#1
What is medical billing?
A process of submitting claims to insurance companies for healthcare services provided
ExplanationSubmitting claims to insurers for healthcare services.
#2
What is the purpose of the ICD-10-CM code set in medical billing?
To identify diagnosis codes for medical conditions and diseases
ExplanationIdentifying diagnosis codes for conditions and diseases.
#3
What is the purpose of the Medicare Claims Processing Manual in medical billing?
To provide guidelines for processing claims submitted to Medicare
ExplanationGuidelines for processing Medicare claims.
#4
What does 'EOB' stand for in medical billing?
Explanation of Benefits
ExplanationExplanation of Benefits (EOB).
#5
What does 'RA' stand for in medical billing?
Remittance Advice
ExplanationRA stands for Remittance Advice.
#6
Which organization oversees the administration of the CPT code set?
American Medical Association (AMA)
ExplanationAMA administers the CPT code set.
#7
What does the HCPCS Level II code set primarily identify?
Medical equipment, supplies, and drugs not included in the CPT code set
ExplanationIdentifying medical equipment, supplies, and drugs.
#8
What is the role of a medical coder in the billing process?
To translate medical procedures and diagnoses into universal codes
ExplanationTranslating procedures and diagnoses into codes.
#9
What is a 'clean claim' in medical billing?
A claim submitted without errors or omissions that can be processed promptly
ExplanationAn error-free claim processed promptly.
#10
What is a 'remittance advice' in medical billing?
A document sent to a healthcare provider detailing payment information for a claim
ExplanationDocument detailing payment information for claims.
#11
What is the purpose of the modifier codes in medical billing?
To provide additional information or circumstances that may affect the claim
ExplanationOffering extra details affecting the claim.
#12
What is the purpose of the NCCI (National Correct Coding Initiative) in medical billing?
To prevent improper payments for Medicare and Medicaid claims
ExplanationPreventing improper payments for Medicare and Medicaid.
#13
What is the difference between ICD-10-CM and ICD-10-PCS code sets?
ICD-10-CM is used for diagnoses, while ICD-10-PCS is used for procedures
ExplanationICD-10-CM for diagnoses; ICD-10-PCS for procedures.
#14
What does 'RBRVS' stand for in medical billing?
Resource-Based Relative Value Scale
ExplanationRBRVS stands for Resource-Based Relative Value Scale.