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CBCS CERTIFICATION EXAM| 407 QUESTIONS| WITH COMPLETE SOLUTIONS

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32 Modifier Correct Answer: Mandated services 33 Modifier Correct Answer: Preventive services 52 Modifier Correct Answer: Reduced services 77 Modifier Correct Answer: Repeat procedure/service by another physician or other qualified health care professional 58 Modifier Correct Answer: Staged/related procedure/service by same physician or other health care professional during postoperative period 59 Modifier Correct Answer: Distinct procedural service 57 Modifier Correct Answer: Decision for surgery used with E/M, Medicare, and Medicine 25 Modifier Correct Answer: Significant separately identifiable E/M service by the same physician or other health care professional and same day of procedure or other service 19 Block CMS-1500 Correct Answer: Additional claim info 14 Block CMS-1500 Correct Answer: Date of current illness injury or pregnancy 9D Block CMS-1500 Correct Answer: Secondary insurance plan or program name 18 Block CMS-1500 Correct Answer: Hospitalization dates related to current services 26 Block CMS-1500 Correct Answer: Pt's account number for office 17 Block CMS-1500 Correct Answer: Name of referring provider or other source 23 Block CMS-1500 Correct Answer: Prior authorization number 30 Block CMS-1500 Correct Answer: Balance due 11C Block CMS-1500 Correct Answer: Insurance plan name or program name Stark 1 Correct Answer: This law pertained only to clinical labs that prohibited physicians from referring a pt to a clinical lab in which the Dr or a member of his or her family had a financial interest. Stark 2 Correct Answer: Prohibit the submission of claims for designated services or referral of pts if the referring physician has a financial relationship with the entity that provides the services. V codes Correct Answer: (V01-V82) are the codes that refer to factors that influence the health statue of a pt. A definite diagnosis cannot be stated, but a valid reason for seeing the provider exists. 24I Block CMS-1500 Correct Answer: Legacy Qualifier rendering provider 28 Block CMS-1500 Correct Answer: Total Charge 30 Block CMS-1500 Correct Answer: Balance Due 29 Block CMS-1500 Correct Answer: Amount Paid ICD-9-CM E Codes (E000-E999) Correct Answer: Supplementary classification of external causes of injury and poisoning. -Alphanumerical designations for injuries and poisoning. -Provides any additional info about external causes. -NEVER a principal (inpatient) diagnosis. ICD-9-CM Section 1: Correct Answer: Index to diseases ICD-9-CM Section 2: Correct Answer: Tables of Drugs & Chemicals ICD-9-CM Section 3: Correct Answer: Index to ext

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CBCS CERTIFICATION EXAM| 407 QUESTIONS| WITH
COMPLETE SOLUTIONS
32 Modifier Correct Answer: Mandated services

33 Modifier Correct Answer: Preventive services

52 Modifier Correct Answer: Reduced services

77 Modifier Correct Answer: Repeat procedure/service by another physician or other qualified
health care professional

58 Modifier Correct Answer: Staged/related procedure/service by same physician or other health
care professional during postoperative period

59 Modifier Correct Answer: Distinct procedural service

57 Modifier Correct Answer: Decision for surgery used with E/M, Medicare, and Medicine

25 Modifier Correct Answer: Significant separately identifiable E/M service by the same
physician or other health care professional and same day of procedure or other service

19 Block CMS-1500 Correct Answer: Additional claim info

14 Block CMS-1500 Correct Answer: Date of current illness injury or pregnancy

9D Block CMS-1500 Correct Answer: Secondary insurance plan or program name

18 Block CMS-1500 Correct Answer: Hospitalization dates related to current services

26 Block CMS-1500 Correct Answer: Pt's account number for office

17 Block CMS-1500 Correct Answer: Name of referring provider or other source

23 Block CMS-1500 Correct Answer: Prior authorization number

30 Block CMS-1500 Correct Answer: Balance due

11C Block CMS-1500 Correct Answer: Insurance plan name or program name

Stark 1 Correct Answer: This law pertained only to clinical labs that prohibited physicians from
referring a pt to a clinical lab in which the Dr or a member of his or her family had a financial
interest.

,Stark 2 Correct Answer: Prohibit the submission of claims for designated services or referral of
pts if the referring physician has a financial relationship with the entity that provides the services.

V codes Correct Answer: (V01-V82) are the codes that refer to factors that influence the health
statue of a pt. A definite diagnosis cannot be stated, but a valid reason for seeing the provider
exists.

24I Block CMS-1500 Correct Answer: Legacy Qualifier rendering provider

28 Block CMS-1500 Correct Answer: Total Charge

30 Block CMS-1500 Correct Answer: Balance Due

29 Block CMS-1500 Correct Answer: Amount Paid

ICD-9-CM
E Codes
(E000-E999) Correct Answer: Supplementary classification of external causes of injury and
poisoning.
-Alphanumerical designations for injuries and poisoning.
-Provides any additional info about external causes.
-NEVER a principal (inpatient) diagnosis.

ICD-9-CM
Section 1: Correct Answer: Index to diseases

ICD-9-CM
Section 2: Correct Answer: Tables of Drugs & Chemicals

ICD-9-CM
Section 3: Correct Answer: Index to external causes of injuries and poisonings (E Codes)

ICD-9-CM
Appendix E: Correct Answer: Three-digit categories

ICD-9-CM
Appendix D: Correct Answer: Industrial accidents

ICD-9-CM
Appendix C: Correct Answer: Drugs

ICD-9-CM
Appendix B: Correct Answer: Glossary of Mental disorders

ICD-9-CM
Appendix A: Correct Answer: Morphology of Neoplasms

, ICD-9-CM
V Codes
(V01.0-V91.9) Correct Answer: Pt not I'll but encounters health services.
-Pt presents for treatment.
-Some are primary only.
--Principle= inpatient
--First-listed= outpatient
-Factors that influence pt's health status.

What is the biggest difference between ICD-9-CM to ICD-10-CM? Correct Answer: 9 has 3-5
digits and 10 has up to 7 digits

ICD-9-CM
Diagnosis Correct Answer: 3

ICD-9-CM
Procedures Correct Answer: 2

Delivering 02 blood to all parts of the body? Correct Answer: Respiratory system

Tort Correct Answer: A wrongful act that harms or cause injury to another person.

On the CMS-1500 form, Blocks 14-33 contain info about what? Correct Answer: The Pt's
condition an provider's info

The EOB states amount billed was $80. The allowed amount is $60, and the pt is required to pay
a $20 coat. What describes the insurance check amount to be posted? Correct Answer: $40
Allowed Amount
-
Company
=
Amount To Be Posted

Electronics Claim Correct Answer: ASC X12N 837

Invalid Form Correct Answer: CMS-1500 form 14905

Ambulance Form Correct Answer: CMS-1500 form 1492

Unprocessable Claim Correct Answer: The term is used for Medicare's editing process, when
returns claims with incomplete or invalid info.

If your claim had a services date of October 1,2008, then what would the filing time limit be for
filing your claim? Correct Answer: December 31,2008

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