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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. evaluation and management.

B. arthroscopy.

C. abdominal distention.

D. osteopathic manipulation.

Question #2

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

A. colon.

B. semicolon.

C. hyphen.

D. comma.

Question #3

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

A. parent code.

B. official code.

C. main term.

D. subterm.

Question #4

The modifier used to report a bilateral procedure is:

A. -22

B. -50

C. -53

D. -47

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. -25

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. -56

B. -55

C. -54

D. -58

Question #8

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

A. exploration of operative area

B. None of these

C. positioning the patient

D. fulguration of bleeding points

Question #9

Anesthesia is reimbursed according to the:

A. experience of the anesthesiologist.

B. type of surgery or procedure being performed.

C. type of drug administered.

D. time under anesthesia.

Question #10

A bundled code refers to a:

A. code used with modifier -99.

B. group of procedures pertaining to the same diagnosis.

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

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

Question #11

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

A. body site.

B. type of drug administered.

C. time under anesthesia.

D. type of surgery or procedure.

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. P3.

B. P1.

C. P4.

D. P6.

Question #13

The physical status modifier P1 refers to a:

A. patient with mild systemic disease.

B. normal, healthy patient.

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

D. patient with severe systemic disease.

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. elective procedure

B. essential procedure

C. primary procedure

D. secondary procedure

Question #16

A surgical package would include:

A. all general anesthesia services.

B. all care provided within 30 days of surgery.

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

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

B. evaluating the patient in the postanesthesia recovery room.

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

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

Question #18

The global surgical period is determined by the:

A. patient's primary care physician.

B. surgeon.

C. insurance carrier or other third-party payer.

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. supply and equipment component.

C. results component.

D. professional 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. supply and equipment component.

D. results component.

Question #21

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

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

B. can bill for obtaining the sample.

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

D. cannot bill for obtaining the sample.

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 vaccine given.

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

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. They are not considered HCPCS codes.

B. Level I HCPCS.

C. Level III HCPCS.

D. Level II HCPCS.

Question #26

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

A. source

B. informant

C. relator

D. plaintiff

Question #27

HCPCS Level II codes are updated annually by the:

A. World Health Organization (WHO).

B. American Dental Association (ADA).

C. American Medical Association (AMA).

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

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. This is not considered an HCPCS code.

C. Level II HCPCS code book.

D. Level III HCPCS code book.

Question #29

An example of an HCPCS Level II code is:

A. 250.00.

B. J0290.

C. E849.0.

D. 99213

Question #30

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

A. diagnostic radiology services.

B. dental procedures.

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. Health Insurance Association of America (HIAA).

B. Blue Cross/Blue Shield Association.

C. All of these.

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. V2020—V2799

D. T1000—T5999

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. F1.

D. LA.

Question #34

The HCPCS modifier GA indicates:

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

B. All of these.

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

D. a waiver of liability statement is on file.

Question #35

Inaccurate coding and incorrect billing can result in:

A. prison sentences.

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

C. delays in receiving payments.

D. All of these.

Question #36

Code linkage refers to the connection between the:

A. procedure and modifier.

B. diagnosis and procedure.

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. age.

B. health condition.

C. gender.

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

C. the therapist must be supervised by a physician.

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

Question #39

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. utilization of controlled substances in medical facilities.

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

Question #40

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

A. exclusion from the American Medical Association.

B. loss of professional license.

C. 10 years in jail.

D. $10,000.00

Question #41

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

A. abuse.

B. fraud.

C. unbundling.

D. upcoding.

Question #42

Misusing Medicare funds is considered:

A. abuse but not illegal.

B. fraud but not illegal.

C. fraud and illegal.

D. abuse and illegal.

Question #43

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

A. inaccurate.

B. fraud.

C. abuse.

D. incomplete.

Question #44

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

A. diagnosis codes only.

B. neatness of the claim.

C. diagnosis and procedure codes.

D. procedure codes only.

Question #45

All the following are true of Column I edits EXCEPT:

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

B. formerly known as the component column.

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

D. contains the comprehensive code.

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. would be treated leniently for asking the question.

B. could claim "not knowing."

C. could be prosecuted.

D. should not change its practices.

Question #48

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