77 Modifier Correct Answer: Repeat procedure/service by another physician or other qualified
health care professional
58 Modifier Correct Answer: Staged/related procedure/service by same physician or other health
care professional during postoperative period
59 Modifier Correct Answer: Distinct procedural service
57 Modifier Correct Answer: Decision for surgery used with E/M, Medicare, and Medicine
25 Modifier Correct Answer: Significant separately identifiable E/M service by the same
physician or other health care professional and same day of procedure or other service
19 Block CMS-1500 Correct Answer: Additional claim info
14 Block CMS-1500 Correct Answer: Date of current illness injury or pregnancy
9D Block CMS-1500 Correct Answer: Secondary insurance plan or program name
18 Block CMS-1500 Correct Answer: Hospitalization dates related to current services
26 Block CMS-1500 Correct Answer: Pt's account number for office
17 Block CMS-1500 Correct Answer: Name of referring provider or other source
23 Block CMS-1500 Correct Answer: Prior authorization number
30 Block CMS-1500 Correct Answer: Balance due
11C Block CMS-1500 Correct Answer: Insurance plan name or program name
Stark 1 Correct Answer: This law pertained only to clinical labs that prohibited physicians from
referring a pt to a clinical lab in which the Dr or a member of his or her family had a financial
interest.
,Stark 2 Correct Answer: Prohibit the submission of claims for designated services or referral of
pts if the referring physician has a financial relationship with the entity that provides the services.
V codes Correct Answer: (V01-V82) are the codes that refer to factors that influence the health
statue of a pt. A definite diagnosis cannot be stated, but a valid reason for seeing the provider
exists.
ICD-9-CM
E Codes
(E000-E999) Correct Answer: Supplementary classification of external causes of injury and
poisoning.
-Alphanumerical designations for injuries and poisoning.
-Provides any additional info about external causes.
-NEVER a principal (inpatient) diagnosis.
ICD-9-CM
Section 1: Correct Answer: Index to diseases
ICD-9-CM
Section 2: Correct Answer: Tables of Drugs & Chemicals
ICD-9-CM
Section 3: Correct Answer: Index to external causes of injuries and poisonings (E Codes)
ICD-9-CM
Appendix B: Correct Answer: Glossary of Mental disorders
ICD-9-CM
Appendix A: Correct Answer: Morphology of Neoplasms
, ICD-9-CM
V Codes
(V01.0-V91.9) Correct Answer: Pt not I'll but encounters health services.
-Pt presents for treatment.
-Some are primary only.
--Principle= inpatient
--First-listed= outpatient
-Factors that influence pt's health status.
What is the biggest difference between ICD-9-CM to ICD-10-CM? Correct Answer: 9 has 3-5
digits and 10 has up to 7 digits
ICD-9-CM
Diagnosis Correct Answer: 3
ICD-9-CM
Procedures Correct Answer: 2
Delivering 02 blood to all parts of the body? Correct Answer: Respiratory system
Tort Correct Answer: A wrongful act that harms or cause injury to another person.
On the CMS-1500 form, Blocks 14-33 contain info about what? Correct Answer: The Pt's
condition an provider's info
The EOB states amount billed was $80. The allowed amount is $60, and the pt is required to pay
a $20 coat. What describes the insurance check amount to be posted? Correct Answer: $40
Allowed Amount
-
Company
=
Amount To Be Posted
Electronics Claim Correct Answer: ASC X12N 837
Invalid Form Correct Answer: CMS-1500 form 14905
Ambulance Form Correct Answer: CMS-1500 form 1492
Unprocessable Claim Correct Answer: The term is used for Medicare's editing process, when
returns claims with incomplete or invalid info.
If your claim had a services date of October 1,2008, then what would the filing time limit be for
filing your claim? Correct Answer: December 31,2008
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