Download Medical Billing & Coding: Final Exam Questions and Answers (Latest Update 2026) and more Exams Medical Records in PDF only on Docsity!
Questions and Answers (Latest
Update 2026)
The largest federal program providing healthcare is __________________ which provides health insurance for citizens aged 65 and older as well as certain patients under the age of 65. - correct answer ✅Medicare The ___________________ ______________ is responsible for filing insurance claims in most medical offices.. - correct answer ✅Medical Assistant Patients are generally asked to sign an _____________ of _____________statement, in which the provider agrees to prepare healthcare claims for patients, receive payments directly from the payers, and accept a payer's allowed charge. - correct answer ✅Assignment, Benefits The ______________ may be called the insured, the member, or the subscriber. - correct answer ✅Policyholder Under an insurance policy, the policyholder pays a __________ or _________________________ for keeping the
Questions and Answers (Latest
Update 2026)
insurance policy in force. - correct answer ✅Premium, an annual charge A ___________________ is a fixed dollar amount that must be paid or "met" once a year, in addition to the premium, before the third-party payer begins to cover medical expenses. - correct answer ✅Deductible A ____________________ is a small, fixed fee collected at the time of the visit from the patients who belong to a managed care health plan. - correct answer ✅Co-payment In a typical medical practice, claims are transmitted within a few business days ____________ the date of service. - correct answer ✅After Insurance claims could be denied as a billing error because if the treatment was not medically necessary based on the ____________________ and there is no
Questions and Answers (Latest
Update 2026)
______________________. -
correct answer ✅Automatic Medicare Part A is a _______________ benefit for patients who are admitted as inpatients for up to the 90-day benefit period. - correct answer ✅hospital A Medicare benefit period begins the day a patient is admitted to the hospital and ends when that patient has not been hospitalized or placed in a skilled nursing facility for a period of ________ continuous days after discharge. - correct answer ✅ 60 Medicaid is a health cost _________________ program designed for low-income, blind, or disabled patients. It is not an ______________ program. - correct answer ✅assistance, insurance Workers of any age who have chronic kidney disease requiring dialysis or end-stage renal disease (ESRD)
Questions and Answers (Latest
Update 2026)
requiring transplant are eligible for ________________. - correct answer ✅Medicare ____________ is a short break provided for caregivers to terminally ill patients. The patient is moved to a respite care center or other facility to remove responsibility for care from the caregiver temporarily. - correct answer ✅Respite ____________ programs provide pallitative care, including pain relief and support for terminal patients and their family members. - correct answer ✅Hospice ___________ is responsible for paying 80% of the allowed charges after the patient has met the annual deductible, as patients typically have an 80- coinsurance. - correct answer ✅Medicare(3) Medigap is not a part of Medicare's _______________________________________________. -
Questions and Answers (Latest
Update 2026)
__________________ claim submissions are cost-efficient even in smaller offices, and claims are generally paid much more quickly- within a week or two instead of 6 to 8 weeks for paper claims. - correct answer ✅Electronic The birthday rule states that the insurance policy of the policyholder whose birthday comes _____________ in the calendar year is the primary payer for all dependents. - correct answer ✅first The information entered on electronic claims is called __________________ _______________. The clearinghouse must receive all of the necessary data elements from the medical office before it can submit a claim. - correct answer ✅data elements _________________ are prepared for electronic submission after all of the required data elements have been posted to the medical billing software
Questions and Answers (Latest
Update 2026)
program. - correct answer ✅Claims Change your password every _______ days or as directed by facility policy. - correct answer ✅ 90 _____________ and _____________ provide healthcare benefits to families of current military personnel, retired military personnel, and veterans. - correct answer ✅TRICARE, CHAMPVA ___________________ uses a resource-based relative value scale to determine the fees they pay for services rendered. - correct answer ✅Medicare (4) Enter all data into the medical billing program using __________ letters. - correct answer ✅Capital
Questions and Answers (Latest
Update 2026)
insurance policy of the policyholder whose birthday occurs first in the calendar year is the primary payer for all dependents. - correct answer ✅birthday A medical office's ________ _________ are the fees charged to most of their patients most of the time under typical conditions. - correct answer ✅fee schedule The _______________________ is a 10-digit number that represents the physician's medical specialty. - correct answer ✅taxonomy code The ABN, or Advance Beneficiary Notice of Noncoverage, must be verbally reviewed with the beneficiary or his or her representative and any questions raised during that review must be answered ________________ it is signed. - correct answer ✅before ______________________ can occur when healthcare providers submit claims for a simple procedure, but
Questions and Answers (Latest
Update 2026)
the medical record reveals that a more complicated procedure was actually performed. - correct answer ✅Underpayment You should contact Medicaid to verify patient's benefit eligibility ___________ time they are seen in the office. - correct answer ✅every With an _____ - _____ coinsurance, your patient will be responsible for 20% off the allowable charge; or 20% of $100, which is $20. - correct answer ✅80- A _______________ is a small fee paid by the patient that is collected at the time of the visit. - correct answer ✅copayment Companies have manuals for _______________ and representatives of the insurance companies are available to answer _______________ about a patient's coverage. - correct answer ✅references
Questions and Answers (Latest
Update 2026)
condition. - correct answer ✅3 to 7 A ____________ code in ICD-10-CM is three characters. - correct answer ✅category A _______________ code in ICD-10-CM has four to five characters. - correct answer ✅subcategory A ___________ in ICD-10-CM has six to seven characters. - correct answer ✅final code Part of ICD-10-CM list _____________ and _____________ alphabetically with corresponding diagnosis codes. - correct answer ✅disease, injuries The _________ list is made up of twenty-one chapters of disease descriptions and their codes. - correct answer ✅tabular
Questions and Answers (Latest
Update 2026)
The ICD-10-CM index to Disease and Injuries is known as the __________________ ______________. - correct answer ✅alphabetical index A ______________ statement is a physician's description of the main reason for a patient's encounter. - correct answer ✅diagnostic When coding, the coder first locates the description/code in the _______________ index and then verifies the proposed code selection by turning to the ______________ index and studying the entries. - correct answer ✅alphabetical, tabular The _____________ means that the coder will need to drill down to select the right code. - correct answer ✅hyphen Each __________ term appears in boldface type and identifies a disease or condition. - correct answer ✅main
Questions and Answers (Latest
Update 2026)
An eponym is usually listed both under the ________ an under the _________ term (disease or syndrome) - correct answer ✅name, main When dealing with syndromes, if the syndrome is not identified, its ___________________ are assigned codes. - correct answer ✅manifestations If the main term or subterm is too long to fit on one line, as is often the case when many non-essential modifiers appear, _____________ lines are used. - correct answer ✅turnover The coder must look up the term that follows the word _________ in the index. - correct answer ✅"see" The _________________ category indicates that the coder should review the additional categories that are mentioned. - correct answer ✅"see also"
Questions and Answers (Latest
Update 2026)
______________________________________ appears with a term when there is no code that is specific for the condition. - correct answer ✅Not Elsewhere Classified Not otherwise specified means
_____________. - correct answer ✅" a condition is not described enough" _____________________ code is a single code that describes both the etiology and manifestation of a particular condition. - correct answer ✅Combination Combination codes that classify __________ diagnoses or a diagnosis with an associated ______________________ may also exist. - correct answer ✅two, complication Character "______" is inserted in a code to fill a blank space. - correct answer ✅"X"
Questions and Answers (Latest
Update 2026)
Excludes ____ is used when two conditions could not exist together. - correct answer ✅ 1 Excludes ____ means a patient could have been conditions at the same time. - correct answer ✅ 2 _______________ are used around descriptions that do not affect the code. - correct answer ✅Parenthesis Use of ICD-10-CM classification system to capture the side of the body that is documented in the concept of ___________________. - correct answer ✅laterality The instruction _________________________________ disease must not be used as a first listed diagnosis. - correct answer ✅code first underlined
Questions and Answers (Latest
Update 2026)
The order of codes must be the same in the Alphabetic Index when the instruction "use ____________________________ code" is noted. - correct answer ✅additional When the affected side of the condition is not known, an ____________________ code is assigned. - correct answer ✅Unspecified CC stands for ________________________________. - correct answer ✅Chief Complaint The patient's _______________________________ describes the reason they are seeking medical care at this time.
correct answer ✅Chief complaint The main term in the diagnostic statement "cerebrovascular accident" is ______________________. - correct answer ✅accident
