CMAA Billing, Coding, and Claims 5

Question 1

A physician performs a laceration repair and also removes a skin tag during the same visit. How should the skin tag removal be billed?

Accepted Answer

Bill separately with modifier -51 appended to the secondary procedure

Answer

Bundle it into the laceration repair code

Answer

Bill separately with modifier -59 appended to the primary procedure

Answer

Do not bill for the skin tag removal

Question 2

Which federal law mandates standard electronic transaction code sets and establishes privacy protections for health information?

Accepted Answer

HIPAA

Answer

FICA

Answer

ACA

Answer

ERISA

Question 3

A claim is denied because the service requires a referral authorization that was not obtained. This is an example of which type of denial?

Accepted Answer

Administrative denial

Answer

Technical denial

Answer

Clinical denial

Answer

Coordination of benefits denial

Question 4

On the CMS-1500 form, Box 21 requires diagnosis codes. How many diagnosis codes can be listed in Box 21?

Accepted Answer

Up to 12

Answer

Up to 4

Answer

Up to 8

Answer

Up to 16

Question 5

Which code set is used to report supplies, durable medical equipment, and services not covered by CPT codes for Medicare billing?

Accepted Answer

HCPCS Level II

Answer

ICD-10-PCS

Answer

CDT codes

Answer

Revenue codes

Question 6

A patient receives services from both an in-network and an out-of-network provider during a single hospital stay. What billing term describes this situation?

Accepted Answer

Balance billing exposure

Answer

Dual coverage

Answer

Split billing

Answer

Mixed-network encounter

Question 7

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

Accepted Answer

A claim submitted without errors that can be processed without additional information

Answer

A claim with no outstanding balance

Answer

A claim that has been audited and approved

Answer

A claim where the patient's deductible has been met