Quiz Review 8. Health Professions - Medical Billing Coding Insurance

Which of the following best defines an established problem?

Medicare calls its remittance advice a(n) __________

The medical biller will need to have good _____________________ skills in order to affect the monthly capitation payment to the provider

4

Select an ICD-9-CM code for contracture of the neck

5

What are stat fees?

6

Rolling River Community Village-Patient Visit Physician sees a new patient in the independent living area of this retirement community. The physician performs a detailed history, expanded problem-focused examination and medical decision making is of moderate complexity. What is the correct E/M code for this service?

7

Ligation right fallopian tube

8

Which of the following does not describe a technical qualification?

9

Patient is a 55-year-old male with a Mentor inflatable three-piece penile prosthesis that had been causing problems. He was experiencing issues with prolonged erections while deflating the prosthesis. It was elected to remove the prosthesis and insert a Duraphase II penile prosthesis. There was some evidence of infection in the area, which was irrigated.

10

Kim is seen by Dr. Smith today. She is complaining of right upper quadrant pain. Dr. Smith records probable gall stones in her record. The first-listed diagnosis should be gallstones.

11

Appendix 2 of HCPCS identifies modifiers.

12

Which of the following is a covered expense associated with prosthetics?

13

A speech/word-recognition assessment was completed using a sound field/booth. This would be reported with code ____________________

14

Most CPT procedures and services are classified as __________ codes, which include a complete description of the procedure or service

15

The physician documents that the patient has diabetes that was diagnosed prior to admission

16

Medicare Part A and B come together

17

Code 76604 reports an ultrasound of the chest, real-time, with image documentation.

18

The ear maintains the sense of balance, which is also known as:

19

The HCPCS codes are most often used for billing Medicare claims but may also be used for Medicaid claims and for some private insurance carriers. Identify and describe the three levels of coding used in this system

20

Ophthalmia neonatorium: ________

21

What are the requirements for the problem focused type single organ system physical examination?

22

Using an ICD-9-CM code book, select the appropriate code(s) for the diagnostic statements given in the following questions

23

Providers may be asked to provide protected health information (PHI) as part of FDA investigations related to product defects or recalls

24

A patient with organ dysfunction and sepsis is commonly diagnosed with __________

25

Routine insertion of indwelling Foley catheter

26

What is the maximum number of services (CPT codes) that can be submitted on one CMS-1500 claim form?

27

Adult and child abuse, neglect and maltreatment, are classified as assault

28

The "INCLUDES" notation does not appear at the __________ digit level(s); however, a listing of diagnoses contained within these levels appears

29

An ambulatory surgical center is designated to perform:

30

Glenn is a 60-year-old white male who has CKD. He recently entered stage 3; his GFR is 58. Glenn was seen by his physician and was complaining of weakness, fatigue, difficulty concentrating, and occasional dizziness, especially upon standing. His physician ran a CBC and found that Glenn was extremely anemic. In addition to the CKD and anemia, Glenn has type 1 diabetes×which is the cause of his

31

What factors contributed to the rapid cost increases of the Medicare and Medicaid programs in the 1960s, 1970s, and early 1980s?

32

The Root Operation definition is a combination of the functional objective of the procedure and the:

33

Professional organization conferences can be held on the:

34

A patient presents to a facility and indicates their injury or medical condition is secondary to employment. This claim will be paid by Worker's Compensation insurance.

35

The following questions may require the use of an ICD-9-CM code book to select the correct answer. Anatomy of the ear is divided in the _________ ear, __________ ear, and __________ ear

36

Ultrasonography of bilateral kidneys

37

Which modifier is appended to the anesthesia code when an anesthesiologist administers monitored anesthesia care for a patient?

38

A detailed examination is the highest level of examination and consists of a multisystem or complete examination of a single organ system.

39

Which of the following CPT codes indicates the highest level of specificity available for an esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube?

40

When is the best time to obtain all pertinent information about a patient's insurance plan?

41

Healthcare providers who participate in a capitated payment type of health maintenance organization ____.

42

How long does Medicare have to respond to an appeal for reconsideration?

43

The phrase referring to the time frame for billing is:

44

The procedure performed for definitive treatment rather than for diagnostic or exploratory purposes, or the procedure performed to resolve a complication, is known as the: