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Medical Coding and Billing Quiz

#1

Which code set is primarily used for medical procedures and services?

CPT
Explanation

CPT is the Current Procedural Terminology, a coding system for medical procedures and services.

#2

What does 'ICD' stand for in medical coding?

International Classification of Diseases
Explanation

ICD stands for International Classification of Diseases, used for medical diagnosis coding.

#3

What does 'HIPAA' stand for in the context of medical billing?

Health Insurance Portability and Accountability Act
Explanation

HIPAA is the Health Insurance Portability and Accountability Act, ensuring privacy and security of health information.

#4

Which code set is used to report medical diagnoses and inpatient procedures?

ICD-10-CM
Explanation

ICD-10-CM is used for reporting medical diagnoses and inpatient procedures.

#5

What is the primary purpose of medical coding?

To facilitate insurance reimbursement
Explanation

The primary purpose of medical coding is to facilitate insurance reimbursement for healthcare services.

#6

What does 'E/M' stand for in medical coding?

Evaluation and Management
Explanation

E/M stands for Evaluation and Management, a coding category for patient encounters.

#7

Which of the following is NOT a type of medical billing?

ADA
Explanation

ADA is not a medical billing type; it stands for the Americans with Disabilities Act.

#8

Which organization is responsible for maintaining the ICD code set?

World Health Organization (WHO)
Explanation

WHO, the World Health Organization, maintains the ICD code set for global use.

#9

What is the purpose of the DRG system in medical coding?

To classify inpatient hospital cases into groups for billing purposes
Explanation

DRG system classifies inpatient hospital cases into groups for efficient billing.

#10

Which organization publishes the CPT code set?

American Medical Association (AMA)
Explanation

The CPT code set is published by the American Medical Association (AMA).

#11

What is the purpose of CPT modifiers in medical coding?

To indicate that a service or procedure has been altered by specific circumstances
Explanation

CPT modifiers indicate alterations to services or procedures due to specific circumstances.

#12

What is the purpose of a remittance advice (RA) in medical billing?

To inform providers of rejected or denied claims
Explanation

RA informs providers of rejected or denied claims in medical billing.

#13

Which of the following is an example of a 'place of service' code in medical billing?

POS 11
Explanation

POS 11 is an example of a 'place of service' code indicating where the medical service was provided.

#14

What does 'NCCI' stand for in the context of medical coding?

National Correct Coding Initiative
Explanation

NCCI stands for National Correct Coding Initiative, aimed at promoting correct coding practices.

#15

What does 'HCC' stand for in the context of medical coding?

Hierarchical Condition Categories
Explanation

HCC stands for Hierarchical Condition Categories, a system used to predict healthcare costs based on patient conditions.

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