Certified Medical Assistant Medical Billing and Coding Questions and Answers

Question 1

A patient is seen for an office visit where the provider diagnoses them with acute bronchitis (J20.9) and performs a chest X-ray (71045).
On the CMS-1500 claim form, what is the purpose of these different types of codes?

Accepted Answer

The ICD-10-CM code indicates the diagnosis, while the CPT code indicates the service performed.

Answer

The CPT code indicates the diagnosis, while the ICD-10-CM code indicates the service performed.

Answer

Both codes are used to describe the services and procedures performed by the provider.

Answer

Both codes are used to identify the patient's diagnosis for tracking purposes.

Question 2

A medical assistant is preparing a claim for an outpatient procedure. Which standardized form should be used to submit the charges to the insurance company?

Accepted Answer

CMS-1500

Answer

UB-04

Answer

ABN (Advanced Beneficiary Notice)

Answer

EOB (Explanation of Benefits)

Question 3

A patient receives services that total $1,200. Their insurance plan has a $1,000 deductible, which has not been met, and a 10% coinsurance. What is the patient's total financial responsibility for this visit?

Accepted Answer

$1,020

Answer

$120

Answer

$1,120

Answer

$1,000

Question 4

Which of the following scenarios is a clear example of upcoding?

Accepted Answer

Billing for a comprehensive office visit (99205) when only a brief, problem-focused exam (99202) was conducted.

Answer

Billing for a service that was not performed.

Answer

Using a modifier to indicate a procedure was performed on the left side of the body.

Answer

Billing separately for services that are typically bundled into a single code.

Question 5

A medical assistant needs to obtain approval from a patient's insurance company before a scheduled non-emergency surgery can proceed. What is this process called?

Accepted Answer

Preauthorization

Answer

Adjudication

Answer

Appealing

Answer

Claim scrubbing

Question 6

When coding for a procedure, the medical assistant adds a two-character code, such as '-50' for a bilateral procedure, to the end of a CPT code. What is this two-character code called?

Accepted Answer

A modifier

Answer

A diagnosis code

Answer

A V-code

Answer

An add-on code

A patient is seen for an office visit where the provider diagnoses them with acute bronchitis (J20.9) and performs a chest X-ray (71045).On the CMS-1500 claim form, what is the purpose of these different types of codes?

A patient is seen for an office visit where the provider diagnoses them with acute bronchitis (J20.9) and performs a chest X-ray (71045).
On the CMS-1500 claim form, what is the purpose of these different types of codes?