Which of the following describes the reason for a claim rejection because of Medicare ncci edits?
Correct Answer: Improper code combinations
A claim is submitted with a transposed insurance member ID number and returne
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Which of the following describes the reason for a claim rejection because of Medicare ncci edits?
Correct Answer: Improper code combinations
A claim is submitted with a transposed insurance member ID number and returned to the provider.
Which of the following describes the status that should be assigned to the claim by the carrier? Correct
Answer: invalid
Medigap coverage is offered to Medicare beneficiaries by which of the following? Correct Answer:
Private third-party payers
Which of the following provisions ensures that an insureds benefits from all insurance companies do not
exceed 100% of allowable medical expenses? Correct Answer: coordination of benefits
A coroner's autopsy is comprised of what examinations? Correct Answer: Gross examination
Which of the following statements is true regarding the release of patients records? Correct Answer:
Patient access to psychotherapy notes may be restricted
Which of the following actions by a billing and coding specialist would be considered fraud? Correct
Answer: billing for services not provided
Which of the following components of an explanation of benefits expedites the process of a phone
appeal? Correct Answer: claim control number
On the cms-1500 claim form, blocks 14 through 33 contain information about which of the following?
Correct Answer: The patient's condition and the provider's information
A billing and coding specialist should understand that the financial records source that is generated by a
providers office is called a Correct Answer: Patient ledger account
Which of the following medical terms refers to the sac that causes the heart Correct Answer:
Pericardium
Hipaa transaction standards apply to which of the following entities? Correct Answer: Health care
clearinghouses
All dependents 10 years of age or older are required to have which of the following for tricare? Correct
Answer: Military identification
The standard medical abbreviation ECG refers to a test used to assess which of the following body
systems? Correct Answer: cardiovascular system
Which of the following is an example of a violation of an adult patient confidentiality? Correct Answer:
Patient information was disclosed to the patient's parent without consent
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