CBCS Billing and Coding Basics 3

Question 1

What does the term 'accounts receivable (AR)' represent in medical billing?

Accepted Answer

Money owed to the practice for services rendered but not yet paid

Answer

Accounts receivable (AR) represents the total amount owed to a healthcare provider for services already rendered but not yet paid by payers or patients.

Question 2

In ICD-10-CM, what does the 7th character extension 'A' typically indicate?

Accepted Answer

Initial encounter

Answer

In ICD-10-CM, the 7th character 'A' designates an initial encounter — the active phase of treatment when the patient is receiving definitive care for the condition.

Question 3

What is a coordination of benefits (COB) situation?

Accepted Answer

When a patient has more than one insurance plan and the order of payment must be determined

Answer

Coordination of benefits occurs when a patient has coverage under two or more insurance plans. Rules determine which plan is primary (pays first) and which is secondary (pays remaining balance).

Question 4

Which type of code is used to report the reason a patient sought medical care?

Accepted Answer

ICD-10-CM diagnosis code

Answer

ICD-10-CM diagnosis codes describe the patient's condition, disease, injury, or reason for the encounter. They justify the medical necessity of the services billed.

Question 5

What is the purpose of a remittance advice (RA)?

Accepted Answer

To inform the provider of claim adjudication results including payments, adjustments, and denials

Answer

A remittance advice (RA), also called an Explanation of Benefits (EOB) when sent to patients, details how a payer processed a claim, including amounts paid, contractual adjustments, and denial reasons.

(CBCS) Certified Billing and Coding Specialist Practice Test

(CBCS) Certified Billing and Coding Specialist Practice Test

CBCS Billing and Coding Basics 3