*
A relative value scale assigns a higher relative value to a procedure that
requires more
Selected Answer:
Correct
all of these.
Answers:
effort.
skill.
time.
Correct
all of these.
Response Feedback:
correct
MC A relative value scale assigns...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.07
Topic: Payer Fee Schedules
*
Question 2
* 2 out of 2 points
*
RACs use a software program to analyze a practice’s claims, looking for
Selected Answer:
Correct
all of these are analyzed.
Answers:
obvious "black and white" coding errors.
medically unnecessary treatment.
excessive number of units billed.
Correct
all of these are analyzed.
Response Feedback:
correct
MC RACs use a software program...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 2 Medium
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.05
Topic: Audits
*
Question 3
* 2 out of 2 points
*
Global periods for a major procedure have which of the following
postoperative periods?
Selected Answer:
Correct
90 days
Answers:
5 days
10 days
30 days
Correct
90 days
Response Feedback:
correct
MC Global periods for a major procedure...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 2 Medium
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.04
Topic: Strategies for Compliance
*
Question 4
* 2 out of 2 points
*
Which of the following codes is used to report supplies and materials
supplied by physician?
Selected Answer:
Correct
99070
Answers:
90471
90710
Correct
99070
96374
Response Feedback:
correct
MC Which of the following codes is used...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.11
Topic: Medicine Codes
*
Question 5
* 2 out of 2 points
*
What does HCPCS use to provide additional information about services,
supplies, and procedures?
Selected Answer:
Correct
Level II modifiers
Answers:
Correct
Level II modifiers
Level III modifiers
Level IV modifiers
All of these are correct
Response Feedback:
correct
MC What does HCPCS use to provide additional...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.13
Topic: HCPCS
Question 6
*
* 0 out of 2 points
*
Under CPT guidelines, all services related to a surgical procedure are not
additionally reimbursed
Selected Answer:
Incorrect
before the global period.
Answers:
before the global period.
after the global period.
Correct
during the global period.
during the E/M period.
Response Feedback:
incorrect
MC Under CPT guidelines, all services related...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.08
Topic: Surgery Codes
Question 7
*
* 2 out of 2 points
*
Which of the following means that a physician has chosen to waive the
charges for services to other physicians?
Selected Answer:
Correct
professional courtesy
Answers:
audit
adjustment
edits
Correct
professional courtesy
Response Feedback:
correct
MC Which of the following means that a physician...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.05
Topic: Audits
Question 8
*
* 2 out of 2 points
*
Which of the following is used with an anesthesia code to indicate a
patient's health status?
Selected Answer:
Correct
physical status modifiers
Answers:
HCPCS modifiers
Correct
physical status modifiers
qualifying circumstances
E/M codes
Response Feedback:
correct
MC Which of the following is used with an anesthesia...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.07
Topic: Anesthesia Codes
Question 9
*
* 2 out of 2 points
*
In the CCI, which type of codes cannot both be billed for a patient on the
same day of service?
Selected Answer:
Correct
mutually exclusive
Answers:
black box
diagnostic
Correct
mutually exclusive
unbundled
Response Feedback:
correct
MC In the CCI, which type of codes cannot...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 2 Medium
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.02
Topic: Knowledge of Billing Rules
Question 10
*
* 2 out of 2 points
*
In an allowed charges payment method, if a provider's charge is higher
than the allowed amount, the provider's reimbursement is based on
Selected Answer:
Correct
the amount allowed.
Answers:
the amount billed.
Correct
the amount allowed.
the deductible.
the co-insurance.
Response Feedback:
correct
MC In an allowed charges payment method...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 2 Medium
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.09
Topic: Fee-Based Payment Methods
Question 11
*
* 0 out of 2 points
*
Which group identifies services for which new HCPCS level II codes are
needed?
Selected Answer:
Incorrect
DMEPOS
Answers:
AMA
DMEPOS
OCR
Correct
CMS HCPCS Workgroup
Response Feedback:
incorrect
MC Which group identifies services...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.13
Topic: HCPCS
Question 12
*
* 2 out of 2 points
*
Which of the following is considered a formal examination?
Selected Answer:
Correct
audit
Answers:
Correct
audit
adjustment
edits
professional courtesy
Response Feedback:
correct
MC Which of the following is considered...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.05
Topic: Audits
Question 13
*
* 0 out of 2 points
*
Which of the following is a cross-reference that might be seen in CPT?
Selected Answer:
Incorrect
See
Answers:
See
See Also
Correct
Both “See” and “See Also” are seen
Neither “See” nor “See Also” is seen
Response Feedback:
incorrect
MC Which of the following is a cross-reference...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.05
Topic: Coding Steps
Question 14
*
* 2 out of 2 points
*
In the CCI, which type of code cannot be billed together with a column 1
code for the same patient on the same day of service?
Selected Answer:
Correct
column 2
Answers:
edit
exclusive
diagnostic
Correct
column 2
Response Feedback:
correct
MC In the CCI, which type of code cannot...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 2 Medium
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.02
Topic: Knowledge of Billing Rules
Question 15
*
* 2 out of 2 points
*
What kinds of services support treatment, like rehabilitation,
occupational therapy, and nutrition therapy?
Selected Answer:
Correct
ancillary services
Answers:
evaluation and management services
Correct
ancillary services
dental procedures
secondary services
Response Feedback:
correct
MC What kinds of services support...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.11
Topic: Medicine Codes
Question 16
*
* 2 out of 2 points
*
CPT was first published in what year?
Selected Answer:
Correct
1966
Answers:
1946
Correct
1966
1970
1992
Response Feedback:
correct
MC CPT was first published...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.01
Topic: Current Procedural Terminology, Fourth Edition (CPT)
Question 17
*
* 2 out of 2 points
*
The Evaluation and Management section was first introduced in what year?
Selected Answer:
Correct
1992
Answers:
1946
1966
1970
Correct
1992
Response Feedback:
correct
MC The Evaluation and Management section...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.06
Topic: Evaluation and Management Codes
Question 18
*
* 2 out of 2 points
*
When did HCPCS become mandatory for coding and billing?
Selected Answer:
Correct
1996
Answers:
1966
1980
Correct
1996
It is not mandatory.
Response Feedback:
correct
MC When did HCPCS become mandatory...
ABHES: 7.d Graduates will be able to: Process insurance claims
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: IX.C.1 Describe how to use the most current procedural coding system
CAAHEP: IX.C.3 Describe how to use the most current HCPCS level II coding system
CAAHEP: IX.P.1 Perform procedural coding
CAHIIM: I.A.1 Apply diagnosis/procedure codes according to current guidelines
CAHIIM: I.A.3 Apply diagnostic/procedural groupings
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 05.13
Topic: HCPCS
Question 19
*
* 2 out of 2 points
*
Which of the following audits Medicare claims to determine if there is an
opportunity to recover incorrect payments from previously paid services?
Selected Answer:
Correct
Recovery Audit Contractor
Answers:
staff members
external consulting company
Compliance Officer
Correct
Recovery Audit Contractor
Response Feedback:
correct
MC Which of the following audits Medicare claims...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 2 Medium
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.05
Topic: Audits
Question 20
*
* 0 out of 2 points
*
What type of coding uses diagnoses that are not as specific as possible?
Selected Answer:
Incorrect
upcoding
Answers:
Correct
truncated coding
assumption coding
upcoding
downcoding
Response Feedback:
incorrect
MC What type of coding uses diagnoses...
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: VIII.P.4 Complete an insurance claim form
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in
healthcare reimbursement
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes
Difficulty: 1 Easy
Est Time: 0-1 minute
Gradable: automatic
Learning Objective: 06.03
Topic: Compliance Errors
.
