NCCT Insurance & Coding

An insurance and coding specialist is reviewing a patient's encounter form that is documented in the medical record prior to competing a CMS-1500 form. She notices that the physician upcoded the encounter form. The specialist has the ethical obligation to first Correct Answer: query the physician A patient had surgery two weeks ago to repair a dislocated ankle, and returns today to have a flexor tendon in the hand repaired. Which of the following modifiers should be reported for today's se...

The patient owes $25.00 for the visit. The amount collected for the office visit is called what? Correct Answer: Copayment The insurance carrier rate is 80% the remaining 20% is called what? Correct Answer: Coinsurance A third party payer made an error when adjudicating a claim which of the following should the specialist do? Correct Answer: resubmit the claim with an attachment explaining the error A claim submitted with all the necessary and accurate information so that it can be p...

An insurance and coding specialist is reviewing a patient's encounter form that is documented in the medical record prior to competing a CMS-1500 form. She notices that the physician upcoded the encounter form. The specialist has the ethical obligation to first - query the physician A patient had surgery two weeks ago to repair a dislocated ankle, and returns today to have a flexor tendon in the hand repaired. Which of the following modifiers should be reported for today's service? - -79 A pat...

An insurance and coding specialist is reviewing a patient's encounter form that is documented in the medical record prior to competing a CMS-1500 form. She notices that the physician upcoded the encounter form. The specialist has the ethical obligation to first - query the physician A patient had surgery two weeks ago to repair a dislocated ankle, and returns today to have a flexor tendon in the hand repaired. Which of the following modifiers should be reported for today's service? - -79 ...