When is it appropriate to file a patient
Question 1
- HCPCS is a multilevel coding system that contains _________ levels.1
2
3
4
2 points
Question 2
- CPT-4 is published annually byAMA
CMS
WHO
Medicare
2 points
Question 3
- CPT index terms that are printed in boldface are calleddescriptors
essential modifiers
main terms
subterms
2 points
Question 4
- An example of a supplemental insurance plan isCHAMPUS
Medicaid
Medigap
TRICARE
2 points
Question 5
- 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
- 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
- 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
- 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
- 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
- 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