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MOA 183 - Intro to Health Insurance » Fall 2022 » Weekly Quiz 6 Chapter 7 & 8

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Question #1

Examples of procedures or services include all of the following EXCEPT:

A. arthroscopy.

B. evaluation and management.

C. osteopathic manipulation.

D. abdominal distention.

Question #2

If two codes apply to an entry in the CPT index, the codes are separated by a:

A. semicolon.

B. hyphen.

C. comma.

D. colon.

Question #3

Within an indented series of codes, the first left-justified code is the:

A. parent code.

B. subterm.

C. main term.

D. official code.

Question #4

The modifier used to report a bilateral procedure is:

A. -22

B. -53

C. -47

D. -50

Question #5

Modifier -47 is used to report:

A. procedure performed by a surgical assistant.

B. anesthesia administered by a surgeon.

C. use of local anesthesia.

D. multiple procedures that involve anesthesia.

Question #6

A special report detailing increased time and difficulty should be submitted with a claim when which modifier is used?

A. -22

B. -79

C. -63

D. -25

Question #7

When a physician performs a surgical procedure but does NOT provide the preoperative and/or postoperative management, the coder should use modifier:

A. -55

B. -56

C. -58

D. -54

Question #8

Which of the following can be billed separately in a surgical procedure?

A. None of these

B. fulguration of bleeding points

C. positioning the patient

D. exploration of operative area

Question #9

Anesthesia is reimbursed according to the:

A. type of drug administered.

B. time under anesthesia.

C. experience of the anesthesiologist.

D. type of surgery or procedure being performed.

Question #10

A bundled code refers to a:

A. group of procedures pertaining to the same diagnosis.

B. group of unrelated procedures done on the same day.

C. code used with modifier -99.

D. group of related procedures covered by a single code.

Question #11

The subsections under Anesthesia in the CPT code book are organized by:

A. time under anesthesia.

B. type of surgery or procedure.

C. type of drug administered.

D. body site.

Question #12

The physical status modifier that should be used for a patient with severe systemic disease that is a constant threat to life is:

A. P1.

B. P4.

C. P3.

D. P6.

Question #13

The physical status modifier P1 refers to a:

A. normal, healthy patient.

B. patient with severe systemic disease.

C. patient who is not expected to survive without the surgery.

D. patient with mild systemic disease.

Question #14

The largest section of the CPT code book is:

A. Pathology and Laboratory.

B. Surgery.

C. Evaluation and Management.

D. Medicine.

Question #15

Which type of procedure is reported as an additional procedure performed in addition to a main procedure?

A. elective procedure

B. primary procedure

C. essential procedure

D. secondary procedure

Question #16

A surgical package would include:

A. one evaluation and management (E/M) encounter on the date immediately prior to the date of the procedure.

B. all general anesthesia services.

C. all care provided within 30 days of surgery.

D. all E/M encounters prior to the date of the procedure.

Question #17

A service NOT included in the surgical package code would be:

A. surgical complications or the presence of other diseases requiring additional services.

B. immediate postoperative care, including talking with the patient's family.

D. evaluating the patient in the postanesthesia recovery room.

E. one related evaluation and management (E/M) encounter on the date immediately prior to the date of the procedure.

Question #18

The global surgical period is determined by the:

A. surgeon.

B. insurance carrier or other third-party payer.

C. patient's primary care physician.

D. patient.

Question #19

In coding radiology services, the part of the procedure that reflects the technologist and the equipment used is the:

A. technical component.

B. results component.

C. professional component.

D. supply and equipment component.

Question #20

The use of the term supervision and interpretation (S&I) means that the radiology code represents only the:

A. professional component.

B. technical component.

C. results component.

D. supply and equipment component.

Question #21

If a physician's office collects a blood sample and sends it to an outside lab, the physician:

A. can bill for analyzing the test results only in certain cases.

B. cannot bill for obtaining the sample.

C. can bill for obtaining the sample.

D. can never bill for any type of lab work.

Question #22

To code for immunizations, the coder should use:

A. one bundled code for the administration and the vaccine given.

B. one code for the vaccine given.

C. one code for the administration and one code for the vaccine.

D. one code for the administration only.

Question #23

A range of codes is shown when more than one code applies to an entry.

A. False

B. True

Question #24

When add-on codes are used, the coder should also use modifier -51 to identify more than one code.

A. True

B. False

Question #25

The five-digit CPT codes used to report services and procedures performed by healthcare providers are also known as:

A. Level I HCPCS.

B. They are not considered HCPCS codes.

C. Level II HCPCS.

D. Level III HCPCS.

Question #26

What is an individual called who files a lawsuit on behalf of the federal government?

A. relator

B. source

C. informant

D. plaintiff

Question #27

HCPCS Level II codes are updated annually by the:

A. Centers for Medicare and Medicaid Services (CMS).

B. World Health Organization (WHO).

C. American Medical Association (AMA).

D. American Dental Association (ADA).

Question #28

A coder who needs to find the code for prosthetic procedures would find it in the:

A. Level II HCPCS code book.

B. Level I HCPCS code book.

C. Level III HCPCS code book.

D. This is not considered an HCPCS code.

Question #29

An example of an HCPCS Level II code is:

A. J0290.

B. 99213

C. E849.0.

D. 250.00.

Question #30

HCPCS Level II codes in the range J0120-J9999 would be used for:

A. dental procedures.

B. diagnostic radiology services.

C. drugs administered other than oral method.

D. durable medical equipment (DME).

Question #31

The National Panel that maintains Level II HCPCS codes includes representatives from:

A. Centers for Medicare and Medicaid Services (CMS).

B. All of these.

C. Health Insurance Association of America (HIAA).

D. Blue Cross/Blue Shield Association.

Question #32

State Medicaid agency codes are reported with what HCPCS code range?

A. V2020—V2799

B. G0008—G9156

C. T1000—T5999

D. C1300—C9899

Question #33

To identify that a procedure was performed on the thumb of the left hand, the coder would select the modifier:

A. L1.

B. F1.

C. LA.

D. FA.

Question #34

The HCPCS modifier GA indicates:

A. the procedure billed may be denied by Medicare as "not medically necessary."

B. All of these.

C. an advance beneficiary notice has been signed by the patient.

D. a waiver of liability statement is on file.

Question #35

Inaccurate coding and incorrect billing can result in:

A. All of these.

B. delays in receiving payments.

C. loss of the provider's license to practice medicine.

D. prison sentences.

Question #36

Code linkage refers to the connection between the:

A. diagnosis and symptom.

B. procedure and modifier.

C. HCPCS Level I and Level II codes.

D. diagnosis and procedure.

Question #37

A. health condition.

B. gender.

C. age.

D. All of these.

Question #38

In physical therapy cases, if a coder bills for supervised attendance:

A. the therapist must be supervised by a physician.

B. the therapist must be in constant attendance with the patient.

C. one-on-one direct contact by the therapist is not required.

D. one-on-one direct contact by the therapist is required.

Question #39

The Stark Law was enacted to govern the practice of:

A. medical office coding practices.

B. physician referrals to other providers such as physical and occupational therapists.

C. physician referrals of Medicare and Medicaid patients to facilities in which he or she has a financial interest.

D. utilization of controlled substances in medical facilities.

Question #40

Under civil law, the maximum penalty for medical fraud is:

A. loss of professional license.

B. exclusion from the American Medical Association.

C. 10 years in jail.

D. $10,000.00

Question #41

To bill for a procedure that was NOT performed is considered:

A. unbundling.

B. fraud.

C. abuse.

D. upcoding.

Question #42

Misusing Medicare funds is considered:

A. fraud and illegal.

B. abuse but not illegal.

C. abuse and illegal.

D. fraud but not illegal.

Question #43

To bill for a procedure that was NOT medically necessary is considered:

A. abuse.

B. fraud.

C. incomplete.

D. inaccurate.

Question #44

Healthcare payers base their decision to pay or deny claims on the:

A. procedure codes only.

B. diagnosis codes only.

C. diagnosis and procedure codes.

D. neatness of the claim.

Question #45

All the following are true of Column I edits EXCEPT:

A. contains the comprehensive code.

B. formerly known as the component column.

C. includes all the services that are described by Column II code.

D. cannot be billed together with the Column I code for the same patient on the same day.

Question #46

Benefits of a voluntary compliance plan include:

A. All of these.

B. avoiding conflicts with the self-referral and anti-kickback statutes.

C. reducing the chances that an audit will be conducted by the CMS or OIG.

D. minimizing billing mistakes.

Question #47

If a provider requests an advisory opinion and fails to follow the advice of the Office of Inspector General (OIG), the provider:

A. could claim "not knowing."

B. should not change its practices.

C. could be prosecuted.

D. would be treated leniently for asking the question.

Question #48

HCPCS is the acronym for Healthcare Coding Procedures in a Common System.