NHA CBCS EXAM PACK|GRADED A|GUARANTEED SUCCESS

UROLOGIST A _____________________________ would be the provider who would perform an orchiopexy EVALUATION AND MANAGEMENT CODES The first section of the CPT manual is the _____________________________________________. ALLOWED AMOUNT ____________________________ means the amount of r...

When a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of th...

The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - correct answer Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - correct answer Add-on codes As of April 1, 2014 what is the maxim...

A patient's health plan is referred to as the payer of last resort. The patient is covered by which of the following health plans? Medicaid CHAMPA Medicare TRICARE Medicaid A provider charged $500 to a claim that had an allowable amount of $400. In which of the following columns should ...

Medical Ethics Standards of conduct based on moral principals. Acting within ethical behavior boundries means carrying out one's responsibilities with integrity, decency, respect, honesty, competence, fairness and trust. Compliance Regulations Most billing related cases are based on HIPAA ...

The attending physician A nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? The patients condition and the providers inform...

Which of the following Medicare policies determines if a particular item or service is covered by Medicare? National Coverage Determination (NCD) A patient's employer has not submitted a premium payment. Which of the following claim statuses should the provider receive from the third-party ...

For non-crossover claims, the billing and coding specialist should prepare an additional claim for the secondary payer and send it with a copy of which? Remittance Advice If a clean claim is received on March 1 of this year, which is the allowable last day of payment in order to meet Medicar...

Which of the following is considered the final determination of the issues involving the settlement of an insurance claim? Adjudication - is the process of putting an insurance claim through a series of edits for final determination. Chapter 4 A form that contains charges, DOS, CPT codes, f...

The test used to check for brain abnormalities? EEG(Electroencephalography) If a claim is denied because a service was not covered by an insurer and there were no errors on the claim, what would be the next step in the accounts receivable process? The claim would not be re-submitted and the...

22 increased procedural services 23 Unusual Anesthesia 25 Significant, separately identifiable evaluation and management service by te same physician or other qualified health care professional on the same day 26 professional component 32 mandated services 33 ...