NCCT Practice Exam Questions and Answers 2023, Exams of Nursing

Download NCCT Practice Exam Questions and Answers 2023 and more Exams Nursing in PDF only on Docsity! NCCT PRACTICE exam latest questions with verified answers 2023 If the insurance and coding specialist suspects Medicare fraud, she should contact the A. DOJ. B. AMA. C. FDA. D. OIG. - Correct Answers ✅D. OIG Collecting statistics on the frequency of copay collection at time of service is a step in the process of A. a recovery audit. B. managing A/R. C. claims management. D. performance reviews. - Correct Answers ✅B. managing A/R When the patient has signed the assignment of benefits form, the payment for services should be sent to the provider unless the provider is A. in-network. B. out of network. NCCT PRACTICE exam latest questions with verified answers 2023 C. the primary care provider. D. a referred specialist. - Correct Answers ✅B. out of network. When speaking with an insurance company representative to follow up on a denied claim, an insurance and coding specialist should have which of the following information available? (Select the three (3) Correct Answers ). A. date of service B. physician's NPI C. patient's mailing address D. patient's insurance ID number E. date the claim was denied - Correct Answers ✅A. date of service D. patient's insurance ID number E. date the claim was denied Which of the following defines the maximum time that a debt can be collected from the time it was incurred or became due? A. benchmark B. practice management payment policy C. statute of limitations NCCT PRACTICE exam latest questions with verified answers 2023 B. The bank made an error. C. Cash is missing. D. There are duplicate cards. - Correct Answers ✅A. Payment is misplaced. A patient is seen in the office for a candidal paronychia nail abscess which was incised and drained. Which of the following is the correct CPT® code assignment for physician services only? A. 10080 B. 10061 C. 10060 D. 11400 - Correct Answers ✅C. 10060 A patient had surgery two weeks ago to repair a dislocated ankle, and returns today to have a flexor tendon in the hand repaired. Which of the following modifiers should be reported for today's service? A. -78 B. -51 C. -58 D. -79 - Correct Answers ✅D. -79 NCCT PRACTICE exam latest questions with verified answers 2023 Which of the following is the correct procedure for keeping a Workers' Compensation patient's financial and health records when the same physician is also seeing the patient as a private patient? A. Separate financial and health records must be used. B. The same financial record may be used, but a separate health record must be maintained. C. The same financial and health records may be used. D. The same health record may be used, but a separate financial record must be maintained. - Correct Answers ✅A. Separate financial and health records must be used. A minor child has come to the physician office for care. Her parents are divorced. Both parents have remarried and the child is listed on the mother's, father's, and both step-parents' policies. The mother's birthday is April 16, stepfather's birthday March 19, father's birthday is February 19, th and the stepmother's birthday is January 20th . Which of the following is correct? A. Mother's plan is primary, stepmother's plan is secondary. B. Father's plan is primary, mother's plan is secondary. C. Mother's plan is primary, father's plan is secondary. NCCT PRACTICE exam latest questions with verified answers 2023 D. Father's plan is primary, stepfather's plan is secondary. - Correct Answers ✅B. Father's plan is primary, mother's plan is secondary. A third party payer made an error while adjudicating a claim. Which of the following should the insurance and coding specialist do? A. Resubmit the claim with a correction. B. Contact the patient to make payment arrangements. C. Resubmit the claim with an attachment explaining the error. D. Contact the insurance commissioner. - Correct Answers ✅C. Resubmit the claim with an attachment explaining the error. Which of the following federal regulations requires disclosure of finance charges, late fees, amount, and due dates for all payment plans? A. Truth in Lending Act B. Fair Debt Collection Practices Act C. Fair and Accurate Credit Transaction Act D. Equal Credit Opportunity Act - Correct Answers ✅B. Fair Debt Collection Practices Act NCCT PRACTICE exam latest questions with verified answers 2023 A. aging B. rejected claims C. claims settlement D. patient listing - Correct Answers ✅B. rejected claims A patient presents to office with RUQ abdominal pain. The physician sends the patient to the hospital for HIDA scan to assess for possible cholelithiasis. Which of the following is the correct ICD-10-CM code assignment? A. R10.9 B. R10.10 C. K80.20 D. R10.11 - Correct Answers ✅D. R10.11 The physician performs an irrigation on the right ear for impacted cerumen. Which of the following CPT® codes should be assigned? A. 69209 B. 69209-RT C. 69210-RT D. 69210 - Correct Answers ✅B. 69209-RT NCCT PRACTICE exam latest questions with verified answers 2023 Collections agencies are regulated by the A. Uniform Bill of 2004. B. Fair Debt Collections Practices Act. C. Health Care Finance Administration. D. Outpatient Prospective Payment System - Correct Answers ✅ Which of the following MCOs always requires an authorization before the patient sees a specialist? A. EPO B. HMO C. PPO D. POS - Correct Answers ✅ Patient presents to office with cough, chest tightness, and sore throat. The physician assessment is URI. Which of the following is the correct ICD-10-CM code assignment? A. R07.89, J02.9 B. J02.9 NCCT PRACTICE exam latest questions with verified answers 2023 C. J06.9 D. R07.89, J06.9 - Correct Answers ✅C. J06.9 The most effective method to manage patient statements and other financial invoices as well as avoid payment delays is to A. collect fees at the time of service. B. use a bimonthly billing system. C. write off overdue balances. D. issue periodic reminders. - Correct Answers ✅A. collect fees at the time of service. Which of the following regulations prohibits the submission of a fraudulent claim or making a false statement or representation in connection with a claim? A. Stark Law B. Federal Claims Collection Act C. Federal False Claims Act D. Anti-Kickback Law - Correct Answers ✅C. Federal False Claims Act NCCT PRACTICE exam latest questions with verified answers 2023 C. calling before 8:00 AM or after 9:00 PM, unless permission is given. D. contacting the person who owes the debt at their place of employment. - Correct Answers ✅C. calling before 8:00 AM or after 9:00 PM, unless permission is given. A patient presents for a colonoscopy. The physician removes a polyp in the transverse colon by hot biopsy forceps. Which of the following is the correct CPT® code assignment? A. 45384 B. 45385 C. 45378 D. 45380 - Correct Answers ✅A. 45384 The patient returned to the hospital 10 days postoperative for an incision and drainage of a deep surgical incision site, due to the organism pseudomonas mallei. Which of the following is the appropriate ICD-10-CM coding? A. T81.4, A24.0 B. T81.4XXD, A24.1 C. T81.42XD, B96.5 D. A49.8, T81.10XD - Correct Answers ✅C. T81.42XD, B96.5 NCCT PRACTICE exam latest questions with verified answers 2023 A 26-year-old female presented to the Emergency Department with complaint of severe headaches of 10-hour duration. An expanded problem focused history and examination were performed. The medical decision making was of moderate complexity. Which of the following is the correct Evaluation and Management code for services provided? A. 99202 B. 99252 C. 99283 D. 99282 - Correct Answers ✅C. 99283 The Stark Law was enacted to govern the practice of A. physician referrals to other providers such as physical and occupational therapists. B. medical office coding practices. C. use of controlled substances in medical facilities. D. physician referrals to facilities that she has a financial interest in. - Correct Answers ✅D. physician referrals to facilities that she has a financial interest in. NCCT PRACTICE exam latest questions with verified answers 2023 When filing an electronic insurance claim, the insurance and coding specialist processes which of the following forms? A. CMS-1500 B. assignment of benefits C. HIPAA waiver D. encounter form - Correct Answers ✅A. CMS-1500 When a capitation account is applied to the ledger it is also known as a A. monthly premium. B. copayment amount. C. fee for service. D. monthly prepayment amount. - Correct Answers ✅D. monthly prepayment amount. Which of the following reports is used to follow up on outstanding claims to third party payers? A. aging B. financial C. accounts payable NCCT PRACTICE exam latest questions with verified answers 2023 D. N13.729, N11.1, B96.20 - Correct Answers ✅ The patient is sent a statement for an office visit. The total amount of the bill is $100.00 and this amount must be paid before the insurance company will pay on the claim. Which of the following is this called? A. deductible B. coinsurance C. copayment D. premium - Correct Answers ✅ A patient was seen in the office. Charges were recorded and submitted to the patient's insurance, and an EOB was received by the office with a payment of $70.89. These transactions should be recorded in the A. encounter form. B. patient ledger. C. patient statement. D. day sheet. - Correct Answers ✅B. patient ledger. NCCT PRACTICE exam latest questions with verified answers 2023 Which of the following is an appropriate way to open the discussion when explaining practice fees to a patient? A. "We will bill you for the visit in full." B. "We can accept your insurance as payment in full." C. "Do you know what your out of pocket cost is today?" D. "Do you have any questions about the cost of today's visit?" - Correct Answers ✅D. "Do you have any questions about the cost of today's visit?" Which of the following patient information is needed to determine a Medicaid sliding fee scale? (Select the three (3) Correct Answers .) A. occupation B. number of dependents C. amount of the bill D. salary E. poverty level - Correct Answers ✅B. number of dependents D. salary E. poverty level Developing an insurance claim begins NCCT PRACTICE exam latest questions with verified answers 2023 A. when the patient arrives for the appointment. B. when the patient calls to schedule an appointment. C. after the medical encounter is completed. D. once the charges have been entered into the computer. - Correct Answers ✅B. when the patient calls to schedule an appointment. The patient presents to the physician's office for an initial encounter of a crushing injury of the left middle finger. Which of the following ICD-10-CM codes should be assigned? A. S67.194A B. S67.193D C. S67.198S D. S67.193A - Correct Answers ✅D. S67.193A The insurance and coding specialist calls a carrier to verify a patient's insurance and the representative states that the patient's insurance was canceled three months ago. Which of the following should the insurance and coding specialist do first? A. Ask the patient to reschedule the appointment. B. Record the information and refer the patient to another provider. NCCT PRACTICE exam latest questions with verified answers 2023 B. pre-authorizations. C. a utilization review. D. the patient's social security number. - Correct Answers ✅B. pre-authorizations. Which of the following forms should be transmitted to obtain reimbursement following a physician's office visit for a patient with active Medicaid coverage? A. UB-04 B. CMS-1500 C. Private Pay Agreement D. CMS-1450 - Correct Answers ✅B. CMS-1500 A Medicare patient presents to an outpatient hospital facility for a scheduled hysterectomy. To which Medicare plan should the facility submit the claim? A. Part C B. Part D C. Part A D. Part B - Correct Answers ✅ NCCT PRACTICE exam latest questions with verified answers 2023 When patients sign Block 13 of the CMS-1500 claim to instruct the payer to directly reimburse the provider, it is known as A. assignment of benefits. B. notice of privacy practice. C. coordination of benefits. D. code linkage. - Correct Answers ✅ A patient presents with low back pain. The physician ordered an MRI and discovered the patient has L5/S1 spondylolisthesis. Which of the following is the correct ICD-10-CM code assignment? A. M43.17 B. M43.07, M54.5 C. M43.07 D. M43.17, M54.5 - Correct Answers ✅ Which of the following protects federal healthcare programs from fraud and abuse by healthcare providers who solicit referrals? A. Fraud and Abuse Act B. Anti-Kickback Statute NCCT PRACTICE exam latest questions with verified answers 2023 C. Utilization Review Act D. Federal Claims Collection Act - Correct Answers ✅B. Anti-Kickback Statute A 45-year-old patient with diabetic proliferative retinopathy is being seen today for her macular edema. Which of the following ICD-10-CM codes should be assigned? A. E11.3519 B. E11.319 C. E11.3599 D. E11.311 - Correct Answers ✅ When is a referral from a provider required? A. if a patient goes to a network hospital for services B. for Workers' Compensation patients C. within 24 hours of a medical procedure D. when contained in the individual policy - Correct Answers ✅D. when contained in the individual policy NCCT PRACTICE exam latest questions with verified answers 2023 A 73-year-old group home resident with ESRD has a nurse come in on Mondays, Wednesdays, and Fridays to perform peritoneal dialysis. Each dialysis session lasts three hours. Once a week (on Friday) the nurse also assists the patient with his meals, cleaning and grocery shopping. Which of the following should the nurse charge for a month (30 days) of services if the 1st of the month landed on a Monday? A. 90966, 99509 x 4 B. 90960, 99509 C. 90970, 99509 x 4 D. 90960, 99509 x 4 - Correct Answers ✅A. 90966, 99509 x 4 A claim submitted with all the necessary and accurate information so that it can be processed and paid is called a A. clean claim. B. timely filing. C. closed claim. D. allowable claim. - Correct Answers ✅ A 70-year-old patient was admitted for coronary ASHD. Cardiac catheterization performed showed numerous native vessels to be 70% to 100% blocked. The NCCT PRACTICE exam latest questions with verified answers 2023 patient was taken to the operating room. A coronary artery bypass graft (CABG) was performed using five venous grafts and four coronary arterial grafts. Which of the following is the correct CPT® coding? A. 33514, 33512 B. 33536, 33517 C. 33533, 33522 D. 33536, 33522 - Correct Answers ✅ The patient has returned to the operating room to aspirate a hematoma that has developed from a surgical procedure performed two days ago. A 16-guage needle is used to aspirate 600 cc's of non-cloudy fluid. Which of the following is the correct CPT® code assignment? A. 10160-58 B. 10140-78 C. 10160-78 D. 10140-58 - Correct Answers ✅C. 10160-78 An established patient has an office visit for the removal of five skin tags from the eye area. During the examination the patient asks the physician to evaluate minor chest pain and pressure. The physician performs an expanded history and NCCT PRACTICE exam latest questions with verified answers 2023 examination with low medical decision making. Which of the following codes should be reported for today's service? A. 99213-25, 11200 B. 99214-25, 11100 C. 99202-51, 11200 D. 99203-51, 11100 - Correct Answers ✅A. 99213-25, 11200 Which of the following processes makes a final determination for payment in an appeal board? A. peer to peer B. deposition C. special handling D. arbitration - Correct Answers ✅ HIPAA allows a health care provider to communicate with a patient's family, friends, or other persons who are involved in the patient's care regarding his or her mental health status providing: A. psychotherapy notes are used for further treatment. B. a second physician signs off on the disclosure. NCCT PRACTICE exam latest questions with verified answers 2023 If the removal of the fallopian tubes and ovaries (Salpingo-Oophorectomy) is the only procedure performed, which of the following is the appropriate code? A. 58720 B. 58700 C. 58615 D. 58150 - Correct Answers ✅A. 58720 Eighteen hours following the delivery of her baby, a female patient who has been discharged suffers atonic postpartum hemorrhage. Which ICD-10-CM code should be assigned? A. O72.3 B. O72.0 C. O72.1 D. O72.2 - Correct Answers ✅C. O72.1 A patient has called to schedule an appointment for an office visit to see the doctor tomorrow for an earache. It is discovered during the scheduling process that the insurance policy on file has been cancelled. Which of the following should the insurance and coding specialist do next? NCCT PRACTICE exam latest questions with verified answers 2023 A. Advise the patient to bring current insurance information to the appointment. B. Ask the patient if he is currently employed and if the cancellation is an error. C. Ask the patient to pay the insurance premium to the office at the time of the visit. D. Advise the patient that he will not be able to schedule an appointment with the doctor. - Correct Answers ✅ When a document is changed in an EHR, the original documentation is A. hidden. B. deleted. C. locked. D. printed. - Correct Answers ✅A. hidden A patient presents to OR with multiple injuries from an MVA. The surgeon explores a penetrating wound of the leg and ligates some blood vessels. Patient also required an open laparotomy to remove a single section of the small intestine (enterectomy) with anastomosis that was injured. Which of the following CPT® codes should be assigned? A. 12004, 49000 B. 44120, 20103 NCCT PRACTICE exam latest questions with verified answers 2023 C. 44126, 12034 D. 13120, 44121 - Correct Answers ✅B. 44120, 20103 Based on the CMS manual system, when updating or maintaining the billing code database, which of the following does the "R" denote? A. Replaced B. Repaired C. Revised D. Revisited - Correct Answers ✅ When should a provider have a patient sign an ABN? A. when a service is excluded from coverage under Medicare. B. when the service is covered under Part B fee schedule. C. prior to treating a patient who requires emergency services that might not be covered. D. when the service(s) may be denied and prior to performing the service. - Correct Answers ✅ Encounter forms should be audited to ensure the NCCT PRACTICE exam latest questions with verified answers 2023 C. security code Which of the following Medicare parts covers inpatient hospital stays? A. Part D B. Part A C. Part B D. Part C - Correct Answers ✅B. Part A In order to have claims paid as quickly as possible, the insurance specialist must be familiar with which of the following? A. prompt pay laws B. automated claims status requests C. clearinghouse processing procedures D. payer's claim processing procedures - Correct Answers ✅D. payer's claim processing procedures When there is a professional courtesy awarded to a patient's account the insurance and coding specialist should post the amount under the A. adjustment column. NCCT PRACTICE exam latest questions with verified answers 2023 B. charges column. C. payment column. D. balance column. - Correct Answers ✅ The patient's total charges are $300. The allowed amount is $150. Benefits pay at 60%. Which of the following will the patient have to pay? A. $150 B. $60 C. $180 D. $90 - Correct Answers ✅B. $60 The patient presents today for upper gastrointestinal (GI) endoscopy and a biopsy of the stomach. Which of the following is the correct CPT® code assignment? A. 43239 B. 43605 C. 43235 D. 43235, 43605 - Correct Answers ✅ NCCT PRACTICE exam latest questions with verified answers 2023 A 73-year-old patient presents for an office visit with diagnoses of gastroesophageal reflux disease, GERD, and hypertension. Today's vitals were normal, but he advised the nurse that he has been having heartburn in spite of taking GERD medication. The physician reviewed and refilled the patient's medications and advised the patient to adjust the GERD dosage and listed today's diagnoses as GERD and hypertension. According to ICD-10-CM guidelines, which of the following codes should be listed first? A. Z00.00 B. I10 C. K21.9 D. R12 - Correct Answers ✅ Which of the following modifiers is required for a return to the operating room for an unplanned related procedure or service by the same physician during the postoperative period? A. -58 B. -78 C. -76 D. -79 - Correct Answers ✅ NCCT PRACTICE exam latest questions with verified answers 2023 C. her policy D. the policy with the highest coverage - Correct Answers ✅ The patient was admitted to the hospital for an aspiration of two thyroid cysts. The physician completed this procedure with CT guidance of the needle with interpretation and report. Which of the following is the correct CPT® code assignment for the professional services? A. 60300 x 2, 77012-26 B. 60300, 76942-26 C. 60300, 10021-51, 77012-26 D. 60300-26, 76942-26 - Correct Answers ✅A. 60300 x 2, 77012-26 Which of the following information should be used to capture charges from an encounter form? A. provider participation status B. past procedures and scheduled future visits C. patient's insurance benefits D. services rendered and reason for visit - Correct Answers ✅ NCCT PRACTICE exam latest questions with verified answers 2023 Which of the following codes are correct when coding hypertensive chronic kidney disease, stage 3? A. N18.4, I12.9 B. I12.9, N18.3 C. I12.9, N18.4 D. N18.3, I12.9 - Correct Answers ✅B. I12.9, N18.3 The patient suffers from atherosclerotic heart disease caused by plaque deposits in a grafted internal mammary artery. The patient underwent arterial bypass graft four months ago. Which of the following ICD-10-CM codes should be assigned? A. I25.3 B. I25.9 C. I25.810 D. I25.10 - Correct Answers ✅C. I25.810 The patient presents to the ED with RLQ abdominal pain and fever. The physician lists appendicitis as a possible diagnosis. Which of the following ICD-10-CM codes should be assigned? A. K37, R10.31, R50.9 NCCT PRACTICE exam latest questions with verified answers 2023 B. R10.31, R50.9 C. K37, R10.12, R50.9 D. R10.813, R50.9 - Correct Answers ✅B. R10.31, R50.9 Which of the following should an insurance and coding specialist do when checking for completion of a new patient's registration form? (Select the three (3) Correct Answers .) A. Check the patient's emergency contacts. B. Make sure that the patient's name matches the insurance card. C. Make sure that the registration form is signed and dated. D. Verify the patient's insurance with his employer. E. Check that demographics are completed. - Correct Answers ✅B. Make sure that the patient's name matches the insurance card. C. Make sure that the registration form is signed and dated. E. Check that demographics are completed. The patient presents for excision of the nail and nail matrix, complete of the left great toe. Which of the following is the appropriate CPT® code assignment? A. 11762-T5 NCCT PRACTICE exam latest questions with verified answers 2023 D. expectation of payment due at time of service E. statement that responsibility for payment lies with patient - Correct Answers ✅C. collection process D. expectation of payment due at time of service E. statement that responsibility for payment lies with patient Which of the following fees posted to the patient's account is an example of "usual, customary, and reasonable?" A. submitted amount B. billed amount C. adjusted amount D. allowed amount - Correct Answers ✅ When using the EHR to schedule a patient visit, which of the following screens should be used to complete the scheduling process? A. clinical care B. correspondence C. patient search D. accounts receivable - Correct Answers ✅C. patient search NCCT PRACTICE exam latest questions with verified answers 2023 Which of the following are violations of the Stark Law? (Select the two (2) Correct Answers .) A. referring patients to facilities where the provider has a financial interest B. upcoding C. negligent handling of protected health information (PHI) D. billing for services not rendered E. accepting gifts in place of payment from patients - Correct Answers ✅ An established patient is being seen by the physician today. The patient owes $25.00 for the visit. The amount collected for the office visit is called the A. copayment. B. balance. C. deductible. D. coinsurance. - Correct Answers ✅ A Medicare patient has an 80/20 plan. The charged amount was $300.00. The amount allowed was $100.00. Which of the following is the patient's coinsurance? A. $80 NCCT PRACTICE exam latest questions with verified answers 2023 B. $60 C. $100 D. $20 - Correct Answers ✅ Which of the following information is necessary to post payments from the RA/EOB? (Select the three (3) Correct Answers .) A. diagnosis codes B. patient's name C. date of service D. billed CPT® codes E. patient's date of birth - Correct Answers ✅ A healthy 32-year-old patient required an urgent vaginal hysterectomy following delivery of her third child. Which of the following anesthesia codes should be assigned? A. 01963-P1 B. 01963 C. 01962 D. 01962-P1 - Correct Answers ✅D. 01962-P1