RMA Medical Billing and Coding 3

Question 1

What does 'upcoding' refer to in medical billing?

Accepted Answer

Reporting a higher-level service than was actually performed

Answer

Upcoding is fraudulently reporting a more expensive service than the one provided.

Question 2

A patient owes a fixed dollar amount at each visit regardless of charges. This is a:

Accepted Answer

Copayment

Answer

A copayment is a set flat fee the patient pays per visit or service.

Question 3

Which document must a Medicare patient sign before receiving a service Medicare may not cover?

Accepted Answer

Advance Beneficiary Notice (ABN)

Answer

An ABN notifies the patient they may be financially responsible if Medicare denies the service.

Question 4

What is the main function of HCPCS Level II codes?

Accepted Answer

Reporting supplies, equipment, and non-physician services

Answer

HCPCS Level II codes cover items like durable medical equipment, drugs, and supplies not in CPT.

Question 5

A claim is returned because the patient's policy number was entered incorrectly. This is a:

Accepted Answer

Rejected claim

Answer

A rejected claim is returned for correction due to errors before being processed.

RMA Practice Test