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LMD LMD
wrote...
6 years ago
Which of the following is an example of fraud?
 a. billing noncovered services as covered services
  b. falsifying certificates of medical necessity plans of treatment
  c. reporting duplicative charges on an insurance claim
  d. submitting claims for services not medically necessary



(Q. 2) A patient is admitted for chemotherapy for treatment of liver metastasis from previous breast
  cancer. She had a mastectomy 4 months ago. Chemotherapy is given today.
 A. C78.7, C85.3, Z51.11 C. C78.7, C85.3
  B. C85.3, C78.7, Z51.11 D. Z51.11, C78.7, Z85.3



(Q. 3) HIPAA defines abuse as involving actions that are __________ with accepted, sound medical, business, or fiscal practices, which directly or indirectly result in unnecessary costs to the program through improper payments.
 a. compatible
  b. inconsistent
  c. recurrent
  d. unvarying



(Q. 4) A 32-year-old female patient presents with right arm (dominant) paralysis due to childhood
  poliomyelitis.
 A. A80.39 C. B91, G83.21
  B. A80.39, G83.21 D. A80.39, G83.3



(Q. 5) HIPAA defines fraud as an __________ deception or misrepresentation that someone makes, knowing it is false, that could result in an unauthorized payment.
 a. accidental
  b. intentional



(Q. 6) Positive HIV test in a patient who is asymptomatic and has a high-risk lifestyle for HIV
  infection.
 A. B20, Z20.6, Z72.89 C. B20, Z20.6, Z72.89
  B. B20, Z21, Z72.89 D. Z21, Z72.89



(Q. 7) Record retention is the __________ of documentation for an established period of time, usually mandated by federal and/or state law.
 a. destruction
  b. privacy and security
  c. release
  d. storage



(Q. 8) A patient is admitted with fever and severe headache. The physician's diagnostic statement at
  discharge is: Fever and severe headache probably due to viral meningitis.
 A. A87.9, R50.9, R51 C. A87.9
  B. A87.8, R50.9, R51 D. A87.8



(Q. 9) Which was implemented to assist with CMS audit, oversight, anti-fraud, and anti-abuse efforts related to the Medicare Part D benefit?
 a. Hospital Inpatient Quality Reporting program
  b. Medicare Integrity Program
  c. Medicare Drug Integrity Contractors Program
  d. Zone Program Integrity Contractor program



(Q. 10) Patient was initially admitted and treated for an amebic abscess of the liver. During the stay the
  patient developed a hospital acquired bacterial pneumonia.
 A. A06.4, J15.9, Y95 C. A06.4, J18.9, Y95
  B. A06.4, J15.8; Y95 D. A06.4, J95.89, Y95
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Replies
wrote...
6 years ago
1)  b

2)  D

3)  b

4)  C

5)  b

6)  D

7)  d

8)  C

9)  c

10)  A
LMD Author
wrote...
6 years ago
Extremely helpful
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