Certification study guide for NHA CBCS Exam QUESTIONS AND ANSWERS

Document Content and Description Below

Certification study guide for NHA CBCS Exam QUESTIONS AND ANSWERS Medical Ethics Correct Answer: Standards of conduct based on moral principals. Acting within ethical behavior boundries means carr... ying out one's responsibilities with integrity, decency, respect, honesty, competence, fairness and trust. Compliance Regulations Correct Answer: Most billing related cases are based on HIPAA and the False Claims Act. HIPAA is an acronym for Correct Answer: Health Insurance Portability and Accountability Act of 1996. Category 1 CPT codes Correct Answer: Medical Procedures. Category 2 CPT codes Correct Answer: Supplemental Codes for Performance Measures. Category 3 CPT codes Correct Answer: Emerging Technologies. Add on Codes Correct Answer: Used for procedures that are always performed during the same operative session, as another surgery in addition to the primary service/procedure and is never performed separately. Anesthesia is found Correct Answer: 00100-01999, 99100-99140. Evaluation and Management (E&M) codes Correct Answer: Are listed first in the CPT manual because they are used by all the different specialties. Brackets Correct Answer: Used to enclose synonyms, alternative wording or and explanatory phrase. Bullets Correct Answer: Represents a new procedure or service code added since the previous edition of the manual. Chief Complaint (CC) Correct Answer: The reason the patient came to see the physician. Circle with a line through it (?) Correct Answer: Exemption from modifier 51. CPT Correct Answer: Used to report services and procedures by physicians. E&M codes Correct Answer: 99201-99499 Guidelines are found Correct Answer: At the beginning of each section and used to provide specific coding rules for that section. History (HX) Correct Answer: The set of information the physician gathers from the patient concerning his/her past. History of Present Illness (HPI) Correct Answer: A chronological account of the development of the complaint from the first sign or symptom that the patient experienced to the present. Indented Codes Correct Answer: Listed under associate and stand alone codes. E Codes Correct Answer: For durable medical equipment for use in home. Level 1 codes Correct Answer: Codes found in the CPT manual. Level 2 codes Correct Answer: National codes for the physician and non-physician service not found in the CPT Level 1. Level 3 codes Correct Answer: Used locally or regionally and have been eliminated by the CMS since the implementation of HIPAA. The List of Modifiers is found where in the CPT Correct Answer: Appendix A and in the front of the book. Modifier 50 Correct Answer: Bilateral procedure. Modifier 24 Correct Answer: Attach to E/M service code when service is provided during postoperative period to indicate that the service is not part of postoperative care and not included in the Surgical Package. Modifier 26 Correct Answer: Provider only provided the professional component. Modifier 51 Correct Answer: Used more than one procedure during the same surgical episode. Modifier 57 Correct Answer: Modifier 57 is used on E/M services the day before or day of major surgery when the initial decision to perform the surgery is identified. Modifier 78 Correct Answer: Physician must return to Operating Room to address complication stemming from initial procedure. Modifier 79 Correct Answer: Procedure or service provided during postoperative period not associated with initial procedure. Modifiers Correct Answer: Reporting indicators that indicate that the procedure or service has been altered by specific circumstance but has not changed in it's definition of code. Parentheses Correct Answer: Used to enclose supplementary words, non-essential modifiers. Past, Family and Social History (PFSH) Correct Answer: Consists of patients personal experiences with illnesses, surgeries, and injuries; Information of illnesses predominant in family' Patients educational background, occupation, marital status and other factors. Pathology and Laboratory Correct Answer: 80048-89356. Plus sign indicates (➕) Correct Answer: Add on codes. Radiology Correct Answer: 77010-79999. Review of Symptoms (ROS) Correct Answer: Inventory of the constitutional symptoms regarding the various body systems. Stand Alone Codes Correct Answer: Contain full description to the procedure for a code. Sideways triangle means ( ▶️ ) Correct Answer: Change in wording between triangles. Bullet means Correct Answer: New procedure codes. Circle with a line through it means Correct Answer: Modifier 51 exempt code. Six sections of CPT Correct Answer: E&M, Anatomical Site, Condition or Disease, Synonym or Eponym, Abbreviation. Three Components for E&M Codes Correct Answer: 1.History, 2.Physical Exam, and 3.Medical Decision-Making. Three Categories for E&M Codes Correct Answer: Category I: Procedures that are consistent with contemporary medical practice and are widely performed. Category II: Supplementary tracking used for performance measures. Category III: Temporary codes for emerging technology, services and procedures. 4 contributing factors for E&M Codes Correct Answer: New or existing patient, History, Physical Exam, Medical Decision making, Time spent can be a 5th factor. Medicare Part A Correct Answer: Part A is hospital insurance provided by Medicare. Most people do not pay a premium for this coverage. Medicare Part B Correct Answer: Part B is medical insurance to pay for medically necessary services and supplies provided by Medicare. (Doctors, Outpatient care, Physical and Occupational Therapist, etc.) Medicare Part C Correct Answer: Part C is the combination of Part A and B. The main difference in Part [Show More]

Last updated: 1 year ago

Preview 1 out of 10 pages