4 Written Questions

1. medical report attached to the claim form substantiating a medical condition
2. assignment of a code to the patient's diagnoses, procedures for the purpose of reimbursement
3. prior approval for treatment by specialists and documentation of post-treatment reports
4. International Classification of Diseases, 9th Revision, Clinical Modification-coding system used to report diagnoses and reasons for encounters, such as an annual physical examination, on outpatient and physician office claims

4 Multiple Choice Questions

1. collecting information from a medical record
   1. ICD-9-CM
   2. Abstracting
   3. CPTa
   4. Coding
2. report detailing the results of processing a claim (Ex: payer reimburses provider $80 on a submitted charge of $100
   1. Explanation of benefits (EOB)
   2. Remittance advice
   3. Preauthorization
   4. Claims attachment
3. documentation submitted to a third-party payer of government program requesting reimbursement for healthcare services provided
   1. Medical necessity
   2. Explanation of benefits (EOB)
   3. Remittance advice
   4. Health insurance claim form (CMS-1500)
4. notice sent by the insurance company that contains payment information about a claim
   1. Remittance advice
   2. Preauthorization
   3. Medical necessity
   4. Abstracting

3 True/False Questions

1. Medical necessity → notice sent by the insurance company that contains payment information about a claim

   True        False

2. CMS → Center for Medicare and Medicaid Services-administrative agency within the federal Department of Health and Human services; responsible for the operation of Medicare and Medicaid

   True        False

3. CPTa → Center for Medicare and Medicaid Services-administrative agency within the federal Department of Health and Human services; responsible for the operation of Medicare and Medicaid

   True        False