billing and coding final

which are 3rd party payers

all of the above

the first letter in an ICD 10 code is always

alphabetic

part D of medicare is

pharmaceutical coverage

which of the following are part of part A of medicare

all of the above

which of the following are billable for a telehealth visit

evaluation and management

rehab and therapeutic exercise

nutrition consultation

according to california business and professions code cash discounts are _____ grant discounts in health or medical care costs when payment is made promptly

expressly authorized

the purposes of the ICD-10 system was to

all of the above

E&M are not used for which 2 of the following

adjustive technique

physiotherapy application

ICD-10 codes were initiated in 1994 by which organization

world health organization (WHO)

medical is california medicaid and is administered and regulated by california but funded predominatly by the government

true

therapeutic exercises are used to help pt regain their strength, endurance, and ROM and are billed as constant attendees codes timed units

true

jan 1 2021 E&M codes use time for face-to-face physician exams which of the following timeframes is incorrect

99204 for 20-44 minutes

the most common code used by DC for an established pt is

99313

98943 is the CPT code for extra-spinal adjusting this is the code used for adjusting the pelvic joints

false

the ending code of “A” after the x of an ICD-10 code means

active care

reading the pt chart and pulling elements regarding the s/s in order to form a diagnosis is termed

abstracting

according to the affordable care act service/procedure payments are made at equal rates to all providers who can legally provide the service/procedure regardless of their discplines

true

ICD-10 codes are updated once per year at the first of which month

october

FAS and HAS accounts can be used to pay for healthcare costs not covered by the patients healthcare plan

true

who is ultimately responsible for billing acuraccy

doctor

E&M code 99211 is a nursing code for minimal examinations

true

which of the statements is true

constant attendance codes require one on one contact with provider and patient

tricare is an HMO insurance plan for active and retired military and their families

true

a patient is considered established if they have been seen in your office ever within the last ___ years

3

part B of medicare is best described as

supplementary medical insurance

part c of medicare covers

both parts A and B

extraspinal adjusting for DC’s use code

98943

all CPT/CMT codes include a routine pre-service evaluation code

true

there are ___ spinal regions for CPT/CMT coding

5

it is recommended that billing an E&M code is appropriate on an established on-going treated patient about every ___ days

30

97112 neuromuscular re-education CPT code used for activites that facilitate muscular re-education of movement, balance, posture, coordination, and proprioception/kinesthetic sense

true

workers compensation insurance coverage will not cover an employee in the following situation

driving from directly their work

for 5 spinal regions adjusted the chiropractor would use code ____

98942

billing and coding are the primary method of communication between the medical practioner and insurance provider

true

employers/unions established healthcare funds to pay health costs of employees/union members these plans are called _____

self-insured plans

97110 therapeutic exercise CPT code is paid by most insurance companies becaue it implies the promotion to wellness instead of passive care modalities. it includes active exercises, active assisted exercises, and passive exercises

true

Dr. Robb Russel states who pays for workers compensation

employers

cost of goods sold

XS is a new medical modifier it has not been widely recognized but it will likely become adopted by most insurance carriers due to the widespread 59 modifier abuse

true

the request for authorization form in workers comp must be presented within 20 days

false

medicare category II ICD-10 codes may have ____ visits for full treatment

16-24

people claiming delayed onset of injuries such as lung disease from chemical exposure are not eligible for workers comp insurance

false

the modifier should be used to indicate that the physicians office has a signed addvanced beneficiary notice and it is retained in the patients medical record the notice is for services that may be denied by medicare

GA

a single ABN is acceptable when it identifies all items and/or services and duration of period of treatment if no treatment changes have occurred and services have not been added or deleted

true

the application of heat packs, ice packs, UV radiation are ____ category for physical medicine

supervised

which one of the following is not used upon filling out a medicare insurance form

punctuation

____ is the site/agency that will issue you NPI

centers for medicare and medicaid services (CMS)

which one of the following is not true in regards to workers comp insurance coverage

paid only after the employees health insurance has been billed first

workers comp insurance and safety act of 1917 was established for

all of the above

the pr-2 workers comp for must be filed within ____ days

45

which one of the following does not apply to a calid workers comp scenario claim

hurt at any time while wearing a company uniform

bank savings accounts allowed by the federal government for employees to take out a certain percentage from their pre-tax wages and use to pay medical deductables, co-pays, pharmacy, optical and other health related expenses are called

HSA/FSA

the proper way to display the date on an insurance form is

MM/DD/YYY or MM/DD/YY

of the 3 major skill sets in coding putting elements from your history and physical exam regarding s/s and co-morbidities is called

abstracting

medi-gap or medicare supplemental insurance is free and covers all healthcare costs that regular medicine does not cover

true

medicare defines a subluxation as ____

alal of the above

Dr. Sam Collins recomended how to evaluate insurance companies to decide to be in or out of network. which of the following are his criteria

all of the above

the earliest age to meet the requirements for medicare is ___ years

65

the ending code “S” (after the X) of an ICD_10 code specifically means

sequelae

a patient is considered an established patient if they have been seen in your office anytime with in the past ___ years

3

a workers comp claim adjuster can deny payment if the doctors notes do not justify the treatment rendered

true

the doctor must diagnose with the highest level of ___

specificity

when there is a change in the pt condition and the doctor wants to request more treatments for the work comp injury and the doctor has documentation to jsutify these extra treatments the doctor must send which form to the insurance claim adjuster

PR-2 primary treating physicians progress report

according to medicare “MLN matter” SE0749 may 7 2019 chiros may be par or non-par but they cannot opt out

true

P.A.R.T. is the system medicare requires for documentation of your diagnoses you must document a minimum of one of the 4 (pains/asymmetry, ROM, tissue tone)

false

these are the key principles of a personal injury case

liability and diagnosis

MIST

prognosis and disability

what is the usual maximum number of treatments allowed in CA for workmans comp injuries

24

the following are not covered by workmans comp

all of the above

the -59 modifier is used to identify a separate procedure that was performed tot a different area of the body on the same day as treatment to another body was rendered

true

the insurance crime bureau “NICB” collects data on all insurance claims in the US for all doctors, all patients, and all homeowners on any claim filed

false

prognosis is the cornerstone of a personal injury case

false

diagnosis is the cornerstone

the -25 modifier is used to

signify a seperate E&M service performed with another procedure

MIST auto cases are

all of the above

regarding treatment codes the level of care is determined by the diagnosis

true

rules and regulations of health care have been documented in

the code of hammurabi

which one of the following would apply in order for the notice of personal chiropractor to be recognized and executed by the employee in a current workers comp injury

filed with the employer prior to the injury