CBCS Practice Exam #2 – Study Guide and Exam Review Material
B) Insurance card - ✔✔Sarah, a medical billing specialist, is verifying insurance eligibility for a
new patient, Mr. Johnson, who is scheduled for a surgical procedure. Which of the following
documents is essential to confirm Mr. Johnson's insurance coverage and benefits for the
surgery?
A) Patient's driver's license
B) Insurance card
C) Patient's medical history
D) Consent form for surgery
B) E11.40 - ✔✔Dr. Smith is treating a patient named John Doe who has been diagnosed with
Type 2 diabetes mellitus with diabetic neuropathy. Which ICD-10-CM code should be used to
accurately reflect this diagnosis?
A) E11.9
B) E11.40
C) E10.9
D) E10.40
B) Fee-for-service (FFS)
,Rationale: Medicare traditionally uses the Fee-for-Service (FFS) payment model, where
providers are paid for each service rendered. This method contrasts with Capitation (A), where
providers receive a set amount per patient regardless of service provided, and Bundled
Payments (C), which involve a single payment for a group of related services. Value-Based
Purchasing (D) is a newer model focusing on quality and efficiency but is not the primary -
✔✔Which of the following payment policies is most commonly associated with Medicare?
A) Capitation
B) Fee-for-service (FFS)
C) Bundled Payments
D) Value-Based Purchasing
A) I21.9 - ✔✔A 45-year-old patient named John presents with chest pain and shortness of
breath. The physician documents a diagnosis of acute myocardial infarction (AMI) and orders a
series of tests and treatments. When abstracting the required health information from the
clinical documentation, which code should be assigned for the diagnosis of AMI?
A) I21.9
B) I20.0
C) I25.10
D) I50.9
,A) Modifier -50 - ✔✔Dr. Smith performed a bilateral procedure on Jane Doe, which was
initially billed as two separate procedures. To correct the claim and ensure proper
reimbursement, which modifier should be used?
A) Modifier -50
B) Modifier -51
C) Modifier -59
D) Modifier -25
C) To share the cost of healthcare between the insured and the insurer - ✔✔What is the
primary purpose of a deductible in a health insurance policy?
A) To limit the total out-of-pocket expenses for the insured
B) To cover the cost of preventative care services
C) To share the cost of healthcare between the insured and the insurer
D) To eliminate the need for co-payments
B) 99204 - ✔✔Dr. Smith conducted a comprehensive history and examination for a new
patient, John Doe, who presented with multiple chronic conditions requiring moderate
complexity medical decision-making. The total face-to-face time spent was 45 minutes. Which
E/M code is most appropriate for this encounter?
, A) 99203
B) 99204
C) 99205
D) 99212
B) Verify if the patient qualifies for any financial assistance programs - ✔✔Emily, an uninsured
patient, visits a healthcare facility for a routine check-up. According to the facility's policies and
procedures regarding uninsured or self-pay patients, which is the first step the billing
department should take?
A) Offer a payment plan immediately
B) Verify if the patient qualifies for any financial assistance programs
C) Provide an estimate of the total cost of services
D) Request full payment upfront before any services are rendered
B) National Center for Health Statistics (NCHS) - ✔✔Sarah, a medical coder, is reviewing the
latest updates to the ICD-10-CM coding guidelines. She needs to ensure that her coding
practices align with the most current standards. Which organization is responsible for publishing
and updating the ICD-10-CM coding guidelines.
A) American Medical Association (AMA)
B) Insurance card - ✔✔Sarah, a medical billing specialist, is verifying insurance eligibility for a
new patient, Mr. Johnson, who is scheduled for a surgical procedure. Which of the following
documents is essential to confirm Mr. Johnson's insurance coverage and benefits for the
surgery?
A) Patient's driver's license
B) Insurance card
C) Patient's medical history
D) Consent form for surgery
B) E11.40 - ✔✔Dr. Smith is treating a patient named John Doe who has been diagnosed with
Type 2 diabetes mellitus with diabetic neuropathy. Which ICD-10-CM code should be used to
accurately reflect this diagnosis?
A) E11.9
B) E11.40
C) E10.9
D) E10.40
B) Fee-for-service (FFS)
,Rationale: Medicare traditionally uses the Fee-for-Service (FFS) payment model, where
providers are paid for each service rendered. This method contrasts with Capitation (A), where
providers receive a set amount per patient regardless of service provided, and Bundled
Payments (C), which involve a single payment for a group of related services. Value-Based
Purchasing (D) is a newer model focusing on quality and efficiency but is not the primary -
✔✔Which of the following payment policies is most commonly associated with Medicare?
A) Capitation
B) Fee-for-service (FFS)
C) Bundled Payments
D) Value-Based Purchasing
A) I21.9 - ✔✔A 45-year-old patient named John presents with chest pain and shortness of
breath. The physician documents a diagnosis of acute myocardial infarction (AMI) and orders a
series of tests and treatments. When abstracting the required health information from the
clinical documentation, which code should be assigned for the diagnosis of AMI?
A) I21.9
B) I20.0
C) I25.10
D) I50.9
,A) Modifier -50 - ✔✔Dr. Smith performed a bilateral procedure on Jane Doe, which was
initially billed as two separate procedures. To correct the claim and ensure proper
reimbursement, which modifier should be used?
A) Modifier -50
B) Modifier -51
C) Modifier -59
D) Modifier -25
C) To share the cost of healthcare between the insured and the insurer - ✔✔What is the
primary purpose of a deductible in a health insurance policy?
A) To limit the total out-of-pocket expenses for the insured
B) To cover the cost of preventative care services
C) To share the cost of healthcare between the insured and the insurer
D) To eliminate the need for co-payments
B) 99204 - ✔✔Dr. Smith conducted a comprehensive history and examination for a new
patient, John Doe, who presented with multiple chronic conditions requiring moderate
complexity medical decision-making. The total face-to-face time spent was 45 minutes. Which
E/M code is most appropriate for this encounter?
, A) 99203
B) 99204
C) 99205
D) 99212
B) Verify if the patient qualifies for any financial assistance programs - ✔✔Emily, an uninsured
patient, visits a healthcare facility for a routine check-up. According to the facility's policies and
procedures regarding uninsured or self-pay patients, which is the first step the billing
department should take?
A) Offer a payment plan immediately
B) Verify if the patient qualifies for any financial assistance programs
C) Provide an estimate of the total cost of services
D) Request full payment upfront before any services are rendered
B) National Center for Health Statistics (NCHS) - ✔✔Sarah, a medical coder, is reviewing the
latest updates to the ICD-10-CM coding guidelines. She needs to ensure that her coding
practices align with the most current standards. Which organization is responsible for publishing
and updating the ICD-10-CM coding guidelines.
A) American Medical Association (AMA)
