MEDICAL BILLING AND CODING CERTIFICATE EXAM|COMPLETE STUDY GUIDE WITH HIGH YIELD QUESTIONS AND 100% RIGHT/AUTHENTIC ANSWERS.| ALREADY GRADED A,GET A PASS ON YOUR FIRST TRIAL

Chief Complaint (element 1 of history) - CORRECT ANSWERS.️️History of present illness, Review symptom, Past, Family, and Social history History Levels (Element 2 of history) and Examination Levels (Element 3 of History) - CORRECT ANSWERS.️️Problem focused, expanded problem focused, detailed, Comprehensive Medical Decision Making Complexity Levels (element 4 of history) - CORRECT ANSWERS.️️Straightforward, Low, Moderate, High straightforward - CORRECT ANSWERS.️️Minimal diagnosis Minimal risk Minimal complexity of data Low - CORRECT ANSWERS.️️Limited diagnosis Limited/low risk to patient Limited data Moderate - CORRECT ANSWERS.️️Multiple diagnosis Moderate risk to patient Moderate amount and complexity of data high - CORRECT ANSWERS.️️Extensive diagnosis high risk to patient extensive amount and complexity of data truncated coding (error in coding) - CORRECT ANSWERS.️️using diagnosis codes that are not as specific as possible assumption coding (fraudulent coding) - CORRECT ANSWERS.️️reporting items of services that are not actually documented errors of the coding process - CORRECT ANSWERS.️️-altering documentation after services are reported -coding without documentation -reporting services provided by unlicensed or unqualified clinical personnel -coding a unilateral service twice instead of choosing the bilateral -not satisfying the condition of coverage for a particular service -codes that report more than one diagnosis with one code is a combination code Unbundling codes - CORRECT ANSWERS.️️when multiple codes are used to code a procedure when a single code should be used Upcoding - CORRECT ANSWERS.️️using a procedural code that provides a higher reimbursement rate than the correct code Downcoding - CORRECT ANSWERS.️️the document does not justify the level of service Most common billing errors - CORRECT ANSWERS.️️Billing non-covered services Billing over limit services Upcoding Downcoding Billing without signatures Using outdated codes External Audits Internal Audits Retrospective audits - CORRECT ANSWERS.️️Types of Audits done to avoid billing and coding errors External Audits - CORRECT ANSWERS.️️a private payer or government investigator's review of selected records of a practice for compliance Internal Audits - CORRECT ANSWERS.️️self-audit conducted by a staff member or consultant Retrospective Audits - CORRECT ANSWERS.️️conducted after the claim has been send the remittance advice has been received Adjustments - CORRECT ANSWERS.️️amounts added to or taken away from the balance of an account Two methods to determine rates to be paid to providers - CORRECT ANSWERS.️️Charge; Resource Charge - CORRECT ANSWERS.️️based fees are established using the fees of providers providing similar services resource - CORRECT ANSWERS.️️-how difficult is it for the provider to do the procedure -how much office overhead is involved -the relative risk the procedure presents to the patient and the provider Clearing Houses - CORRECT ANSWERS.️️Edits and transmits batches of claims to insurance companies