Question 1

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

Accepted Answer

A) True 
 B)False

Question 2

What is physician self-referral as regulated by the Stark Law?

Accepted Answer

Physician self-referral is the...

Question 3

List seven consequences of inaccurate coding and incorrect billing.

Accepted Answer

Consequences include denied claims; dela...

Question 4

Which organizations are represented on the HCPCS National Panel?

Accepted Answer

Representatives are from the B...

Question 5

The Compliance Program Guidance suggests that a physician's office implement a plan that includes all of the following EXCEPT:

Accepted Answer

A)  conducting internal monitoring and auditing of claims.
B)  developing open lines of communication.
C)  conducting appropriate training and education of staff.
D)  dismissing any employee who fails to understand the compliance plan.E) A) and D)
F) All of the above

Question 6

What questions should a coder ask in checking a claim to make sure it is accurate and ready to submit?

Accepted Answer

Is the coded service billable? Are the c...

Question 7

Individuals suspected of medical fraud and abuse can be investigated and prosecuted by all of the following EXCEPT the:

Accepted Answer

A)  U.S. Department of Justice.
B)  Federal Bureau of Investigation (FBI) .
C)  Office of Inspector General (OIG) .
D)  Supreme Court.E) A) and B)
F) A) and C)

Question 8

The federal government will protect and reward people involved in qui tam, or whistle-blower, cases to identify Medicare fraud.

Accepted Answer

A) True 
 B)False

Question 9

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

Accepted Answer

A)  C1300-C9899.
B)  G0008-G9156.
C)  T1000-T5999.
D)  V2020-V2799.E) A) and B)
F) B) and D)

Question 10

The Federal Civil False Claims Act prohibits submitting a(n) __________ claim.

Accepted Answer

The answer of The Federal Civil False Claims Act prohibits...

Question 11

How is the GA modifier used?

Accepted Answer

The GA modifier is appended to...

Question 12

Medicare requires that all physician offices have a seven-part compliance plan in place.

Accepted Answer

A) True 
 B)False

Question 13

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

Accepted Answer

A)  the Centers for Medicare and Medicaid Services (CMS) .
B)  the Blue Cross/Blue Shield Association.
C)  the Health Insurance Association of America (HIA
A)  .
D)  all of the above.E) A) and B)
F) C) and D)

Question 14

If the coder determines that the code checked off by the physician on the encounter form does NOT match the medical record, the coder should:

Accepted Answer

A)  ignore the encounter form and bill based on the medical record.
B)  change the encounter form to match the medical record.
C)  inform the physician of the issue and determine the correct code.
D)  not bill for the questionable services.E) A) and B)
F) All of the above

Question 15

Code linkage refers to the connection between the:

Accepted Answer

A)  procedure and modifier.
B)  diagnosis and procedure.
C)  diagnosis and symptom.
D)  HCPCS Level I and Level II codes.E) A) and B)
F) None of the above

Question 16

HCPCS Level II national codes consist of:

Accepted Answer

A)  five digits.
B)  one alphabetic character and four digits.
C)  two alphabetic characters and two digits.
D)  one alphabetic character and five digits.E) B) and D)
F) A) and D)

Question 17

HCPCS was developed to achieve all of the following goals EXCEPT:

Accepted Answer

A)  coordinating government programs by uniform application of Centers for Medicare and Medicaid Services (CMS)  policies.
B)  ensuring the validity of profiles and fee schedules through standardized coding.
C)  allowing providers and suppliers to communicate their services in a consistent manner.
D)  implementing standard fee structures for all providers across all plans.E) B) and C)
F) A) and D)

Question 18

An advisory opinion from the CMS or OIG is considered legal advice on any question regarding healthcare business.

Accepted Answer

A) True 
 B)False

Question 19

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

Accepted Answer

A)  age.
B)  gender.
C)  health condition.
D)  All of the aboveE) B) and C)
F) A) and D)

Question 20

The Current Procedural Terminology codes are considered HCPCS Level __________ codes.

Accepted Answer

The answer of The Current Procedural Terminology codes are considered...

Exam 9: Hcpcs and Coding Compliance

Code linkage refers to the connection between the:

Correct AnswerverifiedShow Answer

If the coder determines that the code checked off by the physician on the encounter form does NOT match the medical record, the coder should:

Correct AnswerverifiedShow Answer

What questions should a coder ask in checking a claim to make sure it is accurate and ready to submit?

Correct AnswerverifiedIs the coded service billable? Are the c...View AnswerShow Answer

Medicare requires that all physician offices have a seven-part compliance plan in place.

Correct AnswerverifiedShow Answer

HCPCS Level II national codes consist of:

Correct AnswerverifiedShow Answer

Individuals suspected of medical fraud and abuse can be investigated and prosecuted by all of the following EXCEPT the:

Correct AnswerverifiedShow Answer

The Current Procedural Terminology codes are considered HCPCS Level __________ codes.

Correct AnswerverifiedShow Answer

HCPCS was developed to achieve all of the following goals EXCEPT:

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

The federal government will protect and reward people involved in qui tam, or whistle-blower, cases to identify Medicare fraud.

Correct AnswerverifiedShow Answer

Which organizations are represented on the HCPCS National Panel?

Correct AnswerverifiedRepresentatives are from the B...View AnswerShow Answer

What is physician self-referral as regulated by the Stark Law?

Correct AnswerverifiedPhysician self-referral is the...View AnswerShow Answer

List seven consequences of inaccurate coding and incorrect billing.

Correct AnswerverifiedConsequences include denied claims; dela...View AnswerShow Answer

An advisory opinion from the CMS or OIG is considered legal advice on any question regarding healthcare business.

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

How is the GA modifier used?

Correct AnswerverifiedThe GA modifier is appended to...View AnswerShow Answer

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

Correct AnswerverifiedShow Answer

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

Correct AnswerverifiedShow Answer

The Federal Civil False Claims Act prohibits submitting a(n) __________ claim.

Correct AnswerverifiedShow Answer

The Compliance Program Guidance suggests that a physician's office implement a plan that includes all of the following EXCEPT:

Correct AnswerverifiedShow Answer

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Is the coded service billable? Are the c...
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Representatives are from the B...
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Physician self-referral is the...
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Consequences include denied claims; dela...
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Correct Answer
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Correct Answer
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Correct Answer
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The GA modifier is appended to...
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Correct Answer
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