Module 4 Test
Question 1
Voluntary compliance program guidance documents were developed by the Department of HHS OIG for the
health care industry to the development and use of internal controls to adherence to applicable
regulations, statutes, and program requirements.
Answers: a. evaluate; regulate
b. encourage; monitor
c. assess; justify
d. enforce; mandate
Question 2
Which was developed by the Centers for Medicare and Medicaid Services to assign the unique health care
provider and health plan identifiers and to serve as a database from which to extract data?
Answers: a. ICD-10-CM
b. HIPAA
c. NPPES
d. DOD OIG
Question 3
Local coverage determinations specify under which a service is covered and coded correctly.
Answers: a. clinical circumstances
b. service conditions
c. health care settings
d. medical necessity
Question 4
,[Pick the date]
A narrative clinic note is written in a(n) format.
Answers: a. itemized
b. catalogue
c. paragraph
, [Pick the date]
d. list
Question 5
The Medicare durable medical equipment, prosthetics/orthotics, and supplies (DMEPOS) fee schedule
reimburses DMEPOS either percent of the actual charge for the item or the fee schedule amount, whichever is
lower.
Answers: a. 100
b. 50
c. 20
d. 80
Question 6
The procedure or service provided is linked with the that provided medical necessity for performing
the procedure or service.
Answers: a. diagnosis
b. procedure
c. supply
d. service
Question 7
Federally Qualified Health Centers (FQHCs) are safety net providers that primarily provide services typically
furnished in which type of setting?
Answers: a. outpatient clinic
b. home health agency
c. skilled nursing facility
d. inpatient hospital
Question 8
Services provided by nonphysician practitioners may also be reported to Medicare as to the supervising
physician’s service, and as a result, services are reimbursed at 100 percent of the Medicare physician fee schedule
and Medicare pays 80 percent of that amount directly to the physician.
Selected Answer: d.
incident