NHA - (3)Certified Billing and Coding
Specialist (CBCS) Study Guide 30
(COMPLETE SOLUTIONS)
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? -
✔✔Reinstated or recycled code
In
...
NHA - (3)Certified Billing and Coding
Specialist (CBCS) Study Guide 30
(COMPLETE SOLUTIONS)
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? - ✔✔Addon 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 proce
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