HIM 130 CHAPTER 11 TEST ADDITIONAL INFO EXAM QUESTIONS AND
ANSWERS
Block 33 of the CMS-1500 claim requires entry of the name, address, and telephone number of the
billing entity, which is the __________. - CORRECT ANSWER✅✅legal business name of the practice
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? -
CORRECT ANSWER✅✅NPPES
The CMS-1500 paper claim was designed to accommodate optical scanning of __________ claims. -
CORRECT ANSWER✅✅paper
The optical scanning process uses a device that converts __________ characters into text that can be
viewed by an optical character reader (OCR). - CORRECT ANSWER✅✅printed
Supplemental plans usually cover the deductible and copay or coinsurance of a primary health insurance
policy. Which is the best known supplemental plan? - CORRECT ANSWER✅✅Medigap
Provider services for inpatient care are billed on a fee-for-service basis, and service results in a unique
and separate charge designated by a __________ or HCPCS level II service/procedure code. - CORRECT
ANSWER✅✅CPT
Hospital inpatient charges are reported on the __________ claim. - CORRECT ANSWER✅✅UB-04
Which occurs when a physician in the community refers a patient to the hospital for observation,
bypassing the clinic or emergency department? - CORRECT ANSWER✅✅direct admission
Surgeon's charges for inpatient and outpatient surgery are billed according to a global fee, which means
that __________ cover(s) presurgical evaluation and management, initial and subsequent hospital visits,
surgical procedure, the discharge visit, and uncomplicated postoperative follow-up care in the surgeon's
office. - CORRECT ANSWER✅✅one charge
, Postoperative complications requiring a return to the operating room for surgery related to the original
procedure are billed as an additional procedure, and the additional procedure is linked to __________. -
CORRECT ANSWER✅✅a new diagnosis that describes the complication
HIPAA regulations require all payers to accept __________ attachments. - CORRECT
ANSWER✅✅electronic
When completing the CMS-1500, enter a __________ for the dollar sign or decimal in all charges or
totals and parentheses surrounding the area code in a telephone number. - CORRECT
ANSWER✅✅space
When reporting procedures and services on the CMS-1500, list one procedure per line, starting with line
one of Block 24. To report more than six procedures or services for the same date of service,
__________. - CORRECT ANSWER✅✅generate a new claim to enter more procedures/services
When a person uses a title such as Sr., Jr., II, or III, __________. - CORRECT ANSWER✅✅do not enter it
on the claim unless printed on the patient's insurance ID card
When entering a fee in Blocks 24F, 28, or 29, enter __________ in the cents column. - CORRECT
ANSWER✅✅2 zeros
Which is considered a nonphysician practitioner? - CORRECT ANSWER✅✅physician assistant
Which of the following health care professionals is permitted to bill a physician when that physician
provides direct supervision of procedures/services? - CORRECT ANSWER✅✅nonphysician practitioner
Which is a licensed physician in good standing who, according to state regulations, engages in the direct
management of nonphysician practitioners whose duties are encompassed by that physician's scope of
practice? - CORRECT ANSWER✅✅supervising physician
Patients sign Block 13 of the CMS-1500 claim to instruct the payer to directly reimburse the provider.
This concept is called __________. - CORRECT ANSWER✅✅assignment of benefits
ANSWERS
Block 33 of the CMS-1500 claim requires entry of the name, address, and telephone number of the
billing entity, which is the __________. - CORRECT ANSWER✅✅legal business name of the practice
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? -
CORRECT ANSWER✅✅NPPES
The CMS-1500 paper claim was designed to accommodate optical scanning of __________ claims. -
CORRECT ANSWER✅✅paper
The optical scanning process uses a device that converts __________ characters into text that can be
viewed by an optical character reader (OCR). - CORRECT ANSWER✅✅printed
Supplemental plans usually cover the deductible and copay or coinsurance of a primary health insurance
policy. Which is the best known supplemental plan? - CORRECT ANSWER✅✅Medigap
Provider services for inpatient care are billed on a fee-for-service basis, and service results in a unique
and separate charge designated by a __________ or HCPCS level II service/procedure code. - CORRECT
ANSWER✅✅CPT
Hospital inpatient charges are reported on the __________ claim. - CORRECT ANSWER✅✅UB-04
Which occurs when a physician in the community refers a patient to the hospital for observation,
bypassing the clinic or emergency department? - CORRECT ANSWER✅✅direct admission
Surgeon's charges for inpatient and outpatient surgery are billed according to a global fee, which means
that __________ cover(s) presurgical evaluation and management, initial and subsequent hospital visits,
surgical procedure, the discharge visit, and uncomplicated postoperative follow-up care in the surgeon's
office. - CORRECT ANSWER✅✅one charge
, Postoperative complications requiring a return to the operating room for surgery related to the original
procedure are billed as an additional procedure, and the additional procedure is linked to __________. -
CORRECT ANSWER✅✅a new diagnosis that describes the complication
HIPAA regulations require all payers to accept __________ attachments. - CORRECT
ANSWER✅✅electronic
When completing the CMS-1500, enter a __________ for the dollar sign or decimal in all charges or
totals and parentheses surrounding the area code in a telephone number. - CORRECT
ANSWER✅✅space
When reporting procedures and services on the CMS-1500, list one procedure per line, starting with line
one of Block 24. To report more than six procedures or services for the same date of service,
__________. - CORRECT ANSWER✅✅generate a new claim to enter more procedures/services
When a person uses a title such as Sr., Jr., II, or III, __________. - CORRECT ANSWER✅✅do not enter it
on the claim unless printed on the patient's insurance ID card
When entering a fee in Blocks 24F, 28, or 29, enter __________ in the cents column. - CORRECT
ANSWER✅✅2 zeros
Which is considered a nonphysician practitioner? - CORRECT ANSWER✅✅physician assistant
Which of the following health care professionals is permitted to bill a physician when that physician
provides direct supervision of procedures/services? - CORRECT ANSWER✅✅nonphysician practitioner
Which is a licensed physician in good standing who, according to state regulations, engages in the direct
management of nonphysician practitioners whose duties are encompassed by that physician's scope of
practice? - CORRECT ANSWER✅✅supervising physician
Patients sign Block 13 of the CMS-1500 claim to instruct the payer to directly reimburse the provider.
This concept is called __________. - CORRECT ANSWER✅✅assignment of benefits
