MEDICAL CODING AND B ILLING

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MEDICAL CODING AND B ILLING

CERTIFICATION (MCBC) STUDY

GUIDE I VERIFIED TO PASS

Question: What must a coder understand in order to

determine the correct diagnosis code assignment?

Correct answer: The services medically necessary for

diagnostic code linkage

Question: Avoiding the duplication of benefits paid by the

primary and secondary insurance is achieved by:

Correct answer: Correctly identifying primary and

secondary insurance policies in order to preserve coordination of benefits

Question: If a combination code is available, a coder

should:

Correct answer: Use the combination code

Question: When a code is "revised" in the CPT manual, it

will be indicated by:

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Correct answer: Blue triangle

Question: A coder should use an "unlisted" radiology

CPT code when:

Correct answer: Particular radiology service provided is

not described by a specific CPT code

Question: Major topic headings in the Tabular List of

ICD-10-CM are known as:

Correct answer: Code blocks

Question: Most state Medicaid programs use what type of

system to report professional services, procedures, supplies, and equipment?

Correct answer: Healthcare Common Procedure Coding

System

Question: The first character of ICD-10-CM:

Correct answer: Always a letter

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Question: Coding to the highest level of specificity

means:

Correct answer: Using a fourth, fifth, sixth or seventh

digit when required

Question: According to the ICD-10-CM conventions, if

the documentation is unclear or does not state that the complication or comorbidity listed in the code description

is present with the condition, the default is:

Correct answer: Without

Question: Reported in addition to the appropriate casting

code when a cast or splint is intended to be the definitive treatment of a fracture

Correct answer: E/M service codes

Question: Care encounter after the initial care event

Correct answer: Subsequent Encounter

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Question: What information is needed to fill out a CMS-

1500 claim form?

Correct answer: Diagnostic codes from encounter form

Question: Upcoding is:

Correct answer: Billing more than the proper fee for a

service

Question: Why is a superbill/encounter form an important

document in the office?

Correct answer: It ensures the correct patient data

information and procedure codes

Question: Electronic Health Record (EHR) should include

eight core functions

Correct answer: 1. Health information and data elements,

• Results management, 3. Order management, 4.

Decision support, 5. Electronic communications and connectivity, 6. Patient support, 7. Administrative processes, 8. Reporting and population management