Medical Billing and Coding Flashcards

Which coding system is used to report medical diagnoses on insurance claims in the United States?

Answer: ICD-10-CM

ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) is used to report diagnoses on US insurance claims.

What does CPT stand for in medical billing?

Answer: Current Procedural Terminology

CPT (Current Procedural Terminology) codes, maintained by the AMA, describe medical, surgical, and diagnostic services.

Which of the following is an example of a clean claim?

Answer: A claim submitted with all required, accurate information and no errors

A clean claim contains all required information, has no errors, and can be processed without additional information.

What is the purpose of a superbill in a medical office?

Answer: To itemize services rendered and diagnostic codes for billing purposes

A superbill lists all services, procedures, and diagnoses for a patient encounter and is used to generate the insurance claim.

Which federal program provides health insurance primarily for patients aged 65 and older?

Answer: Medicare

Medicare is a federal health insurance program primarily for individuals aged 65 and older and certain younger people with disabilities.

What does the term 'coordination of benefits' mean in medical billing?

Answer: The process of determining which insurance plan pays first when a patient has multiple coverages

Coordination of benefits (COB) determines the order in which multiple insurance plans pay to prevent duplicate payments.