Medical Billing & Coding Flashcards
7 cards from real CMAS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medical Billing & Coding flashcards as text
Which modifier is appended to a CPT code to indicate that a procedure was performed on the left side of the body?
Answer: Modifier -LT
Modifier -LT (Left Side) is used to identify procedures performed on the left side of the body.
A patient has Medicare as primary insurance and Medicaid as secondary. What billing process applies?
Answer: Bill Medicare first, then Medicaid for the remaining balance
Medicare is always billed first as the primary payer, and Medicaid pays last as the payer of last resort.
What does the ICD-10-CM code Z23 represent?
Answer: Encounter for immunization
Z23 is the ICD-10-CM code for Encounter for immunization, used when a patient receives a vaccine.
Which claim form is used to bill Medicare for professional services rendered by a physician?
Answer: CMS-1500
The CMS-1500 form is the standard claim form used by physicians and other non-institutional providers to bill Medicare.
What is the purpose of a remittance advice (RA)?
Answer: To explain how the insurance company processed and paid a claim
A remittance advice is sent by the payer to the provider to explain how each claim was adjudicated and what was paid.
When a procedure is bundled into another under the NCCI edits, what does this mean for billing?
Answer: The component code cannot be billed separately with the comprehensive code
NCCI (National Correct Coding Initiative) edits bundle component procedures into a comprehensive code to prevent unbundling and duplicate payment.
A claim is returned to the provider because a required field is missing. This is known as a:
Answer: Rejected claim
A rejected claim is returned before adjudication because it contains missing or invalid data that prevents processing.