Billing & Coding Practice Exam with all Correct & 100%
Verified Answers |Latest Version |Already Graded A+
Describe the difference between informed and implied consent. ✔Correct Answer-Informed
consent is required in writing after explanation of a procedure, with time to ask questions, while
implied consent is assumed.
What is documentation? ✔Correct Answer-Documentation is the record of clinical observation and
care a patient receives at a health care facility.
Disclosure refers to the way health information is ✔Correct Answer-given to an outside person or
organization.
What is the difference between consent and authorization? ✔Correct Answer-Consent is used only
when the permission is for treatment, payment, or health care operations, and authorization allows
facility to verbally disclose or send health information to other organizations.
True or False: Physicians have the option to decide whether to explain privacy rules to their patients.
✔Correct Answer-False
Auditing refers to ✔Correct Answer-Reviewing claims for accuracy and completeness.
True or False: Fraud is intentional misrepresentation of information for the purposes of receiving
higher payments, while abuse happens unintentionally, often because of poor business practices.
✔Correct Answer-True
Define upcoding ✔Correct Answer-Assigning a code that will deliberately result in a higher
payment.
What does HIPAA stand for? ✔Correct Answer-Health Insurance Portability and Accountability Act.
The Stark Law states that ✔Correct Answer-Physicians can't refer patients to practitioners with
whom they have a financial relationship.
The Office of the Inspector General is responsible for ✔Correct Answer-Fighting Fraud
What does ARRA stand for? ✔Correct Answer-American Recovery and Reinvestment Act.
What does HITECH stand for? ✔Correct Answer-Health Information Technology of Economic and
Clinical Health.
Informed Consent ✔Correct Answer-Providers explain medical or diagnostic procedures, surgical
interventions, and the benefits and risks involved, giving patients an opportunity to ask questions
before medical intervention is provided.
Implied Consent ✔Correct Answer-A patient presents for treatment, such as extending an arm to
allow a venipuncture to be performed.
What does PHI stand for? ✔Correct Answer-Protected Health Information.
, Clearinghouse ✔Correct Answer-Agency that converts claims into a standardized electronic format,
looks for errors, and formats them according to HIPPA and insurance standards.
Individually Identifiable ✔Correct Answer-Documents that identify the person or provide enough
information so that the person could be identified.
de-identified information ✔Correct Answer-Information that does not identify an individual
because unique and personal characteristics have been removed.
Consent ✔Correct Answer-A patient's permission evidenced by signature.
Authorization ✔Correct Answer-Permission granted by the patient or the patient's representative
to release information for reasons other than treatment, payment, or health care operations.
Reimbursement ✔Correct Answer-Payment for services rendered from a third-party payer.
Fraud ✔Correct Answer-Making false statements of representations of material facts to obtain
some benefit or payment for which no entitlement would otherwise exist.
What are HCPCS used for? ✔Correct Answer-ancillary services/procedures
What are CPT-4 used for? ✔Correct Answer-physicians' procedures
What are CDT used for? ✔Correct Answer-dental terminology
What are ICD-9 used for? ✔Correct Answer-diagnosis and hospital impatient procedures
ICD-10 ✔Correct Answer-as of October 1, 2015
NDC ✔Correct Answer-National Drug Codes
Unbundling ✔Correct Answer-Using multiple codes that describe different components of a
treatment instead of using a single code that describes all steps of a procedure
Abuse ✔Correct Answer-Practices that directly or indirectly result in unnecessary costs to the
Medicare program.
What is the difference between fraud and abuse? ✔Correct Answer-Fraud is intentionally
misrepresenting services rendered for the purpose of receiving a higher payment. Abuse refers to
practices that are often done unknowingly as a result of poor business practices, directly in indirectly
resulting in unnecessary costs to the program through improper payments. The difference between
fraud and abuse is the individual's intent.
Physician Self-Referral Law (Stark Law) ✔Correct Answer-fee splitting, when a doctor pays
someone for referrals, it's illegal!
FDCPA ✔Correct Answer-Fair Debt Collection Practices Act
Verified Answers |Latest Version |Already Graded A+
Describe the difference between informed and implied consent. ✔Correct Answer-Informed
consent is required in writing after explanation of a procedure, with time to ask questions, while
implied consent is assumed.
What is documentation? ✔Correct Answer-Documentation is the record of clinical observation and
care a patient receives at a health care facility.
Disclosure refers to the way health information is ✔Correct Answer-given to an outside person or
organization.
What is the difference between consent and authorization? ✔Correct Answer-Consent is used only
when the permission is for treatment, payment, or health care operations, and authorization allows
facility to verbally disclose or send health information to other organizations.
True or False: Physicians have the option to decide whether to explain privacy rules to their patients.
✔Correct Answer-False
Auditing refers to ✔Correct Answer-Reviewing claims for accuracy and completeness.
True or False: Fraud is intentional misrepresentation of information for the purposes of receiving
higher payments, while abuse happens unintentionally, often because of poor business practices.
✔Correct Answer-True
Define upcoding ✔Correct Answer-Assigning a code that will deliberately result in a higher
payment.
What does HIPAA stand for? ✔Correct Answer-Health Insurance Portability and Accountability Act.
The Stark Law states that ✔Correct Answer-Physicians can't refer patients to practitioners with
whom they have a financial relationship.
The Office of the Inspector General is responsible for ✔Correct Answer-Fighting Fraud
What does ARRA stand for? ✔Correct Answer-American Recovery and Reinvestment Act.
What does HITECH stand for? ✔Correct Answer-Health Information Technology of Economic and
Clinical Health.
Informed Consent ✔Correct Answer-Providers explain medical or diagnostic procedures, surgical
interventions, and the benefits and risks involved, giving patients an opportunity to ask questions
before medical intervention is provided.
Implied Consent ✔Correct Answer-A patient presents for treatment, such as extending an arm to
allow a venipuncture to be performed.
What does PHI stand for? ✔Correct Answer-Protected Health Information.
, Clearinghouse ✔Correct Answer-Agency that converts claims into a standardized electronic format,
looks for errors, and formats them according to HIPPA and insurance standards.
Individually Identifiable ✔Correct Answer-Documents that identify the person or provide enough
information so that the person could be identified.
de-identified information ✔Correct Answer-Information that does not identify an individual
because unique and personal characteristics have been removed.
Consent ✔Correct Answer-A patient's permission evidenced by signature.
Authorization ✔Correct Answer-Permission granted by the patient or the patient's representative
to release information for reasons other than treatment, payment, or health care operations.
Reimbursement ✔Correct Answer-Payment for services rendered from a third-party payer.
Fraud ✔Correct Answer-Making false statements of representations of material facts to obtain
some benefit or payment for which no entitlement would otherwise exist.
What are HCPCS used for? ✔Correct Answer-ancillary services/procedures
What are CPT-4 used for? ✔Correct Answer-physicians' procedures
What are CDT used for? ✔Correct Answer-dental terminology
What are ICD-9 used for? ✔Correct Answer-diagnosis and hospital impatient procedures
ICD-10 ✔Correct Answer-as of October 1, 2015
NDC ✔Correct Answer-National Drug Codes
Unbundling ✔Correct Answer-Using multiple codes that describe different components of a
treatment instead of using a single code that describes all steps of a procedure
Abuse ✔Correct Answer-Practices that directly or indirectly result in unnecessary costs to the
Medicare program.
What is the difference between fraud and abuse? ✔Correct Answer-Fraud is intentionally
misrepresenting services rendered for the purpose of receiving a higher payment. Abuse refers to
practices that are often done unknowingly as a result of poor business practices, directly in indirectly
resulting in unnecessary costs to the program through improper payments. The difference between
fraud and abuse is the individual's intent.
Physician Self-Referral Law (Stark Law) ✔Correct Answer-fee splitting, when a doctor pays
someone for referrals, it's illegal!
FDCPA ✔Correct Answer-Fair Debt Collection Practices Act
