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

CPT (Current Procedural Terminology) codes are used to report physician services, outpatient procedures, and other medical services on the CMS-1500 claim form.

Question 2

What does the acronym HCPCS stand for?

Accepted Answer

Healthcare Common Procedure Coding System

Answer

HCPCS stands for Healthcare Common Procedure Coding System, which includes Level I (CPT codes) and Level II (alphanumeric codes for supplies, equipment, and services not in CPT).

Question 3

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

Accepted Answer

To uniquely identify healthcare providers in standard transactions

Answer

The NPI is a unique 10-digit identification number assigned to healthcare providers for use in standard electronic transactions under HIPAA.

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 18 (R codes) covers symptoms, signs, and abnormal clinical and laboratory findings. These codes are used when a definitive diagnosis cannot be established during the encounter.

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 a provider bills for a service, while a payment is the amount actually received. The difference may result in adjustments, write-offs, or patient balances.

(CBCS) Certified Billing and Coding Specialist Practice Test

(CBCS) Certified Billing and Coding Specialist Practice Test

CBCS Billing and Coding Basics 2