AAMA Medical Coding and Billing 3

Question 1

Which HCPCS Level II code category is used for durable medical equipment (DME)?

Accepted Answer

E codes

Answer

HCPCS Level II E codes are assigned to durable medical equipment such as wheelchairs, walkers, and hospital beds.

Question 2

A claim is submitted with an incorrect patient date of birth, causing a denial. This is an example of which type of billing error?

Accepted Answer

Demographic error

Answer

A demographic error involves incorrect patient information such as name, date of birth, or insurance ID that causes a claim denial.

Question 3

What is the global surgical package in CPT coding?

Accepted Answer

A bundle of services included in a surgical fee, covering preoperative, intraoperative, and postoperative care

Answer

The global surgical package bundles all services related to a surgery—pre-op, the procedure itself, and post-op follow-up—into one reimbursement.

Question 4

Which of the following describes 'upcoding'?

Accepted Answer

Billing a higher-level service than was actually performed

Answer

Upcoding is fraud that involves reporting a higher-level or more complex service than was actually provided to receive greater reimbursement.

Question 5

In the CMS-1500 claim form, Box 21 is used to report:

Accepted Answer

Diagnosis codes

Answer

Box 21 on the CMS-1500 form is where the provider enters up to 12 ICD diagnosis codes that justify the medical necessity of the services billed.

(AAMA) American Association of Medical Assistants Certified Practice Test