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Medical Billing and Coding Final Exam with Complete Solutions
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Medical Billing and Coding Final Exam
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Medical Billing and Coding Final ExamWhat is the meaning of each of the modifiers used in the following case examples? A multi -
trauma patient had a bilateral knee procedure as part of a team surgery following a motorcycle
crash. The orthopedic surgeon also reconstructed the patient's pelvis and left wrist. Correct
Ans-80 Assistant Surgeon
HCPCS code for: Administration of hepatitis B vaccine Correct Ans-G0010
HCPCS code for Distilled water used for nebulizer 1000ml Correct Ans-A7018
HCPCS code for Miscellaneous durable medical equipment Correct Ans-E1399
HCPCS code for Infusion of 1000 cc of normal saline solution Correct Ans-J7030
HCPCS code for Wood crutch, underarm Correct Ans-E0113
HCPCS modifier Left foot, great toe Correct Ans-TA
HCPCS modifier Technical componet Correct Ans-TC
HCPCS modifier Waiver of liability statement on file Correct Ans-GA
, HCPCS modifier Upper left eyelid Correct Ans-E1
HCPCS modifier Item or service expected to be denied as not reasonable necessary Correct
Ans-GZ
A patient with Medicare is seen in the physician office The total charge for the visit is $250.00.
The patient has previously paid his deductible under Medicare B, The Par Medicare Fee
Schedule amount for this service is $200.00. The Non Par Fee Schedule amount for this service
is 190.00. Correct Ans-If a physician is a PARTICIPATING physician who accepts assignment,
for this claim, the total amount the physician will receive is ? $200.00
A patient with Medicare is seen in the physician office The total charge for the visit is $250.00.
The patient has previously paid his deductible under Medicare B, The Par Medicare Fee
Schedule amount for this service is $200.00. The Non Par Fee Schedule amount for this service
is 190.00. Correct Ans-If the physician is a NONPARTICIPATING physician who DOES NOT
accept assignment for this claim, the total amount the physician will receive is?218.00
(190+28.50)
190 is non participating fee +15% patient pays of non participating fee.
Assume the patient has already met his or her deductible and that the physicians Medicare
participating (PAR) provider. The physicians' standard fee for the service provided is $120.00
MEDICARE'S par fee is $60.00 Correct Ans-How much reimbursement will the physician
receive from MEDICARE? 45.60 (48.00-2.40)
(60x80%=48) medicare-(48x5%) medicare % par fee
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