CMA Medical Billing and Coding 3

Question 1

Which section of the CPT manual contains codes for Evaluation and Management (E/M) services?

Accepted Answer

99202-99499

Answer

E/M codes are found in the 99202-99499 range of the CPT manual and cover office visits, hospital care, and consultations.

Question 2

What is the significance of a 'clean claim' in medical billing?

Accepted Answer

A claim that meets all payer requirements and can be processed without additional information

Answer

A clean claim contains all required information and is error-free, allowing the payer to process and pay it without requesting additional data.

Question 3

In CPT coding, what does the symbol '►◄' (triangle pointing right and left) adjacent to a code indicate?

Accepted Answer

Text around the symbol contains new or revised guidelines

Answer

The ►◄ symbols in CPT indicate that new or revised guidelines or parenthetical notes appear in that section.

Question 4

A patient's primary insurer pays 80% of the allowed amount. The secondary insurer is responsible for which portion?

Accepted Answer

The remaining balance up to its own allowed amount, following coordination of benefits rules

Answer

Secondary insurance pays according to coordination of benefits (COB) rules, covering some or all of the remaining patient responsibility up to its own benefit limits.

Question 5

What is an Advance Beneficiary Notice (ABN)?

Accepted Answer

A notice informing Medicare patients that a service may not be covered and they may be billed

Answer

An ABN is a written notice given to Medicare beneficiaries before a service that Medicare may deny, allowing the provider to bill the patient if Medicare does not pay.

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CMA Medical Billing and Coding 3