Study guides, Class notes & Summaries

Medical Billing Questions and Answers Already Passed 1. Administrative medical office responsibilities include Claims submissions 2. A claims assistant professional Works for the consumer and helps patients file insurance claims 3. The amount of money an insurance billing specialist earns is dependent on which of the following factors Knowledge,experience, and size of employing institution 4. A billing specialist is entrusted with Holding patient's medical information in confid...

Medical Billing and Coding Test 1 with Complete Solutions ICD-10-CM is mandated code set for diagnosis under the HIPPA: transaction and code sets A code in ICD-10-CM has up to how many characters? Seven An ICD-10-CM category code has how many characters? Three A subcategory code in ICD-10-CM has how many characters? Four An example of subcategory code: S81.2 The correct code set to be used is according to the CMS is based on what? Date of service The first step to begin c...

Medical Billing and Coding Chapter 1 Latest Update 100% Correct Manged Care a system in which healthcare is monitored. Health care provider contract with a health insurance company. What percentage does physicians and nurses make up? 40% of all healthcare providers Solo/private facilities The receptionist and medical biller are often cross-trained. Staff may consist of nurse, receptionist and a medical biller and/or office manger. small group practice four or five general practiti...

Medical Billing and Coding Practice Test with Complete Solutions Which of the following Medicare policies determines if a particular item or service is covered by Medicare? National Coverage Determination (NCD) Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Encounter Form A patient comes to the hospital for ...

Medical Billing and Coding Chapter 7 Latest 2024 Graded A+ CMS 100 - paper claim submitted to TPP for reinbursement ( paper claim ) HIPPA x12 837 - electronic form used to send a claim ( HIPPA 837 P claim (electronic) HIPPA requires electronic transmission of claims by all providers with _________ employees. 10 or more National Uniform Claim Commitee (NUCC) - organization responsible for claim content CMS - 1500 (02/12) -revised- current paper claim approved by the NUCC 501...

Medical Billing and Coding Latest Update 100% Pass code linkage connection between a service and a patient's condition or illness correct coding initiative (CCI) computerized Medicare system that prevents overpayment edits computerized system that identifies improper or incorrect codes CC1 column 1/ column 2 code pair edit Medicare code edit where CPT codes in column 2 will not be paid if reported in the same way as the column 1 code CCI mutually exclusive code (MEC) edit Bot...

MEDICAL BILLING AND CODING LATEST UPDATE GRADED A+ NP New Patient RX Perscription CC Chief Complaint EP Established Patient DX Diagnosis 6 Sections of CPT Medicine Surgery Raidiology Pathology Evaluation Anesthesiology What is a Modifier? Used to further explain service, treatment, diagnosis What does CPT stand for and what do CPT codes represent? Current Procedural Terminology Used to classify service or procedures How many digits does a CPT code contain? ...

Medical Billing and Coding Chapter 1 with Complete Solutions Managed Care Used to describe a system in which healthcare delivery is monitored. Under manages care a healthcare provider will contract with a health insurance company. In this contract the provider agrees to follow guidelines with the aim to control healthcare costs. 3 Categories of a Physician's Practice 1. Solo/Private Practice 2. Small Group (3-9 physicians) 3. Large Group (10 or more physicians) Patient Account S...

Medical Billing and Coding Lesson 1: Reimbursement, HIPAA, and Compliance Already Passed The Medical Coder's Responsibility Each coding system plays a critical role in reimbursement. The role of the medical coder is to optimize payment while adhering to coding guidelines. The coder must accurately code the services, procedures, and diagnosis rendered so that the office is properly reimbursed. Coders may encounter ethical issues about upcoding a procedure or changing a diagnosis to ob...

Medical Billing and Coding Certificate Exam 2024 Graded A+!!