True Or False Quizzes/test/exams

Front 1

Medicare is the largest single medical benefits program in the United States

Back 1

True

Front 2

The AMA is responsible for the operation of the Medicare program and for selections medicare administrative contractors (MACs)

Back 2

False

Front 3

Medicare part d is a prescription drug coverage plan

Back 3

True

Front 4

Medical Savings Programs help people with high income and asset levels pay for healthcare coverage.

Back 4

False

Front 5

A benefit period begins the first day the patient visits the physician and ends when the patient is cured/healed.

Back 5

False

Front 6

Lifetime reserve days (45 days) may be used only once during a patient's lifetime and are usually reserved for use during the patient's final, terminal hospital stay.

Back 6

False

Front 7

Medicare Part B also covers some health patient is not covered by medicare Part A

Back 7

True

Front 8

Medicare limits hospice care to four benefit: two periods of 90 days each, one 30- day period, and a final "lifetime" extension of unlimited duration.

Back 8

True

Front 9

Respite care is the permanent hospitalization of a terminally ill, dependent hospice patient for the purpose of providing relief for the nonpaid person who has the major day-to-day responsibility for care of that patient.

Back 9

False

Front 10

When a patient uses Medicare hospice benefits, all other Medicare benefits stop, with the exception of physician services or treatment for conditions not related to the patient's terminal diagnosis.

Back 10

True

Front 11

Medicare part B helps cover physician services, outpatient hospital care, and other services not covered by Medicare Part A

Back 11

True

Front 12

Medigap is designed to supplement all insurance benefits by paying for services that they do not cover.

Back 12

False

Front 13

Mac's replaced carriers and fiscal intermediaries and process both Medicare A and B claims.

Back 13

True

Front 14

MSA enrollees are required to pay an annual Medicare B premium.

Back 14

False

Front 15

The purpose of obtaining the ABN is to ensure payment for a procedure or service that might not be reimbursed under Medicare.

Back 15

True

Front 16

Medicaid provides medical and health-related services to individuals and families with low incomes.

Back 16

True

Front 17

States are not required to provide Medicaid coverage for individuals who. receive federally assisted income-maintenance payment.

Back 17

False

Front 18

Each state administers its own Medicaid program, and AMA monitors the programs.

Back 18

False

Front 19

The BBA allows states to provide 12 months of continuous Medicare coverage (without reevaluation) for eligible children under the age of 19.

Back 19

True

Front 20

In many cases, Medicare eligibility will depend on the patient's monthly income.

Back 20

True

Front 21

Retroactive eligibility is never granted to patients who had high medical expenses prior to filing for Medicaid

Back 21

False

Front 22

States must provide home health services to beneficiaries who are entitled to receive nursing facility services.

Back 22

True

Front 23

States are not permitted to require nominal deductibles, coinsurances, or copayments for certain services performed.

Back 23

False

Front 24

The medicaid eligibility verification system allows providers to electronically access the state's eligibility file.

Back 24

True

Front 25

Medically necessary services are furnished primarily for the convenience of the recipient or provider.

Back 25

False

Front 26

When a PACE participant needs to use a noncontract providers there is no limit on the amount that these noncontract providers can charge.

Back 26

False

Front 27

Each time upon check-in a Medicaid patient should present a valid Medicaid ID card

Back 27

True

Front 28

Preauthorization is not required as part of the Medicaid program.

Back 28

False

Front 29

When a patient has both Medicare and Medicaid, Medicaid pays first

Back 29

False

Front 30

Health affairs refers to the office responsibility for both military readiness and peacetime health care.

Back 30

True

Front 31

TRICARE sponsors are uniformed service personnel who are active-duty, retired, or deceased.

Back 31

True

Front 32

TRICARE service centers are business offices that assist TRICARE sponsors with health-care needs.

Back 32

True

Front 33

Nurse advisors are available 24/7 to treat sponsors for nonmedical emergencies.

Back 33

False

Front 34

TRICARE case management coordinates and monitors a beneficiary's healthcare options and services.

Back 34

True

Front 35

Beneficiary counseling and assistant coordinators (BACs)were previously called that collection assistant officers

Back 35

False

Front 36

CHAMPVA is always the first payer before Medicare.

Back 36

False

Front 37

TRICARE offers three healthcare options.

Back 37

True

Front 38

The catastrophic cap benefits protects TRICARE physicians from devastating financial loss due to medical malpractice.

Back 38

False

Front 39

All active-duty members are enrolled in TRICARE prime and are not eligible for TRICARE extra.

Back 39

True

Front 40

TRICARE Standard provides beneficiaries with the greatest freedom in selection of civilian providers, yet is the most expensive.

Back 40

True

Front 41

TRICARE claims are submitted to the TMA

Back 41

False

Front 42

TRICARE Extra is a managed-care options similar to an HMO.

Back 42

False

Front 43

TRICARE standard enrolls participating providers.

Back 43

False

Front 44

When a patient has a supplemental health plan in addition to TRICARE, the participating provider submits just one claim.

Back 44

True

Front 45

The worker must physically be on company property to qualify workers' compensation.

Back 45

False

Front 46

Permanent disability refers to an employee's diminished capacity to work to return to work

Back 46

True

Front 47

Schedule loss of use (eyesight, hearing, or body part) compensation is a lifetime benefit.

Back 47

False

Front 48

According to the law, when a patient requests treatment for a work-related injury or disorder and has signed the first report of injury form, the patient has given consent for the filing of compensation claims and reports.

Back 48

False

Front 49

If the employer disputes the legitimacy of the claim, a first report of injury report must be filed anyway.

Back 49

True

Front 50

A detailed narrative progress/supplemental report is filed to document any significant change in the workers medical or disability status.

Back 50

True

Front 51

A health information specialist should personally sign the original and all photocopies of progress reports before filing them for the position.

Back 51

False

Front 52

The employer must be notified by mail when an injured worker presents for the first visit without a written or personal referral from the employer.

Back 52

False

Front 53

OSHA was created to protect employees against injuries from occupational hazards in the workplace.

Back 53

True

Front 54

The first report of injury form is completed in triplicate when the patient first seeks treatment.

Back 54

False

Front 55

Worker's Compensation is not the same program as Workmen's Compensation.

Back 55

False

Front 56

Federal agencies reimburse FECA for Worker's Compensation expenses through annual premiums charged to workers.

Back 56

False

Front 57

A comprehensive record of all vaccinations administered and any accidental exposure incidences must be retained for 30 years.

Back 57

False

Front 58

Worker's Compensation is standardized from state to state.

Back 58

False

Front 59

All providers must except the compensation payment as payment in full.

Back 59

True

Front 60

The health insurance specialist employed in a physician's office assigns ICD-9-CM codes to procedures documents by the healthcare provider.

Back 60

False

Front 61

The ICD-9-CM is organized into three volumes.

Back 61

True

Front 62

An advanced beneficiary notice is signed by the patient to acknowledge that the healthcare provider is a subscriber to the Medicare program.

Back 62

False

Front 63

An inpatient is a person admitted to a hospital for treatment with the expectation that here she will remain in the hospital for a period of 24 hours or more.

Back 63

True

Front 64

The first-listed diagnosis and the primary diagnosis are the same thing.

Back 64

False

Front 65

Codes that describe signs and symptoms, as opposed to definitive diagnoses, are never acceptable for reporting purposes when the physician has not documented an established or confirmed diagnosis.

Back 65

False

Front 66

Preadmission testing is routinely completed prior to an inpatient admission or outpatient surgery to facilitate the patient's treatment and reduce the length of stay.

Back 66

True

Front 67

V codes are located in the index and are assigned for patient encounters when a circumstance other than a disease or injury is present.

Back 67

False

Front 68

E codes are located in the Tabular List of Diseases and describe external causes of injury, poisoning, or other adverse reactions affecting a patient's health.

Back 68

True

Front 69

Supplementary words located in parentheses after a main term in the ICD index to diseases are nonessential modifiers that do not have to be included in the diagnostic statement for the code number listed (after parentheses) to apply.

Back 69

True

Front 70

Coding conventions are rules that apply to the assignments of iCD-9-CM codes and are always found in the guidelines.

Back 70

False

Front 71

A principal procedure is a procedure performed for definitive treatment rather than diagnostic purposes, or one performed to treat a complication, or one that is closely related to the principal diagnosis.

Back 71

True

Front 72

A lesion is a neoplasm defined as any discontinuity of tissue that is not malignant.

Back 72

False

Front 73

An adverse effect or adverse reaction is the appearance of a pathologic condition caused by ingestion or exposure to a chemical substance that is properly administered or taken.

Back 73

True

Front 74

A late of fact as a residual effect or sequelae of a previous acute illness, injury, or surgery.

Back 74

True

Front 75

ICD-10-CM is the abbreviation for the International classification of diseases, 10th edition, clinical modification.

Back 75

False

Front 76

All provider-based offices and outpatient health care settings will continue to report CPT and HCPCS level II codes for procedures and services.

Back 76

True

Front 77

Regular code updates to ICD-9-CM, ICD-10-CM, and ICD-10-PCS were discontinued on October 1, 2011.

Back 77

True

Front 78

Effective October 1, 2011, ICD-9-CM became a legacy coding system.

Back 78

False

Front 79

ICD-10-CM requires seven characters for each code.

Back 79

False

Front 80

ICD-10-CM, when compared to ICD-9-CM, will provide better data for conducting research.

Back 80

True

Front 81

The seventh character and ICD-10-CM is known as an extension.

Back 81

True

Front 82

ICD 10 PCS replaces volume 2 to the ICD-9-CM.

Back 82

False

Front 83

CMS is responsible for updating to ICD 10 PCS on an annual basis.

Back 83

True

Front 84

Eponyms are diseases or syndromes that are named for people.

Back 84

True

Front 85

Parentheses are used in ICD 10 CM to identify manifestation codes.

Back 85

False

Front 86

There are two types of Includes notes and ICD 10 CM.

Back 86

False

Front 87

The see instruction after A main term directs the coder to refer to another term in the index to locate a code.

Back 87

True

Front 88

The table of neoplasms is located in the tabular list of ICD 10 CM.

Back 88

False

Front 89

Qualifiers are supplementary terms that further modify some terms and other qualifiers.

Back 89

True

Front 90

HCPCS is a reimbursement methodology or system; it is important to understand that, just because codes exist for certain products or services, coverage is not guaranteed.

Back 90

False

Front 91

HCPCS level II temporary codes are maintained by the AMA and other members of the HCPCS national panel, independent of permanent level II codes.

Back 91

False

Front 92

Whenever a permanent code is established by the HCPCS National Panel to replace a temporary code, the temporary code is deleted and cross-referenced to the new permanent code.

Back 92

True

Front 93

HCPCS modifiers clarify services and procedures performed by providers.

Back 93

True

Front 94

When using the HCPCS manual, it is important to code and verify directly from the index.

Back 94

False

Front 95

Some services must be reported by assigning both a CPT and HCPCS level II national code. The most common scenario uses the CPT code for the administration of an injection and HCPCS code to identify the procedure.

Back 95

False

Front 96

HCPCS level II modifiers are alphabetic (two letters) or alphanumeric (one letter followed by one number).

Back 96

True

Front 97

OPPS requires hospitals and ambulatory surgery centers report product-specific HCPCS level II C codes with CPT codes to obtain reimbursement for biologicals, devices, drugs, and other items associated with implantable device technologies.

Back 97

True

Front 98

IV chelation therapy is an experimental type of chemical endarterectomy which is used to treat arteriosclerosis.

Back 98

True

Front 99

That NCCI policy manual states that the HCPCS code Q0091 (screening Pap smears) does not include the transportation of the specimen to the laboratory.

Back 99

False

Front 100

The CPT provides a uniform language that describes medical, surgical, and diagnostic services to facilitate communication among providers, patients, and insurers.

Back 100

True

Front 101

The symbol identifies add-on codes for procedures that are commonly, but not always, performed at the same time and by the same surgeon as the primary procedure.

Back 101

True

Front 102

Conscious sedation, marked by a triangle symbol, is the administrative of moderate sedation or analgesia that results in a drug-induced depression or consciousness.

Back 102

False

Front 103

Guidelines are located at the beginning of each CPT section and should be carefully reviewed before attempting to code

Back 103

True

Front 104

Descriptive qualifiers are trims that clarify the assignment of a CPT code and are always found at the beginning of a main clause or after the semicolon.

Back 104

False

Front 105

The CPT index is organized by alphabetical main terms representing procedures or services, organs, anatomical sites, conditions, eponyms, or abbreviations

Back 105

True

Front 106

End-Stage renal dialysis and hemodialysis services would be reported with codes from the surgery section of CPT.

Back 106

False

Front 107

Unbundling means assigning multiple codes to procedures/services when just one comprehensive code should be reported

Back 107

True

Front 108

The separate procedure code is always reported if the procedure or service performed is included in the description of another reported code

Back 108

False

Front 109

When billing multiple surgical procedures performed during the same operative session, the surgical procedure performed first should be coded first on the claim

Back 109

False

Front 110

The professional component of a radiological examination covers the supervision of the procedure and the interpretation and writing of a report describing the examination and it's findings

Back 110

True

Front 111

The technical component of an examination covers the use of the equipment, supplies provided, and employment of the radiologic technicians

Back 111

True

Front 112

Single code numbers are assigned to organ-or disease-oriented panels, which consists of a series of blood chemistry studies routinely ordered by providers at the same time for the purpose of investigating a specific organ or disorder. The panel is very specific, but substitutions of so,e tests are allowed.

Back 112

False

Front 113

Chemotherapy administrative in addition to other cancer treatments, such as surgery and/or radiation therapy, is called adjuvant chemotherapy

Back 113

True

Front 114

An ambulatory surgical center (ACS) is a federally licensed, Medicare-certified supplier of surgical Healthcare Services that must accept assignment of medical claims

Back 114

False

Front 115

CPT codes directly affect DRG assignment.

Back 115

False

Front 116

DRG's are organized into manually exclusive categories called major diagnostic categories (MDCs).

Back 116

True

Front 117

A Medicare administrative contractor (MAC) is a third-party payer that contracts with Medicare to carry out the operational functions of the Medicare program

Back 117

True

Front 118

The ESRD composite payment rate system bundles ESRD drugs and related laboratory work with that composite rate payment.

Back 118

True

Front 119

The IPPS five-day window requires outpatient pre-admission services provided by a hospital on the day of, or during the five day prior to, a patient's admission to the covered by the IPPS DRG payment

Back 119

False

Front 120

Medically manage diagnoses are also known as secondary diagnoses or coexisting diagnoses

Back 120

True

Front 121

It is recommended that an authentication legend be generated when the patient is discharged

Back 121

False

Front 122

A waiver is required by Medicare for all outpatient and physician office procedures/services that are covered by the Medicare program

Back 122

False

Front 123

Auditing processes involve reviewing patient records and CMS-1500 or UB-04 claims to process coding accuracy and completeness of documentation

Back 123

False

Front 124

Chargemaster's are used to select procedures, services, and supplies provided to hospital emergency department patients and outpatients

Back 124

True

Front 125

Local coverage determinations (LCDs) specify under what clinical circumstances A service is covered

Back 125

True

Front 126

Primary purpose of the patient record is to provide continuity of care

Back 126

True

Front 127

Veterans health information systems and technology architecture (VistA) electronic health record was developed by the AMA

Back 127

False

Front 128

Operative reports may very from short narrative descriptions to formal dictated reports

Back 128

False