Question 1

Identify the code with the name of the source document.

-OB9J40Z
A)ICD-10-CM, Diagnosis
B)ICD-10-PCS, Hospital Procedures
C)CPT-4, Physician Procedures
D)CDT-4, Dental Procedures
E)HCPCS, Non-physician Procedures

Accepted Answer

The code OB9J40Z is formatted according to the ICD-10-PCS (International Classification of Diseases, 10th Revision, Procedure Coding System) used for coding hospital procedures.

Question 2

Identify the choice that best completes the statement or answers the question.
-23 Being sure the covered entity is using the proper HIPAA mandated transactions is the responsibility of
A)the software vendor.
B)the head physician of the facility.
C)any member who works at the facility.
D)the HIPAA Officer.

Accepted Answer

The HIPAA Officer is responsible for ensuring that a covered entity complies with HIPAA requirements, including the use of proper HIPAA-mandated transactions.

Question 3

Match the name of the transaction standard with the ID number assigned.

-Health Care Claim Payment/Advice
A)ASC X12N 270
B)ASC X12N 275
C)ASC X12N 276
D)ASC X12N 277
E)ASC X12N 278
F)ASC X12N 834
G)ASC X12N 835
H)ASC X12N 837

Accepted Answer

The Health Care Claim Payment/Advice transaction is designated by the ID number ASC X12N 835.

Question 4

Match the correct reference book to the appropriate types of codes.

-Physician procedures
A)Medicare Level II codes - HCPCS
B)ICD-10-CM
C)ICD-10-PCS
D)CPT-4
E)CDT-4
F)NDC codes

Accepted Answer

CPT-4 (Current Procedural Terminology, 4th Edition) is the reference book used for coding physician procedures.

Question 5

Identify the choice that best completes the statement or answers the question.
-Physician service codes are
A)five-place codes using all numbers or a combination of four numbers and one letter.
B)only number codes using 3, 4, or 5 spaces.
C)seven-space codes using both letters and numbers.
D)number codes using two digits, a decimal, and one or two more digits.

Accepted Answer

Physician service codes, often referred to in contexts such as the Current Procedural Terminology (CPT) codes used in the United States, are typically five characters long and can be a combination of numbers and letters, allowing for a wide range of specific services to be accurately documented and billed.

Question 6

Match the correct reference book to the appropriate types of codes.

-Dental procedures
A)Medicare Level II codes - HCPCS
B)ICD-10-CM
C)ICD-10-PCS
D)CPT-4
E)CDT-4
F)NDC codes

Accepted Answer

CDT-4 (Current Dental Terminology, 4th Edition) is specifically designed for coding dental procedures.

Question 7

Identify the code with the name of the source document.

-P9014
A)ICD-10-CM, Diagnosis
B)ICD-10-PCS, Hospital Procedures
C)CPT-4, Physician Procedures
D)CDT-4, Dental Procedures
E)HCPCS, Non-physician Procedures

Accepted Answer

The answer of Identify the code with the name of...

Question 8

Match the name of the transaction standard with the ID number assigned.

-Health Care Claim, Professional
A)ASC X12N 270
B)ASC X12N 275
C)ASC X12N 276
D)ASC X12N 277
E)ASC X12N 278
F)ASC X12N 834
G)ASC X12N 835
H)ASC X12N 837

Accepted Answer

The Health Care Claim, Professional transaction is identified by the ID number ASC X12N 837. This standard is used for the electronic submission of healthcare claim information.

Question 9

Match the correct reference book to the appropriate types of codes.

-Hospital procedures
A)Medicare Level II codes - HCPCS
B)ICD-10-CM
C)ICD-10-PCS
D)CPT-4
E)CDT-4
F)NDC codes

Accepted Answer

ICD-10-PCS (Procedure Coding System) is specifically designed for coding hospital procedures, making it the correct match.

Question 10

Identify the choice that best completes the statement or answers the question.
-The Accredited Standards Committee architecture of ASC X12N is the basic standard for
A)the health care industry.
B)the insurance industry.
C)the information technology industry.
D)the medical doctor's profession.

Accepted Answer

The answer of Identify the choice that best completes the...

Question 11

Match the name of the transaction standard with the ID number assigned.

-Health Care Claim Status Request
A)ASC X12N 270
B)ASC X12N 275
C)ASC X12N 276
D)ASC X12N 277
E)ASC X12N 278
F)ASC X12N 834
G)ASC X12N 835
H)ASC X12N 837

Accepted Answer

The Health Care Claim Status Request is identified by the transaction standard ID ASC X12N 276.

Question 12

Match the name of the transaction standard with the ID number assigned.

-Benefit Enrollment and Maintenance
A)ASC X12N 270
B)ASC X12N 275
C)ASC X12N 276
D)ASC X12N 277
E)ASC X12N 278
F)ASC X12N 834
G)ASC X12N 835
H)ASC X12N 837

Accepted Answer

Benefit Enrollment and Maintenance corresponds to ASC X12N 834.

Question 13

Identify the choice that best completes the statement or answers the question.
-The phrase "adjudicate a claim" means to
A)decide if the claim has sufficient information to be paid.
B)use software to "scrub" the claim for errors.
C)review the claim for medical necessity.
D)process the claim for settlement.

Accepted Answer

To "adjudicate a claim" means to process it for settlement, which involves reviewing, verifying, and deciding on the claim for payment or denial.

Question 14

Match the correct reference book to the appropriate types of codes.

-Non-physician procedures
A)Medicare Level II codes - HCPCS
B)ICD-10-CM
C)ICD-10-PCS
D)CPT-4
E)CDT-4
F)NDC codes

Accepted Answer

Medicare Level II codes - HCPCS are used for non-physician procedures, including services, supplies, and equipment not covered by CPT-4 codes.

Question 15

Match the name of the transaction standard with the ID number assigned.

-Health Care Services Review
A)ASC X12N 270
B)ASC X12N 275
C)ASC X12N 276
D)ASC X12N 277
E)ASC X12N 278
F)ASC X12N 834
G)ASC X12N 835
H)ASC X12N 837

Accepted Answer

Health Care Services Review transactions are identified by the ASC X12N 278 standard.

Question 16

Match the correct reference book to the appropriate types of codes.

-Drugs and biologics
A)Medicare Level II codes - HCPCS
B)ICD-10-CM
C)ICD-10-PCS
D)CPT-4
E)CDT-4
F)NDC codes

Accepted Answer

NDC codes (National Drug Codes) are specifically used for identifying drugs and biologics. This system is used in the United States to uniquely identify drug products.

Question 17

Match the correct reference book to the appropriate types of codes.

-Diagnosis
A)Medicare Level II codes - HCPCS
B)ICD-10-CM
C)ICD-10-PCS
D)CPT-4
E)CDT-4
F)NDC codes

Accepted Answer

ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) is specifically designed for classifying and coding diagnoses in all healthcare settings.

Question 18

Match the name of the transaction standard with the ID number assigned.

-Health Care Eligibility Benefit Inquiry
A)ASC X12N 270
B)ASC X12N 275
C)ASC X12N 276
D)ASC X12N 277
E)ASC X12N 278
F)ASC X12N 834
G)ASC X12N 835
H)ASC X12N 837

Accepted Answer

The Health Care Eligibility Benefit Inquiry is designated by the transaction standard ID ASC X12N 270. This standard is used by healthcare providers to inquire about a patient's health insurance benefits.

Question 19

Identify the choice that best completes the statement or answers the question.
-For a health care provider to comply with the Transaction and Code Set Rule, they must
A)mail forms via Postal Service with return receipt requested.
B)receive permission first to send claims through fax machine.
C)send claims to insurance plans using ASC X12N format.
D)write insurance claims on special paper.

Accepted Answer

The Transaction and Code Set Rule, part of the Health Insurance Portability and Accountability Act (HIPAA), requires that any electronic transactions, such as claims to insurance plans, adhere to a standardized format. The ASC X12N format is one such standard for electronic transmission of healthcare information, including insurance claims, making option C the correct choice.

Question 20

Match the name of the transaction standard with the ID number assigned.

-Health Care Claim Status Response
A)ASC X12N 270
B)ASC X12N 275
C)ASC X12N 276
D)ASC X12N 277
E)ASC X12N 278
F)ASC X12N 834
G)ASC X12N 835
H)ASC X12N 837

Accepted Answer

The Health Care Claim Status Response transaction is designated by the ID number ASC X12N 277. This standard is used by healthcare providers to inquire about the status of a health care claim.

Quiz 3: Transactions and Code Sets

Identify the code with the name of the source document. -OB9J40Z

Identify the choice that best completes the statement or answers the question. -23 Being sure the covered entity is using the proper HIPAA mandated transactions is the responsibility of

Match the name of the transaction standard with the ID number assigned. -Health Care Claim Payment/Advice

Match the correct reference book to the appropriate types of codes. -Physician procedures

Identify the choice that best completes the statement or answers the question. -Physician service codes are

Match the correct reference book to the appropriate types of codes. -Dental procedures

Identify the code with the name of the source document. -P9014

Match the name of the transaction standard with the ID number assigned. -Health Care Claim, Professional

Match the correct reference book to the appropriate types of codes. -Hospital procedures

Identify the choice that best completes the statement or answers the question. -The Accredited Standards Committee architecture of ASC X12N is the basic standard for

Match the name of the transaction standard with the ID number assigned. -Health Care Claim Status Request

Match the name of the transaction standard with the ID number assigned. -Benefit Enrollment and Maintenance

Identify the choice that best completes the statement or answers the question. -The phrase "adjudicate a claim" means to

Match the correct reference book to the appropriate types of codes. -Non-physician procedures

Match the name of the transaction standard with the ID number assigned. -Health Care Services Review

Match the correct reference book to the appropriate types of codes. -Drugs and biologics

Match the correct reference book to the appropriate types of codes. -Diagnosis

Match the name of the transaction standard with the ID number assigned. -Health Care Eligibility Benefit Inquiry

Identify the choice that best completes the statement or answers the question. -For a health care provider to comply with the Transaction and Code Set Rule, they must

Match the name of the transaction standard with the ID number assigned. -Health Care Claim Status Response