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When a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CORRECT ANSWER CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the following is the amount of the adjustment? - CORRECT ANSWER $75 Which of the following suffixes refers to an abnormal condition? - CORRECT ANSWER -osis Which of the following entiti...

Medical Billing & Coding as a Career - CORRECT ANSWER *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist What are Medical Ethics? - CORRECT ANSWER Standards of conduct based on moral principle. They are generally accepted as a guide for behavior towards pt's,...

What describes the reason for a claim rejection because of Medicare NCCI edits - CORRECT ANSWER Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - CORRECT ANSWER Invalid Medigap coverage is offered to Medicare beneficiaries by whom - CORRECT ANSWER Private third-party payers What provision assures that an insured's benefits from all insurance companies do not exceed 100% of the allowable medical expense - CORRECT A...

BREACH OF CONFIDENTIAL COMMUNICATION - CORRECT ANSWER unauthorized release of information under HIPAA Generate an accounts receivable aging report - CORRECT ANSWER What action should be taken to determine whether an account is delinquent? The risks and expected outcomes of a procedure - CORRECT ANSWER As part of the consent discussion when obtaining informed consent, the provider should explain this. the global period - CORRECT ANSWER Under CPT guidelines, the number of days surrounding ...

A nurse is planning overall strategies to address problems for a client who has a borderline personality disorder. Which of the following strategies is the priority for the nurse to incorporate into the plan of care? a. discuss the appropriate use of assertive behavior with the client b. encourage the client to attend weekly support group meetings c. assist the client to maintain awareness of her thoughts and feelings d. implement measures to prevent intentional self-inflicted injury - COR...

A nurse in an emergency department is caring for a femail adolescent who has a diagnosis of bulimia nervose and has a fainting episode during a ballet performance. Which of the following statements by the parent acknowledges the client's diagnosis? A. "She works so hard at ballet. Will she still be able to perform?" B. "She won't let me take the trash from her room. I'm concerned about what she has in there." C. "She told me she was tired, so I did her chores for her today." D. "...

1. A nurse is assisting with obtaining consent for a client who has been declared legally incompetent . Which of the following actions should the nurse take ? - CORRECT ANSWER Request that the client's guardian sign the consent 2. A nurse in a mental health facility is reviewing a client's medical record . Which of the following actions should the nurse take first ? ( Click on the exhibit button for additional information about the client There are re 3 tabs that contain separate categor...

A nurse on a medical unit is preparing to administer alendronate 40 mg PO for an older adult client who has Paget's disease of the bone. Which of the following actions should be the nurse's priority? - CORRECT ANS Ambulate the client to a chair prior to administering the medication A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects? - CORRECT AN...

If a car is towed 12 miles to the repair shop and the tow charge is $3.50 per mile, how much does the tow cost? (a) $12.00 (b) $3.50 (c) $42.00 (d) $100.00 - CORRECT ANS C. Multiply 12 miles by $3.50 per mile: 12 × $3.50 = $42.00 The sum of two numbers is 70. One number is 8 more than the other. What's the smaller number? (a) 31 (b) 33 (c) 35 (d) 36 - CORRECT ANS A. x + x + 8 = 70, solve for x. x = 31 A sales manager buys antacid in bottles the gross. If he goes through 3 bottles...

A nurse is assessing a client who is receiving intravenous therapy. The nurse should identify which of the following findings as a manifestation of fluid volume excess? a. Decreased bowel sounds b. Distended neck veins c. Bilateral muscle weakness d. Thread pulse - CORRECT ANS b. Distended neck veins A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. Which of the following findings should indicate to the nurse that the tr...