26 Free NCCT Practice Test Online Questions for Medical Insurance Coding

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Increases/decreases to patient accounts not due to charges incurred or payments received

• Adjustment
• M codes
• Co-payment
• V codes

Type of managed care operation that is typically set up as a for-profit corporation with salaried employees

• Health Maintenance organization (HMO)
• Preferred Provider Organization (PPO)
• Preauthorization
• Explanation of Benefits (EOB)

Documentation/codes are ambiguous, reimburse lowest feeFraud

• E codes
• M codes
• Down-coding
• Up-Coding

Separating codes, bill separate to gain more money Fraud

• Unbundling codes
• Bundled codes
• E codes
• V codes

...

• E codes
• V codes
• CMS 1500
• M codes

Add on codes

• E codes
• M codes
• V codes
• Modifier

Identifies procedures performed, diagnoses, charges, and returns

• E codes
• Bundled codes
• V codes
• Encounter forms

Grouping of several services directly related to one procedure and paid as one

• E codes
• Bundled codes
• Unbundling codes
• V codes

Codes for preventative procedures

• Up-Coding
• E codes
• M codes
• V codes

ICD-9-CM codes for external causes of injury, poisoning, that explain how the injury occurred

• Up-Coding
• V codes
• E codes
• M codes

Payment required when seem by the probider

• Co-payment
• Up-Coding
• Adjustment
• Modifier

Signing over of benefits by the beneficiary to another party

• Encounter forms
• Adjustment
• Assignment of Benefits
• Explanation of Benefits (EOB)

Organizations of providers who network together to offer discounts on insurance

• Point-of-Service Plan (POS)
• Preferred Provider Organization (PPO)
• Health Maintenance organization (HMO)
• Preauthorization

Obtaining insurance carriers consent to proceed with patient care and treatment

• Beneficiary
• Modifier
• Medicare Part D
• Preauthorization

Direct communication between office and insurance companies

• Preauthorization
• Point-of-Service Plan (POS)
• Explanation of Benefits (EOB)
• Encounter forms

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terms that are enclosed in a box and are printed in italics. these notation indicates that some code classifications cannot be used with the code selected

• excludes
• notes
• includes
• symbols

a direction to the coder to look elsewhere if the main term or subterm(s) for that entry are not sufficient for coding the information

• see
• see also
• symbols
• code also

used to define terms and give coding instructions

• with
• and
• see
• notes

classifies environmental or external causes injury, poisoning, or other adverse effects on the body

• V codes: The Supplementary Classification of Factors Influencing Health Status and Contact with Health Services
• International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)
• E codes: The Supplemental Classification of External Causes of Injuries and Poisoning
• NEC: not elsewhere classifiable

documented at the patient's first visit with a new physician or provider or upon admission to a hospital and normally includes the CC, personal and family medical history, a physical examination, an assessment, and a treatment plan for the patient

• chief complaint (CC)
• subclassification
• history and physical examination (H&P, HPE)
• use additional code

Volume 2 of the ICD-9-CM coding manual; it lists conditions, injuries, illnesses, and diseases in alphabetical order by main terms, modifying terms, subterms

• excludes
• Alphabetic Index
• notations
• Tabular Index

the manual that establishes the system for classifying diseases to facilitate collection of uniform and comparable health information, for statistical purposes, and for indexing medical records for data storage and retrieval

• E codes: The Supplemental Classification of External Causes of Injuries and Poisoning
• International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Clinical Modification (ICD-10-CM)
• history and physical examination (H&P, HPE)
• International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM)

the physician's determination of what is or may be wrong with the patient based on findings from the history and physical examination (H&P) and includes a preliminary, interim, or final diagnosis

• and
• assessment
• see
• abstract

in the content of the ICD-9-CM, it should be interpreted as and/or

• see
• coding
• with
• and

the concise, technical description of the cause, nature, or manifestations of a condition or problem

• SOAP notes
• notes
• diagnosis
• chapters

adds the highest level of detail to the illness or injury, used to assign a fifth digit when appropriate

• subcategory
• abstract
• subclassification
• manifestation

broad sections of the ICD-9-CM coding manual grouped by disease or illness

• SOAP notes
• notes
• chapters
• category

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mohs micrographic surgery invloves the surgeon acting as

• any physician
• surgeon and pathologist
• new technology
• social history

observastion e/m codes 99218-99220 are used in physician billing when

• it can be used to collect data about nursing care.
• selective catheterization
• centers of medicare and medicaid services.
• a patient is referred to a designated observation status

per cpt guidelines a seperate procedure is

• centers of medicare and medicaid services.
• one code, for the final vessel entered
• considered to an integral part of another, larger service
• surgeon and pathologist

an encoder that takes a coder through a series of questions and choices is called

• e codes
• logic based encoder
• subcategory codes
• v codes

when coding a selective catheterization in cpt, how are codes assigned

• selective catheterization
• subclassification level
• one code, for the final vessel entered
• logic based encoder

which of the following statements does not apply to icd9cm

• centers of medicare and medicaid services.
• a 'with manipulation' code
• one code, for the final vessel entered
• it can be used to collect data about nursing care.

according to cpt, a repair of a laceration that includes retention sutures would be considered what type of closure

• cpt
• volume 1
• complex
• volume 2

if a patient has a excision of a malignant lesion of the skin, the cpt code is determined by the area from which the excision occurs and which of the following.

• diameter of the lesion as well as the most narrow margins required to adequately excise the lesion described in the operative report
• a patient is referred to a designated observation status
• identification of the supplies, products and services provided to patients
• considered to an integral part of another, larger service

which of the following icd9 codes are always alphanumeric

• volume 2
• v codes
• cpt
• e codes

which volume of icd9cm contains the numerical listing of codes that represent diseases and injuries

• complex
• volume 2
• v codes
• volume 1

the codes in the musculoskeletal section of cpt may be used by

• cpt
• any physician
• miscarriage
• ama

which volume of icd9 contains the tabular and alphabetic indexes of procedures.

• volume 1
• volume 2
• complex
• v codes

according to the uhdds whick of the following is the definition of other diagnosis

• considered to an integral part of another, larger service
• identification of the supplies, products and services provided to patients
• receives clinical evaluation or therapeutic treatment or diagnostic procedures or extends the length of stay or increases nursing care and or monitoring
• it can be used to collect data about nursing care.

the two digit modifier that may be reported to indicate a physician preformed the postoperative management of a patient, but another physician performed the surgical procedure

• 55
• cpt
• ama
• complex

what are five-digit icd9cm diagnosis codes referred to as

• subclassification level
• subcategory codes
• subclassification codes
• social history

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In the Medicare program, a clean claim means that :

• there is an emergent need for the information stated by the physician
• supplies, orthotics, prosthetics, DME equipment, ambulance services
• the claim has no deficiencies, the carries does not need to investigate further, the claim passes all electronic edits.
• add or correct the information and resubmit the claim

An organization which provides a wide range of services for a specified group at a fixed periodic payment is termed a(n)

• $100
• HMO
• CBC
• head

Services in which opinions of specialists are requested are called

• Confidential
• -ostomy
• consent
• consultations

The usual abbreviation for complete blood count is ______.

• $100
• HMO
• head
• CBC

If an error is made in a patient's chart, what should be done before adding the correct information nearby?

• services and procedures
• draw a single line through the error
• assignment of benefits form
• Remedial education

A patients medical record should be faxed only if ______.

• there is an emergent need for the information stated by the physician
• add modifier -F5 to the appropriate procedure code
• add or correct the information and resubmit the claim
• previously injured person is injured again at work

One insurance plan jointly sponsored by federal and state government is ___________.

• medicare
• head
• Medicaid
• fraud

Intentional misrepresentation of facts in order to deceive or mislead others is ___________.

• fraud
• $100
• premium
• head

The opposite of ventral is _________.

• dorsal
• head
• fraud
• consent

If a patient had an operative procedure on his/her thumb of the right hand, a coder would ____________________.

• draw a single line through the error
• add or correct the information and resubmit the claim
• add modifier -F5 to the appropriate procedure code
• services and procedures

All of the following are included in the Medicaid EPSDT program for welfare children EXCEPT(treatment for mental defects, developmental assessment, remedial education, dental screening)

• Electronic
• Remedial education
• medicare
• Medicaid

Examples of HCPCS level II codes are

• Drinks at professional meetings
• services and procedures
• Amyotrophic Lateral Sclerosis
• supplies, orthotics, prosthetics, DME equipment, ambulance services

The subsequent injury was established for problems that arise when a _____.

• draw a single line through the error
• Drinks at professional meetings
• services and procedures
• previously injured person is injured again at work

A suffix indicating the surgical creation of an opening is ________.

• -ostomy
• HMO
• dorsal
• consent

HCT is the general medical abbreviation for ____________.

• hematocrit
• HMO
• head
• Medicaid

TBSA refers to

• ALL U.S. states
• total body surface area
• concurrent care
• third degree first

For the insurance check to go directly to the physician, the patient must sign a(n) ______________________.

• indented codes
• assignment of benefits form
• concurrent care
• hypertension

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CPT codes approved by the FDA and representing widely used services and procedures

• ADHD
• Refferal
• Appendix A
• Category I

new or revised text

• Bullet Symbol
• Refferal
• Right / Left triangle symbols
• Solid Triangle Symbol

Services that are provided by the physician in the emergency department for unplanned patient encounters

• Concurrent care
• Critical Care
• Emergency Care Services
• Key Components

Patient who has not been seen by a physician within the past 3 years

• Out patient
• New patient
• Inpatient
• Consultation

Face to Face encounter between a physician and a patient in physicians private office

• Out patient
• Office Visit
• Modifiers
• Inpatient

Physician with the primary responsibility for care of the patient

• Attending Physician
• Category I
• Appendix A
• Admission

The history examination and Medical decision making complexity of an E/M service

• Key Components
• New patient
• Out patient
• Modifiers

Attention Deficit Hyperactivity Disorder

• See
• ADHD
• Modifiers
• Admission

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the name for storage in a computer

• computer menu
• peer review
• computer virus
• computer memory

a legally enforceable document composed by an insurance company describing an agreement

• peer review
• subpoena
• insurance policy
• OCR devices

a transmission device for sending electronic data

• RAM
• fraud
• bytes
• modem

when physicians evaluate other physicians

• OCR devices
• computer virus
• peer review
• RAM

a separate part of a computer keyboard that handles numerical functions only

• bytes
• fraud
• RAM
• keypad

intentional misrepresentation of facts in order to deceive or mislead others

• fraud
• modem
• RAM
• bytes

a lists of items displayed on a computer screen from which the operator can choose a function

• subpoena
• computer virus
• computer memory
• computer menu

scanners for directly reading claims into a computer's memory

• OCR devices
• modem
• computer virus
• peer review

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Everything that a medical claims specialist learns about a patient's condition must remain

• Counseling
• computer
• confidential
• conduct

When a fax is used to transmit medical records, the patient must sign a

• bytes
• keypad
• RAM
• release

Who should interpret reports and laboratory tests to the patient?

• OCR devices
• policy
• keypad
• The physician

When physicians evaluate other physicians, this process is called

• release
• memory
• peer review
• OCR devices

Which of the following is NOT typical knowledge expected of an insurance billing specialist?

• file a DBA form
• Social entertaining
• How to repair a fax machine
• Computer programming

The following should be condsidered wshen selecting and setting up a computer system EXCEPT

• decor
• memory
• CPU
• menu

A legally enforceable document composed by an insurance company describing an agreement is a

• conduct
• IRS
• policy
• modem

Self- employed insurance billing specialists can deduct all but which one of the following expenses from their income taxes?

• Social entertaining
• Computer programming
• Counseling
• confidential

All of the following are expected as part of a professional image EXCEPT

• Social entertaining
• saving data
• confidential
• a strong pleasant fragrance

A transmission device for sending electronic data is called a

• bytes
• modem
• menu
• RAM

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An EOB document

• HMO
• ...
• abuse
• fraud

An organization that provides a wide range of services for a specified group at a fixed periodic payment is called an

• HMO
• abuse
• ...
• fraud

Misconduct that occurs within a physician's field of expertise and results in injury or loss to the recipient of services is called

• x-rays
• appealed
• malpractice
• TRICARE

For the physician involved, Medicare or Medicaid problem related crimes result in

• coordinating benefits
• exclusion from program premeims
• customary fee
• clean claim

A physician who will accept assignment under Blue Cross or Blue Shield is called a

• workers compensation
• malpractice
• Medi-Cal
• member physician

The number of views, part of the body, and type of view are necessary pieces of information for itemizing

• fraud
• ...
• abuse
• x-rays

A form sent to the insurance company to find out the maximum dollar amount that will be paid for a procedure is called an insurance.

• customary fee
• predeterminatio form
• TRICARE
• consent form

A government program that provides medical services for dependents of active military personnel in known as

• x-rays
• TRICARE
• fraud
• abuse

A program that insures a person against on- the- job injury or illness is called

• clean claim
• Informed consent
• member physician
• workers compensation

A correctly completed claim submitted within the policy time limit is termed a

• Medi-Cal
• denied
• TRICARE
• clean claim

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Another name for a release of information form is a(n) __________.

• CBC
• consent
• dorsal
• head

According to income tax regulations, accounting records should be kept for what length of time?

• 4 years
• medicare
• fraud
• head

If an error is made in a patient's chart, what should be done before adding the correct information nearby?

• total body surface area
• standard, extra, prime
• assignment of benefits form
• draw a single line through the error

When a claim is returned for incorrect or missing information, the correct action for the medical biller to take would be to _________.

• add modifier -F5 to the appropriate procedure code
• add or correct the information and resubmit the claim
• Drinks at professional meetings
• draw a single line through the error

When making arrangements in the physicians office to collect payment in more than four installments (excluding down payment), a specific written disclosure agreement needs to be signed according to the _____________________.

• medicare
• 5 digits
• Medicaid
• truth lending act

The anesthesia physical status code modifier for a patient with severe systemic disease is ________________________.

• total body surface area
• -P3 (still valid modifier for 2012)
• third degree first
• assignment of benefits form

When sequencing codes for multiple burns, list _______.

• third degree first
• hypertension
• 5 digits
• indented codes

Self-employed insurance billing specialists can deduct ALL BUT WHICH ONE of the following expenses from income taxes?(business travel expenses, subscriptions to professional magazines, Drinks at professional meetings, depreciation of office equipment)

• Drinks at professional meetings
• services and procedures
• indented codes
• consultations

One insurance plan jointly sponsored by federal and state government is ___________.

• fraud
• Medicaid
• head
• medicare

A suffix indicating the surgical creation of an opening is ________.

• consent
• dorsal
• -ostomy
• HMO

Workers' compensation can be found in what state?

• indented codes
• ALL U.S. states
• 4 years
• consultations

In the Medicare program, a clean claim means that :

• add or correct the information and resubmit the claim
• supplies, orthotics, prosthetics, DME equipment, ambulance services
• the claim has no deficiencies, the carries does not need to investigate further, the claim passes all electronic edits.
• there is an emergent need for the information stated by the physician

The usual abbreviation for complete blood count is ______.

• CBC
• head
• HMO
• $100

The opposite of ventral is _________.

• fraud
• dorsal
• head
• consent

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CPT surgical packages are used only by

• AGE OF THE PATIENT
• SURGICAL TEAM
• THIRD PARTY PAYERS
• NOT PAID BY THIRD PARTY PAYERS

The code for the complicated removal of a subcutaneous foreign body of the foot is

• 28193
• 78761
• 44140
• 88309

To code diagnostic endoscopy procedures

• COUNSELING EXCEEDS 50%OF THE TIME SPENT
• ADD THE SUM OF LENGTHS AND REPORT ONE CODE
• SELECT THE CODE THAT ONE PROCEDURE IN AN OPERATIVE SETTING
• KEEP FROM TRANSPOSING NUMBERS

A triangle symbol in the CPT manual indicates a

• INSTRUCTIONS
• LEVEL OF COMPLEXITY
• REVISED DESCRIPTION
• NOT CODED SEPARATELY

A qualitative drug screen (each procedure) that can assess multiple drug classes using a method other than chromatography would be coded as

• 26010
• 80104
• -80
• 90664

For a breast biopsy the placement of a wire marker is

• PROCEDURE
• NEW CODE
• CODED SEPARATELY
• CODING

When transferring codes to claim form be careful to

• KEEP FROM TRANSPOSING NUMBERS
• AGE OF THE PATIENT
• SERVICES AND PROCEDURES
• MULTIPLE MODIFIERS

The CPT that appropriately describes a set of obstetric laboratory tests for the first obstetric visit is

• 77081
• 80055
• 32655
• 90703

The preoperative placement of a needle localization wire in the breast is coded

• 31297
• 20900
• 99284
• 19290

In CPT coding, the words following the semicolon may indicate all of the following EXCEPT

• LESSER IMPORTANT PROCEDURES
• GLOBAL SURGICAL PACKAGE
• SERVICES AND PROCEDURES
• INDENTED CODES

In a case requiring critical care coding

• INTEGUMENTARY SYSTEM
• SEPARATE FROM INITIAL CARE
• VENTILATOR MANAGEMENT IS INCLUDED
• IN APPENDIX B

CPT codes use

• PATIENTS
• 5 DIGITS
• RADIOLOGY
• 99284

Prosthetic training (upper or lower) for a session of 15 Minutes would be coded as

• 77081
• 90703
• 90664
• 97761