Medical Billing and Coding Certificate Practice Exam

These questions are part of the practice quiz. Start practicing

• What does the term "beneficiary" specifically refer to in healthcare?
• For how long can COBRA allow individuals to purchase group insurance after leaving employment?
• What does the suffix "-ectomy" signify in medical terms?
• What does the term "distal" refer to in anatomical terminology?
• What is indicated by Exclusion Notes in coding?
• What does the prefix "hyper-" indicate?
• What anatomical position is described by the term anterior?
• When should the term NOS be used in coding?
• What is the goal of unbundling codes in medical billing?
• What does a sub-category code represent?
• Which anatomical term describes a position farther from the trunk?
• What is one condition of receiving weekly benefits during temporary disability?
• What is the primary purpose of performing audits in medical billing?
• What does past medical history encompass?
• What is the purpose of a remittance advice?
• What does NEC stand for in medical coding?
• What does the prefix "endo-" refer to?
• What does the suffix -ectomy signify?
• What does "superior" mean in terms of anatomical position?
• What distinguishes an established patient?
• What is upcoding in the context of medical billing?
• When is implied consent typically applied?
• In coding, what is considered a combination code?
• Which of the following best describes billing without signatures?
• Which provision ensures that patients can switch insurance without losing coverage?
• What is defined as expressed consent?
• What does the term "eponym" refer to in medical terminology?
• What is typically recorded on a day sheet?
• What does a co-payment refer to in the medical billing process?
• What can be inferred about understanding patient history during a consultation?
• What is a day sheet used for in medical billing?
• Medicare Advantage Plans are primarily operated by:
• What is the main purpose of Title IV of HIPAA?
• The allowed amount is defined as?
• What does detailed medical history level require from the physician?
• What is the combining form for stomach?
• What is the purpose of using Inclusion Notes in a coding category?
• What is CHAMPVA designed to provide?
• How do audits contribute to the overall effectiveness of medical billing?
• What is the meaning of the combining form cardi/o?
• What is the combining form for head in medical terminology?
• What is a schedule of benefits?
• What does the suffix -graphy refer to in medical terminology?
• What is Medicare Part B primarily known as?
• What structure is described as 'higher on the body, nearer to the head'?
• What percentage of costs does Medicare typically cover for services?
• What is a common use for the employer identification number (EIN) in medical billing?
• What is a Health Maintenance Organization (HMO)?
• What are all healthcare providers and health plans required to comply with under HIPAA?
• What does the prefix 'gravida' signify in medical terminology?
• What does the legal doctrine "Respondeat Superior" imply?
• What does Medicare Part A cover?
• Which title of HIPAA involves application and enforcement of group health plan requirements?
• What is the purpose of brackets in medical billing and coding?
• What is one of the main benefits of preauthorization?
• What is the primary purpose of an assignment of benefits in medical billing?
• Medicaid primarily provides medical benefits for which group of individuals?
• Which of the following influences how difficult it is for a provider to perform a procedure?
• What does a triangle symbol indicate in coding?
• What is the purpose of Category 2 codes?
• What term describes coding without proper documentation in the medical billing process?
• What does a sliding fee scale in healthcare mean?
• In medical terminology, '-osis' typically indicates what kind of condition?
• Which of the following services is NOT covered by Medicare Part A?
• What is the definition of dependents in an insurance plan?
• What do parentheses represent in the context of coding?
• What is the combining form for heart in medical terminology?
• What is TRICARE?
• Past, family, and social history is part of which component in a medical history?
• What distinguishes CHAMPVA from TRICARE?
• The prefix "hypo-" signifies what condition?
• Medicare Part C is also referred to as what kind of plan?
• Which term describes a position toward the tail end of the body?
• What does the suffix -dynia mean?
• What does the suffix -scopy signify?
• What does the combining form sarc/o refer to?
• What information does the history of present illness include?
• What is NOT considered an advantage of electronic health records?
• Which term indicates a position towards the midline of the body?
• When is a retrospective audit performed?
• What is the significance of remittance advice in the medical billing cycle?
• What does HIPAA stand for?
• What does the suffix -stomy mean?
• Which combining form is associated with fetus?
• What is the primary function of a Healthcare Reimbursement Account (HRA)?
• Which of the following combining forms relates to the structure of cells?
• What would be the appropriate code classification for a condition that is not specified in the medical record?
• Which of the following is NOT a direct HIPAA National Identifier?
• Which prefix is commonly used to denote 'joint' in medical terminology?
• Which of the following is a reason for downcoding a medical service?
• What does preauthorization involve in medical billing?
• Which HIPAA title serves as a framework for preventing fraud in healthcare?
• What is a key requirement for a formal referral?
• What defines a 'Straightforward' level of medical decision making?
• What does a consumer-driven health plan (CDHP) typically include?
• What does "excludes 2" suggest in classification terms?
• What does Workers Compensation provide to employees?
• What is the combining form for cell?
• What character count does a category code typically consist of?
• What does 'sequelae' refer to in medical coding?
• Which provision of HIPAA is concerned with preventing health care fraud and abuse?
• What are relative value studies (RVS) used for?
• When a case is rated for permanent disability, what is assessed?
• What type of document provides detailed information about charges and services during a patient visit?
• Which of the following methods is NOT typically used to determine rates to be paid to providers?
• What position does "supine" describe?
• When considering anatomical positions, what is meant by "medial"?
• What does current medications information typically include?
• What date are CPT codes updated annually?
• What is a unique feature of Category 3 codes compared to Categories 1 and 2?
• Which term refers to the cerebrum in medical terminology?
• Which of the following terms would accurately describe a person lying flat on their back?
• In context, what does "non-covered services" refer to?
• What is indicated by a lightning bolt symbol in medical coding terms?
• What does the term posterior refer to?
• Which level of history examination includes "expanded problem focused"?
• Which combining form indicates the brain?
• What does Title V of HIPAA pertain to?
• What is the primary meaning of the combining form dermat/o?
• When a patient is covered under two group plans, which plan is considered primary?
• What type of codes are traditionally associated with CPT?
• What characterizes a fee schedule in medical billing?
• What is the medical term combining form for skin?
• What distinguishes a PPO from an HMO?
• What is the definition of self-referral?
• What does COBRA stand for?
• What does the combining form 'derm/o' refer to?
• What is the suffix -algia associated with?
• What does the prefix "brady-" signify in medical terminology?
• Which combining form denotes something that is cancerous?
• What do facing triangles signify in CPT coding?
• What does "excludes 1" imply in medical coding?
• The prefix "hypo-" indicates less than what condition?
• What characterizes a verbal referral?
• What are external audits in medical billing?
• In anatomical terminology, what does "lateral" refer to?
• Which of the following is NOT a characteristic of 'High' complexity in medical decision making?
• Which title of HIPAA addresses tax-related health provisions?
• Which of the following is NOT covered by Medicare Part B?
• Temporary disability is defined as:
• Which level of history is characterized by multiple diagnoses and moderate risk to the patient?
• Which combining form refers to the uterus?
• What does a deductible signify in the context of Medicare?
• In coding, what does a plus sign symbol represent?
• What does the prefix "sub-" mean?
• In healthcare billing terms, what does PM PM stand for?
• Who is primarily eligible for COBRA coverage?
• What type of consent must be obtained when a patient is capable of making informed decisions?
• What is considered one of the most common billing errors?
• Which term describes a group of related codes in medical billing?
• Which of the following covers prescription drugs for Medicare beneficiaries?
• Which combining form is used to refer to teeth?
• What does the prefix 'ante-' mean in medical terms?
• What does the suffix -osis indicate?
• Which term indicates the combining form for teeth?
• What does self-insurance in a workplace entail?
• What does the suffix -tripsy indicate?
• What does Title III of HIPAA address?
• What characterizes a Preferred Provider Organization (PPO)?
• What does the term 'usual fee' refer to in medical billing?
• What defines a 'New Patient' in a healthcare practice?
• What is the primary focus of Title I of HIPAA?
• What is an EIN in relation to medical billing?
• Which title in HIPAA focuses on revenue offsets?
• What does the combining form ur/o pertain to?
• Which of the following best describes the relationship between providers and Medicare beneficiaries?
• What does the prefix "epi-" mean in a medical context?
• In medical billing, what does the term 'reimbursement' mean?
• What reinforces the need for cost reduction as an advantage of electronic health records?
• What does moderate sedation refer to in medical procedures?
• What is one of the main considerations when determining a reasonable fee?
• The term '-itis' is primarily associated with which type of medical condition?
• What is the primary function of clearing houses in medical billing?
• Which term describes the amount that must be paid by the patient before insurance benefits are valid?
• What is the basis for establishing charge-based fees?
• What does precertification require from a provider?
• What characterizes the 'Low' level of medical decision making complexity?
• In medical terminology, what does the suffix -itis refer to?
• What defines a 'High' level of medical decision making complexity?
• Which of the following terms is used to describe a disease condition?
• Which of the following is an example of an error in the coding process?
• What does the suffix '-sis' signify in the context of medical terminology?
• Which of the following is a correct definition of 'resource' in relation to procedure costs?
• Which term describes a request made by patients themselves to see a specialist?
• What type of patients benefit from a sliding fee scale?
• Co-insurance refers to:
• What is the encounter form also known as in medical billing?
• What does the suffix '-emia' refer to?
• In the context of medical billing, what does a reasonable fee imply?
• Which of the following best defines Category 3 codes?
• What is a formal referral?
• Which of the following best describes a Flexible Savings Account (FSA)?
• What does 'truncated coding' refer to in medical billing?
• In a scenario where the patient's plan is primary because they are a dependent, what often dictates this status?
• What is the term for finding out the maximum dollar amount an insurance will pay for a procedure?
• What is the meaning of the suffix "-ectomy" in medical terms?
• What would be an example of a customary fee?
• What does downcoding indicate when reviewing medical billing documents?
• When does the annual update of CPT codes occur?
• What is the first step to establish financial responsibility in a medical practice?
• What does the suffix -al indicate?
• What does the phrase "Code also" indicate in medical coding?
• In medical billing, what primary role do fees serve?
• What does the term 'beneficiary pays' include in regards to Medicare?
• How is a customary fee defined?
• What medical term describes a condition caused by inflammation?
• What do Inclusion Notes do in medical coding?
• What does the prefix "anti-" indicate?
• What identifies Category 1 codes in medical billing?
• What does the suffix '-osis' represent in medical terminology?
• What does the prefix 'bi/o' refer to in medical terminology?
• What is capitation in the context of physician contracts?
• What does the prefix "peri-" denote in medical terminology?
• Who are the beneficiaries in a health insurance context?
• What does the combining form 'carcin/o' specialize in?
• What does eligibility refer to in the context of medical insurance?
• In a verbal referral, what is typically communicated?
• What does the HIPAA Security Rule establish?
• What does an internal audit in medical billing involve?
• What is a premium in the context of insurance?
• What do adjustments in medical billing refer to?
• A nonparticipating physician typically does what?
• What is a Health Savings Account (HSA)?
• If a patient has coverage under a group plan and an individual plan, which is usually considered primary?
• Who are considered 'providers' in the context of Medicare?
• Which prefix indicates a condition of being around or surrounding?
• Which prefix indicates a condition of being below normal?
• What is included in the Chief Complaint element of a medical history?
• What is the combining form for the nose?
• What does the suffix '-genic' indicate?
• Which of the following statements about employer-sponsored health plans is true?
• What symbol is used in coding to indicate the introduction of a new code?
• Permanent disability refers to what situation?
• What is indicated by the suffix -metry?
• Which suffix refers to an incision in medical terminology?
• Which term best describes having understanding and compassion for a patient’s condition?
• What is the combining form for clotting?
• Which combining form signifies electrical activity?
• What is a point of service plan?
• Which term corresponds to a 'mass or growth' in medical terminology?
• What character range does a sub-category code typically consist of?
• What does the combining form oste/o refer to?
• Which of the following is NOT typically included in the past medical history?
• What is typically the funding source for a Health Savings Account (HSA)?
• What type of insurance do employers provide for workplace injuries?
• What is a fee schedule in the context of medical billing?
• The suffix '-pathy' refers to which of the following?
• What does the prefix "dia-" mean?
• Which term describes the fraudulent action of reporting services not documented?
• Implied consent is best described as which of the following?
• When are colons used in a tabular list?
• Which of the following roles is directly responsible for executing HIPAA regulations in healthcare settings?
• What does the term deep imply in anatomical terms?
• What classification do insurance companies fall under when they manage Medicare claims?
• What condition does the suffix '-itis' denote?
• What is the foundational concept behind preferred provider organizations (PPOs)?
• Which of the following is NOT a type of referral?
• How is a direct referral typically conducted?
• What role does a fiscal intermediary play in the Medicare program?
• What aspect is covered under Title I of HIPAA?
• What is the primary focus of the Medicare program?
• The term '-globin' refers to what type of biological entity?
• Title II of HIPAA is primarily designed to target what issue?
• Who is considered a policyholder?
• What does a participating physician agree to regarding payment?
• What is the combining form for intestines?
• What is the meaning of the prefix "hyper-"?
• What does the term proximal refer to in anatomy?
• When verifying a patient's financial responsibility, which of the following is least likely to be assessed?
• Under HIPAA privacy rule, when is specific authorization required for the release of a patient's private health information?
• What does unbundling codes refer to in medical billing?
• The suffix '-oma' is commonly used to indicate what?
• What constitutes a 'Patient Encounter'?