Billing and Coding Final Exam Questions with all Correct
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A claims assistance professional (CAP) acts as an informal representative of patients and helps
patients interpret insurance contracts. ✔Correct Answer-False
Which level of education is generally required for one who seeks employment as an insurance coder?
✔Correct Answer-c) Completion of an accredited program for coding certification
The amount of money an insurance billing specialist earns is dependent on which factors?
✔Correct Answer-d) All of the above: knowledge, experience, size of employing institution
Medical etiquette refers to... ✔Correct Answer-a) consideration for others
A billing specialist is entrusted with.... ✔Correct Answer-d) All of the above: holding patients'
medical information in confidence, collecting monies, being a reliable resource for coworkers
Standards of conduct by which an insurance billing specialist determines the propriety of his or her
behavior in a relationship are know as medical _____. ✔Correct Answer-ethics
It is _____ to report incorrect information to private insurance carriers because this can possible
damage the individual and the integrity of the database. ✔Correct Answer-unethical
The Office of Civil Right enforces... ✔Correct Answer-privacy and security rules.
Privileged information is related to the treatment and progress of patients. ✔Correct Answer-True
The focus on the health care practice setting and reducing administrative costs and burdens are the
goals of... ✔Correct Answer-HIPAA Title II Administrative Simplification
Which 3 measures should be taken by a coder who has knowledge of fraud or abuse? ✔Correct
Answer-Notify the provider verbally and in writing; document the false statement or representation;
don't discuss the problem with anyone who is not involved
The contract is a worker's comp case exists between the... ✔Correct Answer-physician and
insurance company
In health insurance, the insured is also known as ✔Correct Answer-subscriber, or member, or
policyholder, or recipient.
If a child has health insurance coverage from 2 parents, according to the birthday law... ✔Correct
Answer-the health plan of the person whose birthday (month and day, not year) falls earlier in the
calendar year pays first. If same b-day, person whose policy has been in effect longest.
Conditions that existed and were treated before the health insurance policy was issued are called...
✔Correct Answer-pre-existing conditions
, The act created to protect workers and their families so that they can get and maintain health
insurance if they change or lose their jobs is called the ✔Correct Answer-HIPAA
Assignment of benefits is... ✔Correct Answer-the transfer of one's legal right to collect an amount
payable under an insurance contract.
The SOAP in patient medical record charting may be difined as ✔Correct Answer-b) subjective,
objective, assessment, paln
How should an entry in a patient's electronic medical record be corrected? ✔Correct Answer-a)
input a note of which section is in error and enter correct data with details of why the correction is
necessary and authenticate with electronic signature, date, and time.
The official American Hospital Association policy states that abbreviations should be totally
eliminated from the more vital section of the record, such as the... ✔Correct Answer-d) all of the
above: final dx, operative notes, discharge summaries
A new patient is one who ✔Correct Answer-b) has not received any professional services from a
physician or another physican of the same specialty who belongs to the group practice within the
past 3 yrs.
An established patient is one who ✔Correct Answer-has previously received professional services
from a physician or another physician of the same specialty who belongs to the group practice within
the past 3 yrs.
It is possible for the primary diagnosis and principal diagnosis to be the same. ✔Correct Answer-
True
An E code may never be sequenced in the first position. ✔Correct Answer-True
Fractures are coded as open if there is no indication of wheter the fracture is open or closed.
✔Correct Answer-False
Never code using just one volume of the diagnostic code books. ✔Correct Answer-True
Diagnoses that relate to a patient's previous medical problem and that have no bearing on the
patients' present condition should be __________ when coding. ✔Correct Answer-excluded
Why is the correct sequence of codes on an insurance claim important? ✔Correct Answer-To make
chronology of patient care events understood and to make the severity of disease understood
The Healthcare Common Procedure System (HCPCS)consists of 2 levels of codes. ✔Correct Answer-
True
The key components that determine an evaluation and management code are documented by
a. the medical assistant
b. the physician
c. the insurance billing specialist
d. none of the above ✔Correct Answer-b. the physician
The surgical package for non-Medicare cases includes the
& 100% Verified Answers |Latest Version |Already
Graded A+
A claims assistance professional (CAP) acts as an informal representative of patients and helps
patients interpret insurance contracts. ✔Correct Answer-False
Which level of education is generally required for one who seeks employment as an insurance coder?
✔Correct Answer-c) Completion of an accredited program for coding certification
The amount of money an insurance billing specialist earns is dependent on which factors?
✔Correct Answer-d) All of the above: knowledge, experience, size of employing institution
Medical etiquette refers to... ✔Correct Answer-a) consideration for others
A billing specialist is entrusted with.... ✔Correct Answer-d) All of the above: holding patients'
medical information in confidence, collecting monies, being a reliable resource for coworkers
Standards of conduct by which an insurance billing specialist determines the propriety of his or her
behavior in a relationship are know as medical _____. ✔Correct Answer-ethics
It is _____ to report incorrect information to private insurance carriers because this can possible
damage the individual and the integrity of the database. ✔Correct Answer-unethical
The Office of Civil Right enforces... ✔Correct Answer-privacy and security rules.
Privileged information is related to the treatment and progress of patients. ✔Correct Answer-True
The focus on the health care practice setting and reducing administrative costs and burdens are the
goals of... ✔Correct Answer-HIPAA Title II Administrative Simplification
Which 3 measures should be taken by a coder who has knowledge of fraud or abuse? ✔Correct
Answer-Notify the provider verbally and in writing; document the false statement or representation;
don't discuss the problem with anyone who is not involved
The contract is a worker's comp case exists between the... ✔Correct Answer-physician and
insurance company
In health insurance, the insured is also known as ✔Correct Answer-subscriber, or member, or
policyholder, or recipient.
If a child has health insurance coverage from 2 parents, according to the birthday law... ✔Correct
Answer-the health plan of the person whose birthday (month and day, not year) falls earlier in the
calendar year pays first. If same b-day, person whose policy has been in effect longest.
Conditions that existed and were treated before the health insurance policy was issued are called...
✔Correct Answer-pre-existing conditions
, The act created to protect workers and their families so that they can get and maintain health
insurance if they change or lose their jobs is called the ✔Correct Answer-HIPAA
Assignment of benefits is... ✔Correct Answer-the transfer of one's legal right to collect an amount
payable under an insurance contract.
The SOAP in patient medical record charting may be difined as ✔Correct Answer-b) subjective,
objective, assessment, paln
How should an entry in a patient's electronic medical record be corrected? ✔Correct Answer-a)
input a note of which section is in error and enter correct data with details of why the correction is
necessary and authenticate with electronic signature, date, and time.
The official American Hospital Association policy states that abbreviations should be totally
eliminated from the more vital section of the record, such as the... ✔Correct Answer-d) all of the
above: final dx, operative notes, discharge summaries
A new patient is one who ✔Correct Answer-b) has not received any professional services from a
physician or another physican of the same specialty who belongs to the group practice within the
past 3 yrs.
An established patient is one who ✔Correct Answer-has previously received professional services
from a physician or another physician of the same specialty who belongs to the group practice within
the past 3 yrs.
It is possible for the primary diagnosis and principal diagnosis to be the same. ✔Correct Answer-
True
An E code may never be sequenced in the first position. ✔Correct Answer-True
Fractures are coded as open if there is no indication of wheter the fracture is open or closed.
✔Correct Answer-False
Never code using just one volume of the diagnostic code books. ✔Correct Answer-True
Diagnoses that relate to a patient's previous medical problem and that have no bearing on the
patients' present condition should be __________ when coding. ✔Correct Answer-excluded
Why is the correct sequence of codes on an insurance claim important? ✔Correct Answer-To make
chronology of patient care events understood and to make the severity of disease understood
The Healthcare Common Procedure System (HCPCS)consists of 2 levels of codes. ✔Correct Answer-
True
The key components that determine an evaluation and management code are documented by
a. the medical assistant
b. the physician
c. the insurance billing specialist
d. none of the above ✔Correct Answer-b. the physician
The surgical package for non-Medicare cases includes the
