MCBC practice

A deviated septum due to a nasal fracture could be considered a

What is a correctly completed claim submitted within the policy time limit called?

The day sheet produced by the practice management program shows

When a code has less than six characters and a seventh character applies, is it appropriate to leave a space in the code?

A sequela of an injury is reported with the code that describes the sequela followed by the code for the injury followed by the code for the injury with seventh character "S"

Karen has been in a car accident and broke her arm. Which volume will you refer to first to find a code representing her problem?

Which of the following statements is true under the doctrine of respondeat superior

HIPAA stands for which of the following

Information given by a patient to a medical personnel that cannot be disclosed without consent constitutes

Under the HIPAA privacy rule, providers do not need specific authorization in order to release a patients PHI for purposes. What does TPO stand for

If both parents cover dependants on their plan, the childs primary insurance is usually determined by the birthday rule. What is meant by the birthday rule?

There are three participants in the medical insurance relationship: the first party, the second party and the third party. Who is referred to as the second party?

Payers should comply with the required

What is a capitated (capitation) payment ?

The patient aging report is used to

Medicare part A covers

A payers initial processing of a claim screens for

A claim may be downcoded because

What type of insurance allows treatment virtually anywhere with a high deductible that policy holders are willing to pay

Veterans service related disabilities are eligible for care under which plan?

_____ is usually sponsored and partially paid by an employer

____ are used to report encounters for circumstances other than a disease or injury in the ICD-10-CM

The abbreviation PMPM stands for _____

Schedule of benefits refers to

Janice has breast cancer and is coming into the office today for chemotherapy. In which chapter would you find the code for chemotherapy

In which chapter would you find a malignant cancer of the esophagus

Which type of communication is considered and informal type of correspondence?

Medicare is funded by

Physicians establish a list of their usual fees for

The insurance carrier is allowed to use any method to determine the amount for a service, also known as the ___

Why is a superbill/ encounter form an important document in the office ?

Which of the following facilities does not use CMS-1500 forms?

Physicians usually submit claims for patients and receive payments directly from the payers. The policyholder authorizes this by signing and dating an

Co-insurance is calculated based on _______

If a health plan member recieves medical services from a provider who does not participate in the plan, the cost for the member is typically ______

The tertiary insurance pays

A certification number for a procedure is the result of which transaction and process

Which of the following is one of the sections in the CPT coding manual?

A late effect (sequela) may be indicated in documentation by the use of the expression _________

Multigravida is a term associated with _________

What insurance company is the payer of last resort?

An unintentional, harmful reaction to the correct dosage of a drug is called

Which of the following CPT conventions indicates the code description is revised?

What is meant by the term "code to the highest level of specificity"?

A medical term that contains the root word meaning uterus is

If the patient is treated for both an acute and chronic condition, each of which has a separate code, how should the code be listed?

A new patient is one who has not received services from the physician or any other physician in that group for ____

PFSH is the abbreviation for

The three key factors in selecting E/M codes are

When a panel code from the pathology and laboratory section is reported

What is the Medicare coverage gap also known as the "donut hole"?

CPT is what level of healthcare common and procedure coding system?

Most individuals receiving TANF payments are limited to a ---- year benefit period

Which of the following is not a commonly used transmission method for HIPAA claims?

Medicare Part A covers

A payers initial processing of a claim screens for

A claim may be downcoded because

The word used in medical terminology to mean "toward the midline of the body" is

To indicate that something lies nearer the surface, use the term

The definition of fraud would be ______

In order to find a code using the ICD-10-CM manual, the first step is to look up the ____ in the index

A lab report cannot be used for coding purposes because _____

Which one of the following instructional notes suggests that a second code may be required?

Which CPT modifier should the billing and coding specialist attach to a consultation code when the services performed is required by a third-party payer?

What do the letters NOS indicate?

What do the letters NEC indicate

An established patient presents to the clinic complaining of a sore throat, cough, and a stuffy nose. These are complications with known diabetes and hypertension. The physician documents diabetes, hypertension, and upper respiratory infection. Which of the following is the first listed diagnosis?

A new patient presents to the office complaining of shortness of breath, cough , and pain in the chest. The physician performs a history and medical exam. The patient has a history of diabetes and hypertension. She suspects the patient is suffering from pneumonia and preforms a sputum culture. The physician asks the patient to return in three days to discuss the results. Which of the following diagnoses would be coded if there were no further documentation?

In the following question, identify the term for the first listed diagnosis in the following encounter or visit: Established patient presented to clinic with exacerbation of Crohns disease. Patients rheumatoid arthritis is stable

Identify the term for the first -listed diagnosis in the following encounter or visit. Initial office visit for patient requiring management of COPD and CHF

The UB-04 is used for primarily what type of patient visit?

The term malignant refers to

Which of the following terms refers to a cancerous neoplasm in it's original location

In accordance with the Health Insurance Portability and Accountability Act, which of the following organizations considers health plans, health care providers and clearinghouses as covered entities?

Which of the following forms notifies a patient, in writing, that they will be required to cover the costs for services provided if the payment is denied by Medicare and deemed medically unnecessary?

Which of the following pieces of information would you find on the encounter form?

The common abbreviation for chest x-ray is

When coding HCPCS codes, which of the following symbols would mean that the code is an add-on code?

Assigning the proper ICD-10-CM code means following the proper order of selecting the code. Which steps below should be the very first thing a coder does?

Bad debt is defined as ______.

The principal diagnosis when coding ICD-10-CM codes refers to which of the following

The suffix -scopy means

When working under a managed care plan, physicians agree to ___________

Who should be billed for the treatment of an emancipated minor?

Which of the following statements best describes unbundling?

A patient was suspected of having a myocardial infarction after staying in the hospital as an outpatient in observation the doctor found nothing wrong and sent the patient home. What code would you use in this scenario?

Parenthesis () are used in ICD-10-CM for which of the following reasons

In reference to coding laterally and ICD-10-CM, which of the following statements is NOT TRUE?

Which insurance is provided only for active duty and retired military members and their families

Which of the following is not a correct format for ICD-10-CM?

Medical Necessity is defined as _________

During collections, most practices use ___________

The first three factors a coder must consider when coding is patient status, place of service and ________

The four types of examinations, in order of difficulty (from least difficult to most difficult), are problem-focused, expanded problem-focused, detailed and _______

Coding is the

A code that reports more than one diagnosis with one code is known as a _______

The process done before claims submission to examine claims for accuracy and completeness is to __________

Coding to the highest level of specificity means ______________

Verification of insurance benefits is usually done by ____________

Which Medicare part do most patients have in order to cover vaccinations?

Block 1 of the CMS-1500 contains what information?

What box on the CMS-1500 is for DX codes

Claims that have errors or omissions that must be corrected and resubmitted to receive reimbursement are called ___________

Vocational rehabilitation programs provide ______ for individuals with job related disabilities

Karen was diagnosed with squamous cell carcinoma arising in the cervix. The first 5 digits of the code is M0807. What 6th digit would be used in this diagnosis?

What does the suffix -rrhexis mean?

What does -ectomy mean in the word hysterectomy?

What is the term for the flat fee determined by an insurance provider as a responsibility of the insured for each visit and services rendered?

When typing a physicians name as part of the inside address in a letter, which of the following would be the correct format?