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 would be treated leniently for asking the question.

B should not change its practices.

C could claim “not knowing.”

D could be prosecuted.

Question #4

Benefits of a voluntary compliance plan include:

A All of these.

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

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

D minimizing billing mistakes.

Question #5

All the following are true of Column I edits EXCEPT:

A contains the comprehensive code.

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

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

D formerly known as the component column.

Question #6

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

A diagnosis and procedure codes.

B procedure codes only.

C neatness of the claim.

D diagnosis codes only.

Question #7

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

A fraud.

B abuse.

C inaccurate.

D incomplete.

Question #8

Misusing Medicare funds is considered:

A fraud but not illegal.

B abuse but not illegal.

C abuse and illegal.

D fraud and illegal.

Question #9

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

A upcoding.

B unbundling.

C abuse.

D fraud.

Question #10

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

A exclusion from the American Medical Association.

B $10,000.00

C 10 years in jail.

D loss of professional license.

Question #11

The Stark Law was enacted to govern the practice of:

A utilization of controlled substances in medical facilities.

B medical office coding practices.

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

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

Question #12

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

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

B the therapist must be supervised by a physician.

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

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

Question #13

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

A All of these.

B gender.

C health condition.

D age.

Question #14

Code linkage refers to the connection between the:

A diagnosis and symptom.

B procedure and modifier.

C diagnosis and procedure.

D HCPCS Level I and Level II codes.

Question #15

Inaccurate coding and incorrect billing can result in:

A prison sentences.

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

C All of these.

D delays in receiving payments.

Question #16

The HCPCS modifier GA indicates:

A a waiver of liability statement is on file.

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

C All of these.

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

Question #17

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

A F1.

B FA.

C L1.

D LA.

Question #18

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

A G0008—G9156

B T1000—T5999

C C1300—C9899

D V2020—V2799

Question #19

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

A All of these.

B Blue Cross/Blue Shield Association.

C Centers for Medicare and Medicaid Services (CMS).

D Health Insurance Association of America (HIAA).

Question #20

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

A durable medical equipment (DME).

B diagnostic radiology services.

C dental procedures.

D drugs administered other than oral method.

Question #21

An example of an HCPCS Level II code is:

A J0290.

B 250.00.

C 99213

D E849.0.

Question #22

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

A This is not considered an HCPCS code.

B Level I HCPCS code book.

C Level III HCPCS code book.

D Level II HCPCS code book.

Question #23

HCPCS Level II codes are updated annually by the:

A American Dental Association (ADA).

B American Medical Association (AMA).

C World Health Organization (WHO).

D Centers for Medicare and Medicaid Services (CMS).

Question #24

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

A informant

B source

C plaintiff

D relator

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 True

B False

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 vaccine given.

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

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

Question #29

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

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

B can never bill for any type of lab work.

C cannot bill for obtaining the sample.

D can bill for obtaining the sample.

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 technical component.

B supply and equipment component.

C professional component.

D results component.

Question #32

The global surgical period is determined by the:

A insurance carrier or other third-party payer.

B surgeon.

C patient’s primary care physician.

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.

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

E 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 general anesthesia services.

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

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

D all care provided within 30 days of surgery.

Question #35

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

A essential procedure

B primary procedure

C elective procedure

D secondary procedure

Question #36

The largest section of the CPT code book is:

A Pathology and Laboratory.

B Medicine.

C Evaluation and Management.

D Surgery.

Question #37

The physical status modifier P1 refers to a:

A normal, healthy patient.

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

C patient with severe systemic disease.

D patient with mild systemic disease.

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 P6.

B P1.

C P4.

D P3.

Question #39

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

A body site.

B type of surgery or procedure.

C time under anesthesia.

D type of drug administered.

Question #40

A bundled code refers to a:

A group of unrelated procedures done on the same day.

B group of related procedures covered by a single code.

C code used with modifier -99.

D group of procedures pertaining to the same diagnosis.

Question #41

Anesthesia is reimbursed according to the:

A type of drug administered.

B type of surgery or procedure being performed.

C time under anesthesia.

D experience of the anesthesiologist.

Question #42

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

A None of these

B exploration of operative area

C fulguration of bleeding points

D positioning the patient

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 -54

B -55

C -58

D -56

Question #44

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

A -22

B -25

C -79

D -63

Question #45

Modifier -47 is used to report:

A multiple procedures that involve anesthesia.

B anesthesia administered by a surgeon.

C procedure performed by a surgical assistant.

D use of local anesthesia.

Question #46

The modifier used to report a bilateral procedure is:

A -50

B -22

C -53

D -47

Question #47

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

A main term.

B subterm.

C parent code.

D official code.

Question #48

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

A comma.

B semicolon.

C hyphen.

D colon.

Question #49

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

A evaluation and management.

B arthroscopy.

C abdominal distention.

D osteopathic manipulation.

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Weekly Quiz 6 Chapter 7 & 8

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