Free CCMA Medical Billing and Coding Basics Questions and Answers 1

Question 1

Which coding system is used to report diagnoses and conditions on insurance claims?

Accepted Answer

ICD-10-CM

Answer

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) is the standard system used by healthcare providers to classify and code all diagnoses, symptoms, and procedures. This system is essential for billing and tracking disease prevalence.

Question 2

A fixed amount that a patient pays for a covered healthcare service at the time of the visit is called a(n):

Accepted Answer

Copayment

Answer

A copayment, or copay, is a set amount determined by the insurance plan that the patient must pay for a specific service, such as a doctor's visit or prescription. This is different from a deductible, which is the amount paid out-of-pocket before insurance begins to pay.

Question 3

Which claim form is used by physicians and other non-institutional providers to bill for their services?

Accepted Answer

CMS-1500

Answer

The CMS-1500 form is the standard paper claim form used by healthcare professionals and suppliers to bill Medicare Part B, Medicaid, and other insurance carriers for services rendered. The UB-04 form is used by facilities like hospitals.

Question 4

Which government-sponsored insurance program primarily covers individuals aged 65 and older?

Accepted Answer

Medicare

Answer

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources.

Question 5

In medical billing, what does the acronym 'EOB' stand for?

Accepted Answer

Explanation of Benefits

Answer

An Explanation of Benefits (EOB) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. It is not a bill, but rather a summary of the claim and payment details.

CCMA - Certified Clinical Medical Assistant Practice Test

CCMA - Certified Clinical Medical Assistant Practice Test

Free CCMA Medical Billing and Coding Basics Questions and Answers 1