When is it appropriate to file a patient

Question 1

  1. HCPCS is a multilevel coding system that contains _________ levels.1

    2

    3

    4

2 points

Question 2

  1. CPT-4 is published annually byAMA

    CMS

    WHO

    Medicare

2 points

Question 3

  1. CPT index terms that are printed in boldface are calleddescriptors

    essential modifiers

    main terms

    subterms

2 points

Question 4

  1. An example of a supplemental insurance plan isCHAMPUS

    Medicaid

    Medigap

    TRICARE

2 points

Question 5

  1. The Medicare physician fee schedule amount for code 99213 is $100. Calculate the nonPAR allowed charge.$20

    $80

    $95

    $102.25

2 points

Question 6

  1. The purpose of the creation of HCPCS codes was to furnish health care providers with a :mandate to use electronic claims submission

    method for obtaining higher reimbursement from Medicare.

    standardized language for reporting professional services, procedures, supplies, and equipment.

    standardized way of reporting inpatient and outpatient diagnoses.

2 points

Question 7

  1. Medicare participating providers commonly report actual fees to Medicare but adjust fees after payment is received. The difference between the fee reported and the payment received is afee adjustment

    limiting charge

    neutral charge

    write-off

2 points

Question 8

  1. Nonparticipating (nonPAR) providers are restricted to billing at or below thefee-for-service

    limiting charge

    physician fee schedule

    relative value scale

2 points

Question 9

  1. Modifiers are used with HCPCS codes tochange the original description of the service, procedure, or supply item.

    decrease payment from Medicare.

    increase payment from Medicare.

    provide additional information regarding the product or service identified.

2 points

Question 10

  1. When is it appropriate to file a patient’s secondary insurance claim?after a copy of the explanation of benefits is received by the practice

    after the explanation of benefits is received by the patient

    after the remittance advice is received by the medical practice

    at the same time the primary insurance claim is filed, if the primary and secondary payers are different

2 points

 

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