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NHA - Certified Billing and Coding Specialist (CBCS) Study Guide verified solution 2022 $11.49   Add to cart

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NHA - Certified Billing and Coding Specialist (CBCS) Study Guide verified solution 2022

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

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  • December 28, 2022
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  • 2022/2023
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NHA - Certified Billing and Coding
Specialist (CBCS) Study Guide verified
solution 2022
The symbol "O" in the Current Procedural Terminology reference is used to indicate
what? - Reinstated or recycled code

In the anesthesia section of the CPT manual, what are considered qualifying
circumstances? - Add-on codes

As of April 1, 2014 what is the maximum number of diagnoses that can be reported on
the CMS-1500 claim form before a further claim is required? - 12

What is considered proper supportive documentation for reporting CPT and ICD codes
for surgical procedures? - Operative report

What action should be taken first when reviewing a delinquent claim? - Verify the age of
the account

A claim can be denied or rejected for which of the following reasons? - Block 24D
contains the diagnosis code

A coroner's autopsy is comprised of what examinations? - Gross Examination

Medigap coverage is offered to Medicare beneficiaries by whom? - Private third-party
payers

What part of Medicare covers prescriptions? - Part C

What plane divides the body into left and right? - Sagittal

Where can unlisted codes be found in the CPT manual? - Guidelines prior to each
section

Ambulatory surgery centers, home health care, and hospice organizations use which
form to submit claims? - UB-04 Claim Form

What color format is acceptable on the CMS-1500 claim form? - Red

Who is responsible to pay the deductible? - Patient

A patient's health plan is referred to as the "payer of last resort." What is the name of
that health plan? - Medicaid

, Informed Consent - Providers explain medical or diagnostic procedures, surgical
interventions, and the benefits and risks involved, giving patients an opportunity to ask
questions before medical intervention is provided.

Implied Consent - A patient presents for treatment, such as extending an arm to allow a
venipuncture to be performed.

Clearinghouse - Agency that converts claims into standardized electronic format, looks
for errors, and formats them according to HIPAA and insurance standards.

Individually Identifiable - Documents that identify the person or provide enough
information so that the person can be identified.

De-identified Information - Information that does not identify an individual because
unique and personal characteristics have been removed.

Consent - A patient's permission evidenced by signature.

Authorizations - Permission granted by the patient or the patient's representative to
release information for reasons other than treatment, payment, or health care
operations.

Reimbursement - Payment for services rendered from a third-party payer.

Auditing - Review of claims for accuracy and completeness.

Fraud - Making false statements of representations of material facts to obtain some
benefit or payment for which no entitlement would otherwise exist.

Upcoding - Assigning a diagnosis or procedure code at a higher level than the
documentation supports, such as coding bronchitis as pneumonia.

Unbundling - Using multiple codes that describe different components of a treatment
instead of using a single code that describes all steps of the procedure.

Abuse - Practices that directly or indirectly result in unnecessary costs to the Medicare
program.

Business Associate (BA) - Individuals, groups, or organizations who are not members of
a covered entity's workforce that perform functions or activities on behalf of or for a
covered entity.

What is the main job of the Office of the Inspector General (OIG)? - The OIG protects
Medicare and other HHS programs from fraud and abuse by conducting audits,
investigations , and inspections.

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