Medical Billing and Coding test ICD-10 questions and answers.., Exams of Nursing

Download Medical Billing and Coding test ICD-10 questions and answers.. and more Exams Nursing in PDF only on Docsity! Medical Billing and Coding test ICD-10 questions and answers. Which of the following modifiers is not approved for hospital outpatient department reporting Answer- Modifier 22 Increased Procedural Services This modifier is not approved for hospital outpatient department use A physician performs laser surgery to remove a lesion from the patient's back. Choose the CPT classification for this procedure. Answer- Destruction Laser treatment on a lesion is considered a form of destruction. True or False : In the hospital outpatient setting, laboratory codes are usually assigned by a computerized process through the Chargemaster, rather than by an HIM employee. Answer- True In the hospital outpatient setting, laboratory codes are usually assigned by a computerized process through the Chargemaster, rather than by an HIM employee Which of the following are official resources for CPT coding guidelines? Answer- American Medical Association (AMA) and CMS AMA is the primary authoritative source of CPT coding information, but CMS also issues guidelines related to billing and reimbursement. True or False: The arrangement of the Category III codes reflects the overall arrangement of CPT by body system. Answer- False Correct answer. The Category III codes are arranged in numeric order according to the date that they were added and do not reflect the overall organization of CPT True or False: The CPT codes were developed by and are maintained by the Centers for Medicare and Medicaid Services (CMS). Answer- False Correct answer. They were developed by and are maintained by the American Medical Association (AMA). How many diagnoses may be submitted on a CMS-1500 claim form? Answer- Twelve Twelve diagnoses may be submitted. In preparation for ICD-10, the CMS 1500 added additional lines. Which appendices contains a comprehensive summary of CPT additions, deletions, and revisions Answer- Appendix B Contains a Summary of Additions, Deletions, and Revisions and shows the actual changes that were made to the code descriptors. What is indicated by a circled bullet (bullseye) symbol preceding a CPT code? Answer- Conscious sedation is included in the code and should not be reported separately. Circled bullet symbol preceding a CPT code indicates that conscious sedation is included and should not be reported separately How are repeat diagnostic laboratory tests reported? Answer- With the use of modifier 91 appended to the CPT code.. Repeat diagnostic laboratory tests are reported with the use of modifier 91. Before assigning an unlisted procedure code, what other coding systems should the coder review to determine whether an alternate code exists? Answer- CPT Category III codes and HCPCS Level II National codes What code sets are used to report physician services? Answer- The codes sets used by physicians are ICD-10-CM (diagnosis codes) and HCPCS/CPT (procedure codes). How many years after publication or extension will CPT Category III codes be archived if they are not accepted for conversion to CPT Category I? Answer- Five years A patient is seen in the emergency department for a gunshot wound. What claim form would the hospital use for submitting its claim? Answer- Only the CMS-1450 (UB-04) is acceptable for use by hospital outpatient departments. A fee schedule is: Answer- Developed by third-party payers and includes a list of healthcare services, procedures, and charges associated with each A hospital needs to know how much Medicare paid on a claim so they can bill the secondary insurance. What should the hospital refer to'? Answer- Remittance advice A patient has two health insurance policies: Medicare and a Medicare supplement. Which of the following statements is true'? Answer- Monies paid to the healthcare provider cannot exceed charges. A provision of the law that established the resource-based relative value scale (RBRVS) stipulates that refinements to relative value units (RVUs) must maintain: Answer- Budget neutrality Assignment of benefits is a contract between a physician and Medicare in which the physician agrees to bill Medicare directly for covered services and the beneficiary for _____ and to accept the Medicare payment as payment in full. Answer- Coinsurance or deductible Health insurance for spouses, children, or both is known as: Answer- Dependent (family) coverage How does Medicare or other third-party payers determine whether the patient has medical necessity for the tests. procedures, or treatment billed on a claim form'! Answer- By reviewing all the diagnosis codes assigned to explain the reasons the services were provided.