CBCS Billing and Coding Basics 2

Question 1

Which code set is used to report physician and outpatient services on a CMS-1500 claim form?

Accepted Answer

CPT

Answer

ICD-10-CM

Answer

UB-04

Answer

HCPCS Level III

Question 2

What does the acronym HCPCS stand for?

Accepted Answer

Healthcare Common Procedure Coding System

Answer

Health Care Procedural Coding System

Answer

Health Claims Processing and Coding Standards

Answer

Hospital Coding and Payment Classification System

Question 3

What is the purpose of a National Provider Identifier (NPI)?

Accepted Answer

To uniquely identify healthcare providers in standard transactions

Answer

To identify a patient's insurance plan

Answer

To classify diagnoses for billing purposes

Answer

To authorize prior approval for services

Question 4

Which section of ICD-10-CM is used to code a patient's chief complaint when no definitive diagnosis has been established?

Accepted Answer

Chapter 18: Symptoms, signs, and abnormal clinical findings (R codes)

Answer

Chapter 1: Certain infectious and parasitic diseases

Answer

Chapter 21: Factors influencing health status (Z codes)

Answer

Chapter 19: Injury, poisoning, and external causes

Question 5

What is the main difference between a charge and a payment in the revenue cycle?

Accepted Answer

A charge is the amount billed by the provider; a payment is the amount received from the payer or patient

Answer

A charge is the amount collected; a payment is the amount billed

Answer

A charge is the Medicare fee schedule amount; a payment is the negotiated rate

Answer

A charge is the copay; a payment is the deductible

Question 6

Which form is used to submit inpatient hospital claims to Medicare?

Accepted Answer

UB-04 (CMS-1450)

Answer

CMS-1500

Answer

ADA Dental Claim Form

Answer

HCFA-1450