Billing and Coding Basics Flashcards
6 cards from real CBCS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Billing and Coding Basics flashcards as text
Which code set is used to report physician and outpatient services on a CMS-1500 claim form?
Answer: CPT
CPT (Current Procedural Terminology) codes are used to report physician services, outpatient procedures, and other medical services on the CMS-1500 claim form.
What does the acronym HCPCS stand for?
Answer: Healthcare Common Procedure Coding System
HCPCS stands for Healthcare Common Procedure Coding System, which includes Level I (CPT codes) and Level II (alphanumeric codes for supplies, equipment, and services not in CPT).
What is the purpose of a National Provider Identifier (NPI)?
Answer: To uniquely identify healthcare providers in standard transactions
The NPI is a unique 10-digit identification number assigned to healthcare providers for use in standard electronic transactions under HIPAA.
Which section of ICD-10-CM is used to code a patient's chief complaint when no definitive diagnosis has been established?
Answer: Chapter 18: Symptoms, signs, and abnormal clinical findings (R codes)
Chapter 18 (R codes) covers symptoms, signs, and abnormal clinical and laboratory findings. These codes are used when a definitive diagnosis cannot be established during the encounter.
What is the main difference between a charge and a payment in the revenue cycle?
Answer: A charge is the amount billed by the provider; a payment is the amount received from the payer or patient
A charge is the amount a provider bills for a service, while a payment is the amount actually received. The difference may result in adjustments, write-offs, or patient balances.
Which form is used to submit inpatient hospital claims to Medicare?
Answer: UB-04 (CMS-1450)
The UB-04 (also known as CMS-1450) is the standard claim form used by institutional providers such as hospitals, skilled nursing facilities, and home health agencies for inpatient and outpatient billing.