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Study Guide (Certified Medical Coding and Billing Specialist) questions with precise answers
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UB04 |! form |! is |! used |! for |! - |! Correct |! answer |! ✔Hospice, |! Ambulatory |! Surgery |! Centers, |! Home |! Health |! Care patient |! confidentiality |! - |! Correct |! answer |! ✔treating |! patient's |! medical |! information |! as |! private |! and |! not |! for |! publication signing |! an |! Acknowledgement |! of |! Notice |! of |! Privacy |! Practice |! is |! accepting |! what |! - |! Correct |! answer |! ✔HIPAA form |! to |! authorize |! sharing |! of |! medical |! information |! - |! Correct |! answer |! ✔medical |! release |! form standard |! form |! used |! for |! medical |! billing |! - |! Correct |! answer |! ✔CMS- must |! appear |! on |! CMS |! 1500 |! form |! prior |! to |! submission |! - |! Correct |! answer |! ✔birth |! date |! in |! 8 |! digit |! format, |! all |! caps
encounter |! form |! - |! Correct |! answer |! ✔financial |! record |! source |! document |! to |! record |! treated |! diagnosis |! and |! services |! rendered |! to |! the |! patient |! during |! the |! current |! encounter. |! also |! called |! the |! superbill where |! non |! allowed |! charges |! are |! recorded |! - |! Correct |! answer |! ✔adjustment |! column 10 |! digit |! numeric |! identifier |! required |! in |! box |! 33A |! of |! CMS |! 1500 |! - |! Correct |! answer |! ✔National |! Provider |! Identifier |! (NPI) CLIA |! - |! Clinical |! Laboratory |! Improvement |! Act |! - |! Correct |! answer |! ✔quality |! standards |! for |! lab |! tests most |! common |! reason |! for |! claim |! rejection |! - |! Correct |! answer |! ✔incorrect |! or |! incomplete |! information PICA |! pitch |! 10 |! - |! Correct |! answer |! ✔written |! CMS |! 1500 |! form PICA |! pitch |! 12 |! - |! Correct |! answer |! ✔electronic |! CMS |! 1500 |! form delinquent |! claim |! - |! Correct |! answer |! ✔not |! paid |! within |! a |! certain |! amount |! of |! time implied |! contract |! - |! Correct |! answer |! ✔patient |! scheduling |! an |! appointment |! with |! a |! new |! provider
appeal |! - |! Correct |! answer |! ✔explains |! why |! claim |! should |! be |! re-considered |! for |! payment offer |! Medigap |! - |! Correct |! answer |! ✔private |! commercial |! insurance |! companies hemodialysis |! - |! Correct |! answer |! ✔found |! in |! medicine |! secion |! of |! CPT |! manual payer |! of |! last |! resort |! - |! Correct |! answer |! ✔Medicaid Medicare |! Administrative |! Contractor |! (MAC) |! - |! Correct |! answer |! ✔Third |! party |! that |! contracts |! with |! CMS |! (Centers |! for |! Medicare |! and |! Madicaid |! Services) |! to |! process |! claims |! and |! perform |! integrity |! tasks |! - |! accepts |! electronic |! claims pending |! - |! Correct |! answer |! ✔submitted |! for |! review |! not |! yet |! paid co-payment |! - |! Correct |! answer |! ✔cost |! sharing |! requirement |! for |! the |! insured |! to |! pay |! at |! the |! time |! of |! service steps |! for |! coding |! 1st, |! 2nd, |! and |! 3rd |! degree |! burns |! - |! Correct |! answer |! ✔depth, |! extent, |! agent |! (e-code). |! 3rd |! degree |! first privacy |! officer |! - |! Correct |! answer |! ✔protects |! patient |! health |! information
ICD-9 |! principle |! - |! Correct |! answer |! ✔code |! signs |! and |! symptoms |! in |! absence |! of |! established |! diagnosis classifications |! of |! neoplasms |! in |! table |! of |! neoplasms |! - |! Correct |! answer |! ✔malignant, |! benighn, |! uncertain, |! un-specified, |! specific, |! in-situ |! (6) form |! needed |! for |! medicare |! patient |! when |! services |! for |! diagnostic |! tests |! are |! not |! covered |! - |! Correct |! answer |! ✔ABN |! (Advanced |! Beneficiary |! Notice) valid |! ICD-9 |! principle |! - |! Correct |! answer |! ✔code |! to |! the |! full |! number |! of |! digits |! required |! for |! that |! code |! or |! it |! is |! invalid claim |! control |! number |! - |! Correct |! answer |! ✔claim |! ID |! or |! DCN |! (document |! control |! number) |! assigned |! to |! each |! claim time |! reporting |! - |! Correct |! answer |! ✔guideline |! for |! anesthesiology, |! 24G |! on |! CMS |! 1500 developed |! and |! updates |! the |! CPT |! manual |! - |! Correct |! answer |! ✔AMA |! (American |! Medical |! Association) patient |! ledger |! account |! - |! Correct |! answer |! ✔permanent |! record |! of |! all |! financial |! transactions |! between |! the |! practice |! and |! the |! patient bull's |! eye |! - |! Correct |! answer |! ✔CPT |! symbol |! for |! conscious |! moderate |! sedation