Weekly Quiz 6 Chapter 7 & 8

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Question #1

HCPCS is organized by code number rather than by service or supply name.

A False

B True

Question #2

HCPCS is the acronym for Healthcare Coding Procedures in a Common System.

A False

B True

Question #3

If a provider requests an advisory opinion and fails to follow the advice of the Office of Inspector General (OIG), the provider:

A should not change its practices.

B could claim “not knowing.”

C could be prosecuted.

D would be treated leniently for asking the question.

Question #4

Benefits of a voluntary compliance plan include:

A minimizing billing mistakes.

B reducing the chances that an audit will be conducted by the CMS or OIG.

C avoiding conflicts with the self-referral and anti-kickback statutes.

D All of these.

Question #5

All the following are true of Column I edits EXCEPT:

A includes all the services that are described by Column II code.

B formerly known as the component column.

C cannot be billed together with the Column I code for the same patient on the same day.

D contains the comprehensive code.

Question #6

Healthcare payers base their decision to pay or deny claims on the:

A diagnosis and procedure codes.

B neatness of the claim.

C diagnosis codes only.

D procedure codes only.

Question #7

To bill for a procedure that was NOT medically necessary is considered:

A inaccurate.

B fraud.

C abuse.

D incomplete.

Question #8

Misusing Medicare funds is considered:

A fraud but not illegal.

B abuse and illegal.

C abuse but not illegal.

D fraud and illegal.

Question #9

To bill for a procedure that was NOT performed is considered:

A unbundling.

B upcoding.

C fraud.

D abuse.

Question #10

Under civil law, the maximum penalty for medical fraud is:

A exclusion from the American Medical Association.

B $10,000.00

C loss of professional license.

D 10 years in jail.

Question #11

The Stark Law was enacted to govern the practice of:

A physician referrals to other providers such as physical and occupational therapists.

B physician referrals of Medicare and Medicaid patients to facilities in which he or she has a financial interest.

C utilization of controlled substances in medical facilities.

D medical office coding practices.

Question #12

In physical therapy cases, if a coder bills for supervised attendance:

A one-on-one direct contact by the therapist is not required.

B the therapist must be in constant attendance with the patient.

C one-on-one direct contact by the therapist is required.

D the therapist must be supervised by a physician.

Question #13

Procedure and diagnostic codes should be appropriate to the patient’s:

A health condition.

B gender.

C All of these.

D age.

Question #14

Code linkage refers to the connection between the:

A diagnosis and symptom.

B HCPCS Level I and Level II codes.

C procedure and modifier.

D diagnosis and procedure.

Question #15

Inaccurate coding and incorrect billing can result in:

A All of these.

B loss of the provider’s license to practice medicine.

C prison sentences.

D delays in receiving payments.

Question #16

The HCPCS modifier GA indicates:

A an advance beneficiary notice has been signed by the patient.

B All of these.

C the procedure billed may be denied by Medicare as “not medically necessary.”

D a waiver of liability statement is on file.

Question #17

To identify that a procedure was performed on the thumb of the left hand, the coder would select the modifier:

A L1.

B FA.

C LA.

D F1.

Question #18

State Medicaid agency codes are reported with what HCPCS code range?

A C1300—C9899

B V2020—V2799

C G0008—G9156

D T1000—T5999

Question #19

The National Panel that maintains Level II HCPCS codes includes representatives from:

A All of these.

B Health Insurance Association of America (HIAA).

C Centers for Medicare and Medicaid Services (CMS).

D Blue Cross/Blue Shield Association.

Question #20

HCPCS Level II codes in the range J0120-J9999 would be used for:

A drugs administered other than oral method.

B durable medical equipment (DME).

C dental procedures.

D diagnostic radiology services.

Question #21

An example of an HCPCS Level II code is:

A 250.00.

B J0290.

C E849.0.

D 99213

Question #22

A coder who needs to find the code for prosthetic procedures would find it in the:

A Level II HCPCS code book.

B Level III HCPCS code book.

C This is not considered an HCPCS code.

D Level I HCPCS code book.

Question #23

HCPCS Level II codes are updated annually by the:

A American Medical Association (AMA).

B American Dental Association (ADA).

C Centers for Medicare and Medicaid Services (CMS).

D World Health Organization (WHO).

Question #24

What is an individual called who files a lawsuit on behalf of the federal government?

A relator

B informant

C source

D plaintiff

Question #25

The five-digit CPT codes used to report services and procedures performed by healthcare providers are also known as:

A Level II HCPCS.

B Level III HCPCS.

C They are not considered HCPCS codes.

D Level I HCPCS.

Question #26

When add-on codes are used, the coder should also use modifier -51 to identify more than one code.

A False

B True

Question #27

A range of codes is shown when more than one code applies to an entry.

A True

B False

Question #28

To code for immunizations, the coder should use:

A one code for the administration only.

B one code for the administration and one code for the vaccine.

C one bundled code for the administration and the vaccine given.

D one code for the vaccine given.

Question #29

If a physician’s office collects a blood sample and sends it to an outside lab, the physician:

A can never bill for any type of lab work.

B can bill for obtaining the sample.

C cannot bill for obtaining the sample.

D can bill for analyzing the test results only in certain cases.

Question #30

The use of the term supervision and interpretation (S&I) means that the radiology code represents only the:

A technical component.

B professional component.

C results component.

D supply and equipment component.

Question #31

In coding radiology services, the part of the procedure that reflects the technologist and the equipment used is the:

A supply and equipment component.

B results component.

C professional component.

D technical component.

Question #32

The global surgical period is determined by the:

A surgeon.

B patient’s primary care physician.

C insurance carrier or other third-party payer.

D patient.

Question #33

A service NOT included in the surgical package code would be:

A evaluating the patient in the postanesthesia recovery room.

B surgical complications or the presence of other diseases requiring additional services.

C immediate postoperative care, including talking with the patient’s family.

D one related evaluation and management (E/M) encounter on the date immediately prior to the date of the procedure.

Question #34

A surgical package would include:

A all care provided within 30 days of surgery.

B all E/M encounters prior to the date of the procedure.

C one evaluation and management (E/M) encounter on the date immediately prior to the date of the procedure.

D all general anesthesia services.

Question #35

Which type of procedure is reported as an additional procedure performed in addition to a main procedure?

A primary procedure

B elective procedure

C essential procedure

D secondary procedure

Question #36

The largest section of the CPT code book is:

A Pathology and Laboratory.

B Evaluation and Management.

C Surgery.

D Medicine.

Question #37

The physical status modifier P1 refers to a:

A patient with mild systemic disease.

B patient who is not expected to survive without the surgery.

C patient with severe systemic disease.

D normal, healthy patient.

Question #38

The physical status modifier that should be used for a patient with severe systemic disease that is a constant threat to life is:

A P1.

B P3.

C P6.

D P4.

Question #39

The subsections under Anesthesia in the CPT code book are organized by:

A type of surgery or procedure.

B type of drug administered.

C body site.

D time under anesthesia.

Question #40

A bundled code refers to a:

A code used with modifier -99.

B group of related procedures covered by a single code.

C group of unrelated procedures done on the same day.

D group of procedures pertaining to the same diagnosis.

Question #41

Anesthesia is reimbursed according to the:

A type of drug administered.

B time under anesthesia.

C experience of the anesthesiologist.

D type of surgery or procedure being performed.

Question #42

Which of the following can be billed separately in a surgical procedure?

A positioning the patient

B fulguration of bleeding points

C exploration of operative area

D None of these

Question #43

When a physician performs a surgical procedure but does NOT provide the preoperative and/or postoperative management, the coder should use modifier:

A -55

B -56

C -58

D -54

Question #44

A special report detailing increased time and difficulty should be submitted with a claim when which modifier is used?

A -22

B -63

C -79

D -25

Question #45

Modifier -47 is used to report:

A procedure performed by a surgical assistant.

B anesthesia administered by a surgeon.

C use of local anesthesia.

D multiple procedures that involve anesthesia.

Question #46

The modifier used to report a bilateral procedure is:

A -50

B -53

C -22

D -47

Question #47

Within an indented series of codes, the first left-justified code is the:

A official code.

B main term.

C subterm.

D parent code.

Question #48

If two codes apply to an entry in the CPT index, the codes are separated by a:

A semicolon.

B comma.

C hyphen.

D colon.

Question #49

Examples of procedures or services include all of the following EXCEPT:

A evaluation and management.

B osteopathic manipulation.

C arthroscopy.

D abdominal distention.

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Weekly Quiz 6 Chapter 7 & 8

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