An insurance and coding specialist is reviewing a patient's encounter form that is documented in the
medical record prior to competing a CMS-1500 form. She notices that the physician upcoded the
encounter form. The spe
...
An insurance and coding specialist is reviewing a patient's encounter form that is documented in the
medical record prior to competing a CMS-1500 form. She notices that the physician upcoded the
encounter form. The specialist has the ethical obligation to first - ✔✔query the physician
A patient had surgery two weeks ago to repair a dislocated ankle, and returns today to have a flexor
tendon in the hand repaired. Which of the following modifiers should be reported for today's service? -
✔✔-79
A patient has called to schedule an appointment for an office visit to see the doctor tomorrow for an
earache. It is discovered during the scheduling process that the insurance policy on file has been
cancelled. Which of the following should the insurance and coding specialist do next? - ✔✔Advise the
patient to bring current insurance information to the appointment.
An established patient is being seen by the physician today. The patient owes $25.00 for the visit. The
amount collected for the office visit is called the - ✔✔copayment
Applying the birthday rule, a minor child comes in. Both parents have remarried and the child is listed on
the mother's, father's, and both step-parents' policies. The mother's birthday is April 16, stepfather's
birthday March 19, father's birthday is February 19th, and the stepmother's birthday is January 20th.
Which of the following is correct? - ✔✔Father's plan is primary, mother's plan is secondary.
A provider performed a right sided facet joint injection using fluoroscopic guidance. The billed codes
were 64493 and 77003. An EOB was returned denying the charge of 77003. Why was this charge
denied? - ✔✔Imaging guidance is an inclusive component of 64493.
A patient was seen in the office. Charges were recorded and submitted to the patient's insurance, and
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