An appliance, apparatus, or product intended for use in assisting or treating a patient is sometimes covered by insurance and is billed as:
durable medical equipment (DME).
pharmaceuticals.
office supplies.
surgical supplies.
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Q. 2) Two codes that could NOT have both been reasonably performed during a single patient encounter are referred to as:
mutually exclusive codes.
not medically necessary codes.
comprehensive codes.
component codes.
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Q. 3) The types of edits for National Correct Coding Initiative (NCCI) errors include all of the following EXCEPT:
modifier indicators.
diagnostic and procedure code linkages.
mutually exclusive edits.
comprehensive versus component edits.
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Q. 4) Billing the parts of a bundled procedure as separate procedures for higher reimbursement is referred to as:
bundling.
unbundling.
upcoding.
downcoding.
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Q. 5) Using a procedure code that provides a higher reimbursement rate than the code that actually reflects the services provided is referred to as:
bundling.
unbundling.
upcoding.
downcoding.
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Q. 6) To bill for a procedure that was NOT medically necessary is considered:
fraud.
abuse.
inaccurate.
incomplete.
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Q. 7) In physical therapy cases, if a coder bills for supervised attendance:
the therapist must be in constant attendance with the patient.
the therapist must be supervised by a physician.
one-on-one direct contact by the therapist is not required.
one-on-one direct contact by the therapist is required.
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Q. 8) Misusing Medicare funds is considered:
abuse and illegal.
abuse but not illegal.
fraud and illegal.
fraud but not illegal.
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Q. 9) To bill for a procedure that was NOT performed is considered:
fraud.
abuse.
unbundling.
upcoding.
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Q. 10) An action that misuses money the government has allocated is considered:
fraud.
abuse.
an error.
a mistake.
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