CCT Billing and Coding Compliance

Question 1

What is 'upcoding' in medical billing?

Accepted Answer

Billing for a more complex or expensive service than was actually provided

Answer

Billing for a less complex service than was actually provided

Answer

Submitting duplicate claims for the same service

Answer

Failing to submit a claim within the timely filing deadline

Question 2

What does the acronym 'CPT' stand for in medical coding?

Accepted Answer

Current Procedural Terminology

Answer

Certified Procedure Terminology

Answer

Clinical Practice Terminology

Answer

Comprehensive Patient Treatment

Question 3

What is 'unbundling' in medical billing?

Accepted Answer

Billing each component of a procedure separately when a single comprehensive code exists

Answer

Combining multiple services into a single procedure code

Answer

Submitting a claim without the required supporting documentation

Answer

Using modifiers to bypass payer payment restrictions

Question 4

Which federal agency administers the Medicare and Medicaid programs?

Accepted Answer

Centers for Medicare & Medicaid Services (CMS)

Answer

Office of Inspector General (OIG)

Answer

Department of Justice (DOJ)

Answer

Health Resources and Services Administration (HRSA)

Question 5

What is the primary purpose of the National Correct Coding Initiative (NCCI)?

Accepted Answer

To prevent improper code combinations that result in inappropriate Medicare payment

Answer

To assign unique identifiers to healthcare providers

Answer

To establish documentation quality standards for medical records

Answer

To track healthcare outcomes across Medicare populations

Question 6

What does Modifier 25 indicate when appended to an Evaluation and Management (E/M) code?

Accepted Answer

A significant, separately identifiable E/M service was provided on the same day as a procedure

Answer

The service was performed by a physician assistant under supervision

Answer

The procedure was discontinued before completion

Answer

The claim is being resubmitted after a previous denial

Question 7

What is the primary purpose of ICD-10-CM codes in medical billing?

Accepted Answer

To identify the diagnoses, symptoms, and conditions that justify services provided

Answer

To describe the procedures and services performed during patient care

Answer

To classify the complexity level of an office visit

Answer

To specify the type of anesthesia administered during surgery