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Medical Billing and Coding, Medical Law and Ethics Flashcards

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2977546441Murder and robbery are considered to be felonies because they are crimes that carry punishment of imprisonment up to one year.False0
2977551259Unintentional torts occur when the patient is injured as a result of the MA not exercising the ordinary standard of care.True1
2977553356The President is a part of the judicial branch.False2
2977562526Monetary awards by a court to a person who has been harmed in especially malicious or willful way are called nominal damages.False3
2977567874An implied contract is an agreement that is made through inference by signs, silence, or inactions.True4
2977572617The physician is legally obligated to report:deaths, births, communicable diseases, and abuse. All of the above5
2977578642The government organization that investigates a violation of a patient's medical privacy is:OCR6
2977585830The threat of doing bodily harm to another person-- stating for example, "If you won't allow us to continue this procedure, we will have to tie your hands"-- is:assualt7
2977590092The amount of federal tax withheld is based on the employee's exemptions, pay period, andEmployee's marital status8
2977594668A process by which a physician in one state is granted a license to practice medicine in another state is:reciprocity9
2977596942A new employee must complete which of the following?W-4 form10
2977601789All of the following are reasons for revoking a physician's license except:Providing atypical care11
2977604992A Schedule 1 controlled substancecannot be prescribed12
2977607028The three branches of the U.S. Government includeExecutive, Legislative, and Judicial13
2977609668An authorization in advance to withdraw artificial life support is:An advance directive14
2977619814The person who brings the action into litigation is called aplaintiff15
2977622995Patient information that is released without the patient's authorization might result in a legal charge of:Invasion of privacy16
2977625256Improper performance of an otherwise proper or lawful actmisfeasance17
2977627018Taking away a license to practice medicine is calledrevocation and expulsion18
2977631905When a patient has HMO managed care insurance, who is the gatekeeper to authorize consultations with specialists?The primary care provider19
2977634652If a patient refuses to consent to treatment, the medical assistant should:Delay treatment and inform or consult with the physician20
2977639949The common law of the past that is based on a decision made by judges is calledcase law21
2977642396When making a claim for payment after a patient has died, the claim (or bill) must besent to the administrator of the estate of the deceased person22
2977644055The patient's medical record belongs to:The physician23
2977648152Takes place when the physician or healthcare worker and the patient's relationship is establishedDuty24
2977651290The Patient Self-Determination Act, which includes health care directives, ensures that patients are able to:Control their own health care decisions25
2977654225Research that will not directly benefit the research subject is:non therapeutic26
2977655581Legally, a physician:May refuse to accept a patient if he or she chooses27
2977659520When implementing HIPAA, physicians and physician groups shouldhire a privacy officer, implement a notice of privacy practices, retain signed authorizations for a least six years, enter into agreements with non-employee service providers. All of the above28
2977669219The patient may be angry with everyone and may express an intense angeranger29
2977671988In-vitro fertilization occurs as a result ofimplantation of the fertilized ovum in the uterus and growth of the fertilized ovum in the laboratory.30
2977677079Release of a patient's medical records without proper authorization might result in charges of:Invasion of privacy31
2977679915Active euthanasiais illegal32
2977681618What are the two main types of law?Criminal and Civil33
2977686581A coroner or health official will have to sign a death certificate in the case ofa death as a result of a criminal action, an unlawful death such as assisted suicide, unexplained or unexpected death.34
2977690032AIDS is the same asacquired immunodeficiency syndrome35
2977693575To release medical information:The patient must sign a release form36
2977696495Which of the following should be reported to the health department?Human immunodeficiency virus (HIV)37
2977702233Which of the following forms indicates an employee's withholding allowance?W-438
2977705046In the U.S. legal system, the burden of proof is placed uponthe plaintiff39
2977708135Removing one's clothing in order to allow the physician to perform a physical examination is animplied contract40
2977718824The conscience clause refers tohospitals not choosing to perform sterilization procedures and physicians and hospitals not being able required to participate in sterilization41
2977727597Medical issues relating to bioethics includeabortion, surrogate parenthood, and genetic counseling42
2977735873A patient complains of a sore throat. The provider takes a swab for a throat culture to diagnose and treat the complaint. The act is considered:Implied consent43
2977740509Federal reimbursement guidelines mandate that all medical records be completed with how many days following the patient's discharge from a hospital?3044
2977755220Which branch of the U.S. government interprets the law?Judicial45
2977757982Informed consent includes which of the following elements?Benefits and risks of the treatment, purpose of treatment, nature of the patient's condition, and assessment of the patient's understanding of the treatment. All of the above46
2977766005An oral testimony that is made before a public officer of the court to be used in a lawsuit is adeposition47
2977768826Dr. Elizabeth Ross is known for the study ofstage of death and dying48
2977772031The statute of limitations varies somewhat from state to state but is typicallyone to three years49
2977774225HIPAA compliance in the medical front office refers to:Patient confidentiality50
2977776855Standard of care refers to the care thata reasonable person would use, is ordinary care, a prudent person would use, and healthcare professionals in all specialties must practice. All of the above51
2977781934If called to testify in court, one shouldnot memorize his or her testimony ahead of time, not answer questions he or she does not understand, always tell the truth, and be professional. All of the above52
2977786794An enforceable contract contains:An offer, An acceptance, A consideration, A capacity. All of the above53
2977789052Respondeat superior means thatthe employer is liable for the actions of the employee54
2977791005Rules and laws made by agencies are defined asRegulatory law55
2977796734The Health Information Portability and Accountability Act of 1996 was enacted to regulate all of the following except:Setting standards for employees with disabilities56
2977798717A procedure or treatment that is needed refers toordinary57
2977801660A violation of HIPAAis a criminal offense58
2977804248Which of the following is the most important factor in coding?Accuracy of codes59
2977807967Insurance that protects a person in the event of a certain type of accident, such as an automobile or plane crash, is calledspecial risk insurance60
2977809383A direction to consider additional codes is:See also61
2977811336A Medicare claim for a deceased beneficiary may be paid directly to the physician if:The estate is billed62
2977813812Which of the following is the main purpose of the ICD-9-CM?to compile statistical data, to index medical records for data storage and retrieval, to facilitate the collection of uniform and comparable health information63
2977821398A claim may be rejected by an insurance company because of the omission of:complete diagnosis, policy number, patient birth date, itemization of charges. All of the above64
2977828726The ICD-9-CM codes for classifying the cause of injuries, poisonings, or adverse drug reactions areE codes65
2977829902The patient must pay a regular monthly premium for:Medicare Part b66
2977832505A two-digit modifier attached to the five-digit CPT code indicatesA service or procedure has been altered67
2977834586Which is the best way to work with patients regarding financial matters?Explain the office financial policies when patients make an appointment68
2977837534Which of the following ICD-9-CM codes indicates the cause of an accident?E811.069
2977839617A claim that is printed and mailed to the carrier is called a ______ copyhard70
2977847880What is the monthly net income for a medical practice whose expenses are $8500, revenue is $14,130, total assets are $263,000, and liabilities are $53,000?$563071
2977850117How many digits are assigned to the primary code in the CPT coding system?572
2977855852A type of insurance that protects workers from loss of wages after an industrial accident that happened on the job is calledworkers' compensation73
2977857669Organizations that fund their own insurance programs offer their employeesself-insured plans74
2977859119Which of the following is an example of fraud?Altering a patient's chart to increase the amount reimbursed75
2977862809The purpose of a charge slip is toprovide an itemized billing statement on which the physician notes charges76
2977867510To examine claims for accuracy and completeness before they are submitted is to ____ the claimsaudit77
2977869834Which coding system is not associated with medical procedures?International Classification of Diseases, ninth, edition, Clinical Modification (ICD-9-CM)78
2977876413The universal claim form developed by Health Care Financing Administration (HCFA) is:CMS-150079
2977878603Which of the following are Evaluation and Management descriptors?Physical examination, school physical, well baby check up, and preoperative physical. All of the above80
2977883137Which of the following must always be completed on the insurance claim form?If the physician accepts assignment of benefits81
2977884760Which of the following is a type of insurance verification method?asking about the patient's insurance during the initial appointment telephone call, copying the insurance card when the patient arrives for an appointment, and calling the carrier to verify benefits and eligibility82
2977893064A V-code:refers to factors that influence health status83
2977897513Which of the following items is not covered by Medicare Part B?Hospitalization84
2977899805Which of the following Medicare programs covers hospital charges?Part A85
2977901255Under a managed care plan, the physician agrees to:Accept predetermined fees86
2977903093Third-party participation in an office indicates the relationships among the:physician, patient, and insurance company87
2977905169The most common insurance claim form is theCMS-150088
2977906999Which is an example of a third party payer?Medicare89
2977910442When a patient has managed care insurance, who is the gatekeeper to authorize consultations with specialists?The primary care provider90
2977913083The current Health Care Claim form has also been calledHCFA 1500, Universal Claim Form, and CMS-150091
2977918146When using the ICD-9-CM codes, which of the following will occur when the fourth and fifth digits are omitted?Claim denials92
2977922302All of the following would require a CPT code except:Diarrhea93
2977923791An E code in the ICD-9-CM coding system:Refers to external causes94
2977926931Which of the following would be the least helpful for encouraging patients to make prompt payments?Sending collection letters to all patients with a balance due95
2977928490Capitation siFixed payment made for each enrolled patient rather than reimbursement based on the type and number of services provided96
2977933774Which of the following expenses would be paid by Medicare Part B?Physician's office visits97
2977935905According to the CPT, E&M code begin with which of the following 2 digits?9998
2977939167Which of the following is new to ICD-10 (compared with ICD-9)?expansion of injury codes, more information on ambulatory care, greater number of codes, and additional letters and digits. All of the above99
2977942341EHR is an acronym for:Electronic Health Record100
2977945868Which type of insurance organization uses the fee-for-services concept?Preferred provider organization (PPO)101
2977951337Modifiers are used primarily to signify which of the following?only part of procedure was performed, a service or procedure has been increased or reduced, and a service or procedure was performed more that once, or by more than one physician. All of the above102
2977958262Which of the following is a diagnostic coding system that is used to code morbidity?ICD-9-CM103
2977961126The physician who enters into a contract with an insurance company and agrees to certain rules and regulations is called a ____ providerparticipating104
2977962676Disadvantages of the EMR system includecost, training time, and learning curve. All of the above105
2977965261Which of the following is a coding system used to document the procedure for suturing a laceration?CPT106
2977967319Which factor is not included when determining the level of service for E&M codes?Cost of services107
2977969299Which of the following requires an ICD-9-CM code?Irritable bowel syndrome108
2977971993When selecting the E&M code for CPT coding, which of the following elements is required for all levels of the history?Chief Complaint109
2977975206How many chapter of disease descriptions and codes are included in the Tabular List?17110
2977977018The federal insurance program that provides for the medically indigent is:Medicaid111
2977979315How do insurance companies use procedure codes?To decide whether the care being given corresponds to the patient's disease112
2977981886Medicare's UPIN stands for _____ identification numberunique provider113
2977985004The individual entitled to receive benefits from an insurance policy or program is called thebeneficiary114
2977988531If a policy holder of an 80-20 plan had for surgery that costs $3,600 how much of this bill is the subscriber responsible to pay?$720115
2977990728Veterans of the U.S. armed forces may be covered byCHAMPVA116
2977993845ICD-9-CM codes that refer to factors that may influence the patient's health status are:V-codes117
2977995562Verification of insurance benefits is usually done bycalling the insurance carrier118

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