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.
evaluation and management.
B.
osteopathic manipulation.
C.
arthroscopy.
D.
abdominal distention.
Question #2
If two codes apply to an entry in the CPT index, the codes are separated by a:
A.
comma.
B.
semicolon.
C.
colon.
D.
hyphen.
Question #3
Within an indented series of codes, the first left-justified code is the:
A.
parent code.
B.
main term.
C.
subterm.
D.
official code.
Question #4
The modifier used to report a bilateral procedure is:
A.
-50
B.
-47
C.
-22
D.
-53
Question #5
Modifier -47 is used to report:
A.
anesthesia administered by a surgeon.
B.
use of local anesthesia.
C.
procedure performed by a surgical assistant.
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.
-25
B.
-79
C.
-22
D.
-63
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.
-58
C.
-54
D.
-56
Question #8
Which of the following can be billed separately in a surgical procedure?
A.
fulguration of bleeding points
B.
None of these
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.
type of surgery or procedure being performed.
D.
experience of the anesthesiologist.
Question #10
A bundled code refers to a:
A.
group of unrelated procedures done on the same day.
B.
group of related procedures covered by a single code.
C.
group of procedures pertaining to the same diagnosis.
D.
code used with modifier -99.
Question #11
The subsections under Anesthesia in the CPT code book are organized by:
A.
body site.
B.
time under anesthesia.
C.
type of surgery or procedure.
D.
type of drug administered.
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.
P4.
B.
P6.
C.
P1.
D.
P3.
Question #13
The physical status modifier P1 refers to a:
A.
patient with severe systemic disease.
B.
normal, healthy patient.
C.
patient with mild systemic disease.
D.
patient who is not expected to survive without the surgery.
Question #14
The largest section of the CPT code book is:
A.
Pathology and Laboratory.
B.
Medicine.
C.
Surgery.
D.
Evaluation and Management.
Question #15
Which type of procedure is reported as an additional procedure performed in addition to a main procedure?
A.
primary procedure
B.
secondary procedure
C.
essential procedure
D.
elective procedure
Question #16
A surgical package would include:
A.
all care provided within 30 days of surgery.
B.
all general anesthesia services.
C.
all E/M encounters prior to the date of the procedure.
D.
one evaluation and management (E/M) encounter on the date immediately 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.
C.
immediate postoperative care, including talking with the patient's family.
D.
one related evaluation and management (E/M) encounter on the date immediately prior to the date of the procedure.
E.
evaluating the patient in the postanesthesia recovery room.
Question #18
The global surgical period is determined by the:
A.
insurance carrier or other third-party payer.
B.
surgeon.
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.
results component.
B.
professional component.
C.
technical 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.
results component.
C.
supply and equipment component.
D.
technical component.
Question #21
If a physician's office collects a blood sample and sends it to an outside lab, the physician:
A.
cannot bill for obtaining the sample.
B.
can bill for obtaining the sample.
C.
can bill for analyzing the test results only in certain cases.
D.
can never bill for any type of lab work.
Question #22
To code for immunizations, the coder should use:
A.
one code for the administration and one code for the vaccine.
B.
one code for the administration only.
C.
one code for the vaccine given.
D.
one bundled code for the administration and the vaccine given.
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.
False
B.
True
Question #25
The five-digit CPT codes used to report services and procedures performed by healthcare providers are also known as:
A.
They are not considered HCPCS codes.
B.
Level III HCPCS.
C.
Level II HCPCS.
D.
Level I HCPCS.
Question #26
What is an individual called who files a lawsuit on behalf of the federal government?
A.
plaintiff
B.
source
C.
informant
D.
relator
Question #27
HCPCS Level II codes are updated annually by the:
A.
American Medical Association (AMA).
B.
Centers for Medicare and Medicaid Services (CMS).
C.
American Dental Association (ADA).
D.
World Health Organization (WHO).
Question #28
A coder who needs to find the code for prosthetic procedures would find it in the:
A.
Level I HCPCS code book.
B.
Level III HCPCS code book.
C.
This is not considered an HCPCS code.
D.
Level II HCPCS code book.
Question #29
An example of an HCPCS Level II code is:
A.
J0290.
B.
E849.0.
C.
250.00.
D.
99213
Question #30
HCPCS Level II codes in the range J0120-J9999 would be used for:
A.
dental procedures.
B.
durable medical equipment (DME).
C.
drugs administered other than oral method.
D.
diagnostic radiology services.
Question #31
The National Panel that maintains Level II HCPCS codes includes representatives from:
A.
Health Insurance Association of America (HIAA).
B.
All of these.
C.
Blue Cross/Blue Shield Association.
D.
Centers for Medicare and Medicaid Services (CMS).
Question #32
State Medicaid agency codes are reported with what HCPCS code range?
A.
C1300—C9899
B.
G0008—G9156
C.
T1000—T5999
D.
V2020—V2799
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.
FA.
C.
LA.
D.
F1.
Question #34
The HCPCS modifier GA indicates:
A.
an advance beneficiary notice has been signed by the patient.
B.
a waiver of liability statement is on file.
C.
All of these.
D.
the procedure billed may be denied by Medicare as "not medically necessary."
Question #35
Inaccurate coding and incorrect billing can result in:
A.
loss of the provider's license to practice medicine.
B.
All of these.
C.
delays in receiving payments.
D.
prison sentences.
Question #36
Code linkage refers to the connection between the:
A.
diagnosis and procedure.
B.
procedure and modifier.
C.
diagnosis and symptom.
D.
HCPCS Level I and Level II codes.
Question #37
Procedure and diagnostic codes should be appropriate to the patient's:
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.
one-on-one direct contact by the therapist is not required.
B.
the therapist must be in constant attendance with the patient.
C.
the therapist must be supervised by a physician.
D.
one-on-one direct contact by the therapist is required.
Question #39
The Stark Law was enacted to govern the practice of:
A.
utilization of controlled substances in medical facilities.
B.
physician referrals of Medicare and Medicaid patients to facilities in which he or she has a financial interest.
C.
medical office coding practices.
D.
physician referrals to other providers such as physical and occupational therapists.
Question #40
Under civil law, the maximum penalty for medical fraud is:
A.
exclusion from the American Medical Association.
B.
$10,000.00
C.
10 years in jail.
D.
loss of professional license.
Question #41
To bill for a procedure that was NOT performed is considered:
A.
fraud.
B.
upcoding.
C.
unbundling.
D.
abuse.
Question #42
Misusing Medicare funds is considered:
A.
abuse and illegal.
B.
fraud but not illegal.
C.
abuse but not illegal.
D.
fraud and illegal.
Question #43
To bill for a procedure that was NOT medically necessary is considered:
A.
abuse.
B.
inaccurate.
C.
incomplete.
D.
fraud.
Question #44
Healthcare payers base their decision to pay or deny claims on the:
A.
procedure codes only.
B.
diagnosis and procedure codes.
C.
neatness of the claim.
D.
diagnosis codes only.
Question #45
All the following are true of Column I edits EXCEPT:
A.
formerly known as the component column.
B.
cannot be billed together with the Column I code for the same patient on the same day.
C.
contains the comprehensive code.
D.
includes all the services that are described by Column II code.
Question #46
A.
minimizing billing mistakes.
B.
reducing the chances that an audit will be conducted by the CMS or OIG.
C.
avoiding conflicts with the self-referral and anti-kickback statutes.
D.
All of these.
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 be prosecuted.
B.
would be treated leniently for asking the question.
C.
should not change its practices.
D.
could claim "not knowing."
Question #48
HCPCS is the acronym for Healthcare Coding Procedures in a Common System.
A.
True
B.
False
Question #49
HCPCS is organized by code number rather than by service or supply name.
A.
False
B.
True
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