NHA Medical Billing and Coding exam 2023 with 100% correct answers

Which of the following describes the reason for a claim rejection because of Medicare NCCI edits? Improper Code Combinations (Medicare NCCI edits will trigger a claim rejection for improper code combinations) A claim is submitted with a transposed insurance member ID number and returned to the provider. Which of the following describes the status that should be assigned to the claim by the carrier? Invalid (Invalid claim contains illogical or incorrect information and is returned to the provider unprocessed) Medigap coverage is offered to Medicare beneficiaries by which of the following Private Third-Party Payers (Private third-party payers offer supplement coverage to Medicare beneficiaries who pay their Medicare premium.) Which of the following provisions ensures that an insured's benefits from all insurance companies do not exceed 100% of allowable medical expenses? Coordination of benefits (Coordination of benefits ensures that the insured benefits from all insured companies do not exceed 100% of allowable medical expenses) A coroner's autopsy is comprised of which of the Gross Examination (Gross examination is an integral part of an autopsy.) Which of the following statements is true regarding the release of patient records? A. Verbal requests for records from life insurance companies are appropriate. B. Identification is not required when requesting access to patient records. C. Providers cannot share a patient's medical information with other health care professionals if the patient is mentally unstable. D. Patient access to psychotherapy notes may be restricted Patient access to psychotherapy notes may be restricted (Patients cannot access psychotherapy notes or information compiled for lawsuits.) Which of the following actions by a billing and coding specialist would be considered fraud? A. Submitting a claim for services that are not medically necessary B. Violating participating provider agreements with third-party payers C. Billing for services not provided D. Billing non-covered services as covered services Billing for services not provided (Billing for services not provided is considered fraud and can result in fines for the billing and coding specialist and the physician.)