Certified Billing and Coding Specialist

When coding for outpatient and professional services and procedures, a billing and coding specialist must sequence the diagnosis codes according to ICD-10-CM guidelines. Which of the following describes the first listed diagnosis code on a claim? Correct Answer: Primary diagnosis Which of the following terms describes the amount the patient must pay for a service when they have an insurance plan benefit that pays 70% of the allowed amount and the patient is responsible for 30% of the allowed...

All are eligible under Medicare health insurance except: a) retiree of the Civil Service Retirement System b) persons of 65 years or older, retired on Social Security benefits c) those diagnosed with end-stage renal disease (ESRD) d) All kidney donors - d) All kidney donors Which provider/network must accept the payer's allowable amount as 100% payment for procedures or services provided? a) Out of Network provider b) Participating provider c) Non-participating provider d) Both a & b ...

The insured may not necessarily be the patient seen for the medical service. - True Personal insurance is usually less expensive than other health insurance. - False Time limits stated in individual health insurance policies about an insurance company's obligation to pay benefits are the same for all insurance companies. - False There is standardization of format for the explanation of benefit document for all private insurance carriers. - False What organization publishes diagnostic and ...