to submit
claims? - Ans-UB-04 Claim Form
What color format is acceptable on the CMS-1500 claim form? - Ans-Red
Who is responsible to pay the deductible? - Ans-Patient
A patient's health plan is referred to as the "payer of last resort." What is the name of that health
plan? - Ans-Medicaid
Informed Consent - Ans-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.
Implied Consent - Ans-A patient presents for treatment, such as extending an arm to allow a
venipuncture to be performed.
Clearinghouse - Ans-Agency that converts claims into standardized electronic format, looks for
errors, and formats them according to HIPAA and insurance standards.
Individually Identifiable - Ans-Documents that identify the person or provide enough information so
that the person can be identified.
De-identified Information - Ans-Information that does not identify an individual because unique and
personal characteristics have been removed.
Consent - Ans-A patient's permission evidenced by signature.
Authorizations - Ans-Permission granted by the patient or the patient's representative to release
information for reasons other than treatment, payment, or health care operations.
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