CCMA Medical Billing and Coding Basics 2

Question 1

What is the purpose of a CMS-1500 form?

Accepted Answer

To submit medical claims to insurance companies for reimbursement

Answer

The CMS-1500 is the universal paper claim form used by physicians and other non-institutional providers to submit claims to Medicare, Medicaid, and most commercial insurers.

Question 2

Which ICD-10-CM coding rule requires the most specific diagnosis code available to be used?

Accepted Answer

Code to the highest level of specificity

Answer

ICD-10-CM guidelines require coding to the highest level of specificity — using the most detailed code that accurately describes the diagnosis.

Question 3

What does the term 'clean claim' mean in medical billing?

Accepted Answer

A claim submitted without errors that can be processed immediately for payment

Answer

A clean claim is one that contains all required information with no errors or missing data, allowing the payer to process it immediately without requesting additional information.

Question 4

A modifier in medical coding is used to:

Accepted Answer

Provide additional information about a procedure without changing its definition

Answer

A modifier is a two-digit code appended to a CPT code that provides additional information about the circumstances of the procedure without changing the procedure's definition.

Question 5

When a provider accepts Medicare assignment, they agree to:

Accepted Answer

Accept Medicare's approved fee as full payment for covered services

Answer

Accepting Medicare assignment means the provider accepts Medicare's approved fee as full payment, collecting only the 20% coinsurance from the patient.

CCMA - Certified Clinical Medical Assistant Practice Test

CCMA - Certified Clinical Medical Assistant Practice Test

CCMA Medical Billing and Coding Basics 2