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

When multiple procedures are performed at the same session, modifier -51 (Multiple Procedures) is appended to the secondary/lower-value procedure.

Question 2

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

Accepted Answer

HIPAA

Answer

HIPAA (Health Insurance Portability and Accountability Act) established national standards for electronic health care transactions and protected health information.

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

An administrative denial occurs due to procedural or policy issues such as missing authorizations, eligibility problems, or incomplete information.

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

The current version of the CMS-1500 (02/12) allows up to 12 diagnosis codes to be listed in Box 21.

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

HCPCS Level II codes (alphanumeric, starting with A–V) are used to bill Medicare and Medicaid for supplies, DME, injections, and other services not in CPT.

CMAA - Certified Medical Administrative Assistant Practice Test

CMAA - Certified Medical Administrative Assistant Practice Test

CMAA Billing, Coding, and Claims 5