1- The NUBC is coordinated through
A ( American Hospital Association)
2- Which payer action can be appealed
A ( Claim denial)
3- Which payer action calls for corrected and resubmitted claim?
B ( Claim rejection)
4- Physician must submit electronic 837P claims for Medicare Part B unless:
B They have less than 10 full-time or equivalent employees and never send any kind of electronic health care transaction
5- How many unlabeled form locators does the UB-04 have?
D (11)
6-Which of the following is not an advantage of EDI claim transmittal?
D ( More expensive because requires higher level of personnel to process claims
7-Which of the following is not a common reason for a claim not to pass the clean claim requirements?
C ( Incorrect provider address)
8- THe data element E8888 on the UB-04 is an example of which type of format?
D ( Alphanumeric)
9- The second digit in the type of bill code represents the
A ( Type of facility)
10- The third digit in the type of bill code represent the
C ( Type of service)
11- The fourth digiti int he type of bill code represents the
B ( Bill frequency)
12- To correctly report the date of service in FL6, the MMDDYY format is required. Which of the following is an example of a correct entry?
B ( 01022006)
13- Number assigned to a patient that is used for multiple episodes of care at the facility
C (Medical record number)
14- A type of bill code has how many digits
C ( Four)
15- The number 1 as the second digit in the TOB code represents what place of service
A ( Hospital)
16- The number 1 as the third digit in the TOB code represent what type of service
D ( Inpatient (including Medicare Part A)
17- The number 3 as the third digit in the TOB code represent what type of service
B ( Outpatient)
18- Which of the following is not a basic category of patient dischare status
A ( Nonroutine discharge)
19- If a patient's date of birth is March 8, 1951, is should be entered in FL10 as
C ( 03081951)
20- In which type of admission is the patient admitted to the first available suitable accommodation
B ( Urgent)
21- which type of admission indicates the patient's condition is sever, life threatening or potentially disabling
C ( Emergency)
22- In which type of admission is the healh of the patient not in jeopardy
A ( Elective)
23- Which of the foolowing types of information is not part of the patient information section on the UB-04 claim form?
C (Patients medical record number)
24- If an admission date is June 4, 2010, is should be entered in the FL 12 as
B ( 060410)
25- In FL 8, which is the correct format for entering a patient's name that is hyphenated, such as Sanchez-Jones
C ( Sanchez-Jones)
26- In FL 8, which is the correct format for entering a patient's name that has an apostrophe, such as O'Connor?
B ( OConnor)
27- On FL 8. which is the correct format for entering a patient's name that has a prefix, such as Van Buren?
A ( VanBuren)
28- If the cold in FL14 (Type of Admission or Visit) is 4 (newborn) what Point of Origin for Admission of Visit code would be entered if the newborn was born outside of the hospital submitting the claim
C (6)
29- FL 15 (Point of Orgin for Admission or Visit) has two coding structures, each with it own set of codes. What type of admission has its own set of codes?
D (Newborn)
30-Conditon code 01 (military service related) is an example of which group of condition codes?
A (insurance)
31- Condition code 36 (General Care Patient in a Special Unit) is an example of which group of condition codes
B ( Patient Condition codes)
32- Conditin code E0 ( Change in Patien Discharge Status) is an example of which group of condition codes
D ( Claim change reason code)
33- Condition code 18 (Maiden Name Retained ) is an exapmple of which group of condition codes
B ( Patient condition codes)
34- Condition code 22 (patient on multiple drug regimen) is an example of which group of condition codes
B ( Patient condition codes)
35- Condition code D2 (Changes in Revenue Code?HCPCS/HIPPS Rate Code) is an example of which group of conditions codes
D ( Claim change reason codes)
36- Conditons code 39 (Private Room Medically Necessary) is an example of which group of condition codes
C ( Room Codes)
37- Condition code 31 ((patient is a student - full time day) is an example of which group of condition codes.
B ( Patient condition codes)
38- Whien either condition code 20 (Beneficiary requested billing) or 21 ( billing for denial notice) is reported, the services are known by the provider to be non-covered or exluded by medicare and the paatient should have been issued a(n)
B ( ABN(Advanced beneficiary Notice)
39- On a claim form, the date on which an accident occureed is reported using
C ( Occurrence code)
40- On a claim form, the period of skeilled nursing care that occurs druing aninpatient acute hospital stay is reported using
B ( Occurrence code span)
41- Occurrence code 02 (no-fault insurance involved) is an expample of which type of occurrence code
A ( An accident-related code)
42- Occurence code 40 ( scheduled date of admission) is an example of which type of Occurence code
D ( A service related code)
43- Occurence code 16 ( date of lat threapy ) is an example of which type of Occurence code
D ( A service related code)
44- A payment requested from medicare before a primary payer's payment is received, when medicare is the secondary payer and the provider believes that the primary payer will not pay within 120 days is call a
A ( Conditional payment)
45- when an Occurence code is reported on a claim, what must also be reported
C ( Date)
46- Occurence code 11 (Onset of Symptoms/Illness) is ofter used with which of the following codes
D ( Date treatment Started for Physical Therapy)
47 _ Medicare coinsurance amount in the first calendar year is billing period is a description of
B ( Value code)
48- Working Aged Beneficiary/Spouse with an EGHP is a description of a
D ( MSP value code)
49- Value code A1 (Deductible Payer A) is used to report the amount to be applied by the provider to the patient's deductible for the indicated
B ( payer)
50- Which of the following is an MSP value code
D ( 47 Any liability insurance)
51- For hospitals, the total number of covered days reported with value code 80 (Covered Days) will not exceed
A (150)
52- Value code 50 (Physical Therapy Visits) indicates
C ( The number of PT visits provided from the onset of tx through the billing period)
53- If an accident occurred at 3:45 in the morning, how would this time be entered for value code 45 (Accident hour)
C (03.00)
54 - In addition to value code 45 (Accident Hor), what other type of code must be entered to report the date of accident
B ( Occurrence code)
55- When value code 02 (Hospital Has Noemiprivate rooms) is used, what amount is entered
A (0.00)
56- The most commonly used revenue code for room charges is
C ( 012X, Room and Board-Semiprivate(two-Beds)
57- Revenue code 0292 9 Purchase of new DME) is an example of
B ( An Ancillary service code)
58- Revenue code 0352 (CT-body scan) is an example of
B ( An Ancillary service code)
59- Which of the following subcatergory describtions is not included in revenue code series 063X (Pharmacy - Extension of 025X)
A ( Drugs incident to other diagnostic services)
60- Which revenue code range represents accommodation revenue codes
C ( 01X-021X)
61- Revenue code 0171 (Nursery, Newborn - level 1) is an example of
A ( An accommodation code)
62- Revenue code 0201 (Intensive Care, Surgical) is an example of
D ( An accommodation code)
63- Medicare does not require a detailed revenue code for
A (General pharmacy charges)
64- On the UB-04 claim form, with the exception of revenue code 0001, revenue codes shold be listed in what order
B ( Ascending numeric order by date of service)
65- Revenue code series 18X (Leave of Absence) is an example of
D ( An accommodation code)
66- Which of the follwoing is a subcategory description uner revenue code 026X (IV Therapy)
A ( IV therapy/supplies)
67- Ememergency room charges (045X) can be billed on
A ( Both inpatient and outpatient claims)
68- A revenue code for physical, occupational or speech therapy is also reported with
C ( A value code and an occurrence code)
69- Which of the following is a subcatergory description under revenue code 032X (Radiology-Diagnostic)
D ( Chest X-ray)
70
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71 For claims other than Medicare, wich field contains the covered and noncovered charges for each revenue code
a FL49
b FL46
c. FL 47
d. FL 48
...
72- In FL 50 (payer name), which line is used to report the primary payer
A ( Line A)
73- The code chices to complete FL 52 (release of information certification indicator) are
C Y(yes), I informed consent
74- To indicate that the patient has refused to assign benefits, what code is reported in FL 53 (Assignment of Beneficts Certification Indicator)
B ( W not applicable)
75- Code 01 (spouse) is a choice for which of these form locators
B ( FL 59 patient relationship to insured)
76- The health insurance claim number is entered in whihc of thes form locators
C ( FL 60 insured unique identifier)
77- In FL 58, the name Geller-Brown should be entered using the following format
A (Geller-Brown)
78- WHich of the following types of provider data contained in the NPI database is not considered disclosable under the Freedom of Information Act
A ( Social Security Number)
79- Which of the following codes is used in FL 59 (Patients Relationship to Insured) to identify a child of the insured
C (19)
80- Which of the following is not an accurate description of a change from the UB-92 to the UB-04 claim form
a decreased dumber of fields for secondarty diagnoses
81- the correct format on the UB - 04 form for diagnosis code 425.4
C - 4254
82- In which of the following encounters wold it not be appropriate to use a V Code
b. patient being evaluated postoperatively
83 which type of codes are liste first highet priority amoung the other secondary diagnosis codes on a claim
b. comorbidities and complications
84- The CMS-assigned UPIN had how many alphanumeric characters?
c- six
85- Fl 78-79 Other proveders names and identifiers are used to report which of the followin
d. a physician other thena the attending and operating physician who treated the patiednt
86- Which of the following is not a qualifier code used in the Code-Code field?
a. R1 (Overflow Revenue Codes)
87- In physician billing taxonomy codes are used to indicate
a. the providers specialty
88><<>>>>>
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89 In hospital billing, taxonomy codes are used to indicate
a the type of hospitat that is submitting the claim
90- The letter U in UB-04 stands for uniform
true
false
...
90- The I in the 837I stands for inpatient
true
false
...
91- THe paper claim used by physician is the CMS-1450
true
false
...
92- When a continuing claim is submitted, the provider expects that subsequent bills will be sent
TRUE
93- A continuing claim is the first in a series of claims to be submitted
FALSE
94- TOB is the abbreviation for type of bill
TRUE
96- the priniciple dialog in
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97-only one procedure code can be reported for a billing perion
...
98- a provider number is assigned by a payer
...
99 A document control number and intranal control serve as 2 different purpose
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100- NPI is the abbreviation for nation provider identifier
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