CPB final exam study exam part 1 Questions & Answers
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Course
CPB
Institution
CPB
A biller at a medical practice notices that all claims contain CPT code 81002. She questions the nurse who tells her that because they are an OB/Gyn office, they bill every patient for a urinalysis. What does this violate? - ANSWERSFalse Claims Act
In addition to the standardization of the codes...
CPB final exam study exam part 1
Questions & Answers
A biller at a medical practice notices that all claims contain CPT code 81002. She
questions the nurse who tells her that because they are an OB/Gyn office, they bill
every patient for a urinalysis. What does this violate? - ANSWERSFalse Claims Act
In addition to the standardization of the codes (ICD-10, CPT, HCPCS, and NDC) what
other identifier is used on all claim?
a. Unique passcode
b. Unique identifier for employers and providers
c. Social Security number of the provider
d. Social Security number of the office manager - ANSWERSb. Unique identifier for
employers and providers
When a practice sends an electronic claim to a commercial health plan for payment,
what is this considered?
a. A code set
b. A transaction
c. A data set
d. Minimum necessary - ANSWERSb. A transaction
What is the purpose of the Privacy Rule? - ANSWERSto make sure that individuals'
health information is properly protected
Billing for a lower level of care than is supported in documentation, making false
statements to obtain undeserved benefits or payment from a federal healthcare
program, or billing for services that were not performed is defined as what by CMS?
a.Fraud
b.Abuse
c.a Stark violation
d.an Anti-kickback - ANSWERSa. Fraud
What does the abbreviation HIPAA stand for? - ANSWERSHealth Insurance Portability
and Accountability Act
Which of the following services is NOT covered under Medicare Part B?
A) Outpatient services
B) Diagnostic Tests
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