Fill in Order Details

  • Submit paper details for free using our simple order form

Make Payment Securely

  • Add funds to your account. There are no upfront payments. The writer will only be paid once you have approved your paper

Writing Process

  • The best qualified expert writer is assigned to work on your order
  • Your paper is written to standard and delivered as per your instructions

Download your paper

  • Download the completed paper from your online account or your email
  • You can request a plagiarism and quality report along with your paper


  1. Diabetic neuropathy is an example of a(n)








  3. 2 points  

Question 2

  1. When other insurers are initially liable for payment on a medical service or supply provided to a patient, Medicare classifies them as the _________ payer.


    Medicare secondary







2 points  

Question 3

  1. What term is used to describe the types and categories of patients treated by a health care facility or provider?


    Medicare mix


    case mix


    secondary adverse


    covered population

2 points  

Question 4

  1. HCPCS level II modifiers consist of two characters that are


    alphabetic only


    alphabetic or alphanumeric


    alphanumeric only


    one letter and one symbol

2 points  

Question 5

  1. Provider services for inpatient medical cases are billed on what basis?




    global fee




    services not billed

2 points  

Question 6

  1. New CPT codes go into effect


    twice each year, on January 1 and July 1.


    twice each year, on October 1 and April 1.


    once each year, on October 1.


    once each year, on December 1.

2 points  

Question 7

  1. The legal business name of the practice is also called the


    administrative contractor


    billing entity


    provider identity


    third-party payer

2 points  

Question 8

  1. Modifiers are reported to


    alter or change the meaning of the code reported to the CMS-1500 claim.


    decrease the reimbursement amount to be processed by the payer.


    increase the reimbursement amount to be processed by the payer.


    indicate an alteration in the description of the procedure service performed.

2 points  

Question 9

  1. Each relative value component is multiplied by the geographic cost practice index (GCPI), and then each is further multiplied by a variable figure called the


    common denominator


    conversion factor


    related work total


    relative value unit

2 points  

Question 10

  1. Qualified diagnoses are a necessary part of the patient’s hospital and office record; however, physician offices are required to report


    qualified diagnoses for inpatients/outpatients


    qualified diagnoses related to outpatient procedures


    signs and symptoms in addition to qualified diagnoses


    signs and symptoms instead of qualified diagnoses

2 points  

Question 11

  1. RBRVS contains relative value components that consist of


    geographic cost, work experience, expense to the practice.


    intensity of work, expense to perform services, geographic location.


    liability and work expense, practice expense, malpractice expense.


    work expense, practice expense, malpractice expense.

2 points  

Question 12

  1. Q codes are used


    to identify services that would not ordinarily be assigned a CPT code (e.g, drugs, biologicals, and other types of medical equipment or services.


    to identify professional health care procedures and services that do not have codes identified in CPT.


    by state Medicaid agencies when no HCPCS level II permanent codes exist but are needed to administer the Medicaid program.


    by regional MACs when exisiting permanent national codes do not include codes needed to implement a regional MAC medical review coverage policy.

2 points  

Question 13

  1. “Incident to” relates to services provided by nonPARs that are defined as services


    provided incidental to other services provided by a physician.


    provided solely for the comfort and best interest of the beneficiary.


    provided without the nonparticipating provider’s supervision.


    that would otherwise not be reimbursed by the Medicare carrier.

2 points  

Question 14

  1. Which special codes allow payers the flexibility of establishing codes if they are needed before the next January 1 annual update?


    level III







2 points  

Question 15

  1. The prospective payment system providing a lump-sum payment that is dependent on the patient’s principal diagnosis, cormorbidities, complications, and principal and secondary procedures is


    ambulatory payment classifications (APCs)


    diagnosis-related groups (DRGs)


    Medicare Physician Fee Schedule (MPFS)


    resource-based relative value scale (RBRVS)

2 points  

Question 16

  1. Level I HCPCS codes are created by the









2 points  

Question 17

  1. Which statement is true of durable medical equipment?


    It can withstand repeated use.


    It is primarily used to serve a purpose of convenience.


    It is routinely purchased by individuals who are not suffering from an illness or injury.


    It is used by the patient in an outpatient rehabilitaiton facility.

2 points  

Question 18

  1. Level II HCPCS codes are created by the









2 points  

Question 19

  1. A bullet or black dot located to the left of a CPT code indicates


    a deleted CPT code that should not be used.


    a new, never previously published CPT code.


    a revised CPT code from an earlier publication.


    that special rules apply to the use of this code.

2 points  

Question 20

  1. Which organization is responsible for providing suppliers and manufacturers with assistance in determining HCPCS codes to be used?






    durable medical equipment, prosthetic, and orthotic supplies dealers.


    statistical analysis Medicare administrative contractor.

2 points  

Question 21

  1. HCPCS is a multilevel coding system that contains _________ levels.









2 points  

Question 22

  1. CPT-4 is published annually by









2 points  

Question 23

  1. CPT index terms that are printed in boldface are called




    essential modifiers


    main terms



2 points  

Question 24

  1. An example of a supplemental insurance plan is









2 points  

Question 25

  1. The Medicare physician fee schedule amount for code 99213 is $100. Calculate the nonPAR allowed charge.









2 points  

Question 26

  1. The purpose of the creation of HCPCS codes was to furnish health care providers with a :


    mandate to use electronic claims submission


    method for obtaining higher reimbursement from Medicare.


    standardized language for reporting professional services, procedures, supplies, and equipment.


    standardized way of reporting inpatient and outpatient diagnoses.

2 points  

Question 27

  1. Medicare participating providers commonly report actual fees to Medicare but adjust fees after payment is received. The difference between the fee reported and the payment received is a


    fee adjustment


    limiting charge


    neutral charge



2 points  

Question 28

  1. Nonparticipating (nonPAR) providers are restricted to billing at or below the




    limiting charge


    physician fee schedule


    relative value scale

2 points  

Question 29

  1. Modifiers are used with HCPCS codes to


    change the original description of the service, procedure, or supply item.


    decrease payment from Medicare.


    increase payment from Medicare.


    provide additional information regarding the product or service identified.

2 points  

Question 30

  1. When is it appropriate to file a patient’s secondary insurance claim?


    after a copy of the explanation of benefits is received by the practice


    after the explanation of benefits is received by the patient


    after the remittance advice is received by the medical practice


    at the same time the primary insurance claim is filed, if the primary and secondary payers are different

2 points  

Question 31

  1. Temporary additional payments over and above the OPPS payment made for certain innovative medical devices, drugs, and biologicals provided to Medicare beneficiaries are known as __________




    temporary pass-through


    transitional additional


    transitioal pass-through

2 points  

Question 32

  1. Prospective price-based rates are established by the


    actual charges for inpatient care reported to payers after discharge of the patient from the hospital.




    payer, based on a particular category of patient.


    reported health care costs from which a per diem rate has been determined.

2 points  

Question 33

  1. When reporting CPT codes on the CMS-1500 claim, medical necessity is proven by


    attaching a special report to the CMS-1500 claim.


    linking the CPT code to its ICD-10-CM counterpart.


    reporting ICD-10-CM codes for the patient’s condition.


    sequencing CPT codes in a logical, chronological order.

2 points  

Question 34

  1. The deadline for filing Medicare claims is


    six months from the date of service


    three years from the date of service


    there is no deadline


    none of the above

2 points  

Question 35

  1. Birth dates are entered as ___________ on the CMS-1500 claim depending on block instructions.









2 points  

Question 36

  1. A black triangle located to the left of a CPT code indicates that the code


    has been deleted and should not be used.


    has been revised from previous CPT publications.


    has special rules that apply to its use.


    is new to this edition of CPT.

2 points  

Question 37

  1. Hospice provides which services for patients?


    medical care in the home with the goal of keeping the patient out of the acute or long-term care setting


    medical care, as well as psychological, sociological, and spiritual care


    no copay if the patient has had a three-day minimum qualifying stay in an acute care facility


    temporary hospitalization for a terminally ill, dependent patient for the purpose of providing relief from duty for the nonpaid caregiver of that patient

2 points  

Question 38

  1. The ICD-10-CM system classifies




    mortality data


    provider services


    supplies and services

2 points  

Question 39

  1. When office-based services are performed at a facility other than the physician’s office, Medicare payments are reduced because the physician did not provide the supplies, drugs, utilities, or overhead. This payment reduction is called a(n)


    ambulatory payment classification


    facility write-off


    outpatient fee reduction


    site-of-service differential

2 points  

Question 40

  1. The reporting of diagnosis codes on the CMS-1500 claim is necessary to demonstrate


    accuracy of the procedure code


    higher payment


    medical necessity


    quality of care

2 points  

Question 41

  1. HCPCS “J codes” classify medications according to


    generic or chemical name of drug, route of administration, and dosage.


    generic or chemical name of drug, approval for Medicare coverage, and cost.


    product name of drug, method of delivery, and cost.


    product name of drug, route of administration, and dosage.

2 points  

Question 42

  1. The diagnosis that is the most significant condition for which procedures/services were provided is the


    first-listed diagnosis


    primary diagnosis


    principal diagnosis


    principal procedure

2 points  

Question 43

  1. CPT Appendix A contains information about


    deleted codes




    new code descriptions


    revised codes

2 points  

Question 44

  1. Medicare administrative contractors must keep Medicare fees within a $20 million spending ceiling, as stated in the Balanced Billing Act (BBA). This is called


    balanced budget rule


    budget neutrality


    Medicare spend-down


    the Medicare spending limit

2 points  

Question 45

  1. The document formerly known as the Explanation of Medicare Benefits is now known as the


    Advance Beneficiary Notice


    Medicare Payment Notice


    Medicare Remittance Advice


    Medicare Summary Notice

2 points  

Question 46

  1. The hospital assigns CPT codes to report


    inpatient ancillary services


    inpatient and outpatient surgery


    inpatient surgical procedures


    outpatient services and procedures

2 points  

Question 47

  1. The Medicare physician fee schedule amount for code 99213 is $100. The participating provider’s usual charge for this service is $125. Calculate the patient’s coinsurance amount.









2 points  

Question 48

  1. The unique identifier that CMS will assign to providers as part of the HIPAA requirements is called the


    Grp #







2 points  

Question 49

  1. Medicare is available to an individual who has worked at least


    5 years in Medicare-covered employment, is at least 65 years old, and is a permanent resident of the U.S.


    10 years in Medicare-covered employment, is at least 62 years old, and is a citizen of the U.S.


    10 years in Medicare-covered employment, is at least 65 years old, and is a citizen or permanent resident of the U.S.


    25 years in Medicare-covered employment, is at least 62 years old, and is a citizen of the U.S.

2 points  

Question 50

  1. Which resources should be referenced when determining the potential for Medicare reimbursement?


    CPT coding manual


    HCPCS coding manual


    ICD-10-CM coding manual


    Medicare Carriers Manual and Coverage Issues Manual


  • Google Rating
  • Sitejabber
  • Trustpilot
Cindy L
Cindy L
You can't fault the paper quality and speed of delivery. I have been using these guys for the past 3 years and I not even once have they ever failed me. They deliver properly researched papers way ahead of time. Each time I think I have had the best their professional writers surprise me with even better quality work. Elite Academic Research is a true Gem among essay writing companies.
Samuel Y
Samuel Y
I really appreciate the work all your amazing writers do to ensure that my papers are always delivered on time and always of the highest quality. I was at a crossroads last semester and I almost dropped out of school because of the many issues that were bombarding but I am glad a friend referred me to you guys. You came up big for me and continue to do so. I just wish I knew about your services earlier.
Mindi D
Mindi D
Brilliant writers and awesome support team. You can tell by the depth of research and the quality of work delivered that the writers care deeply about delivering that perfect grade.
Stuart L
Stuart L
Thanks for keeping me sane for getting everything out of the way, I’ve been stuck working more than full time and balancing the rest but I’m glad you’ve been ensuring my school work is taken care of. I'll recommend Elite Academic Research to anyone who seeks quality academic help, thank you so much!
Zahraa S
Zahraa S
Absolutely spot on. I have had the best experience with Elite Academic Research and all my work have scored highly. Thank you for your professionalism and using expert writers with vast and outstanding knowledge in their fields. I highly recommend any day and time.


Consider Your Assignments Done

“All my friends and I are getting help from eliteacademicresearch. It’s every college student’s best kept secret!”

Jermaine Byrant

“I was apprehensive at first. But I must say it was a great experience and well worth the price. I got an A!”

Nicole Johnson
Finance & Economics

Our Top Experts


See Why Our Clients Hire Us Again And Again!


Avg Rating


Elite Academic Research Promises You:

Always on Time

If we are a minute late, the work is on us – it’s free!


If the work we produce contains plagiarism we’ll pay out a £5,000 guarantee.


Providing quality work is core to our beliefs, which is why we will strive to give you exactly that, and more!

Written to Standard

All of our assignments go through a stringent quality checking process from start to finish.

Success Guarantee

When you order form the best, some of your greatest problems as a student are solved!






Pay an expert to take your online class and say goodbye to poor grades, missed deadlines, and the struggles
of balancing your education with other work/life responsibilities. Life Is too Short to Spend on Classes
You Have No Interest In. Focus on what is really important in your life. Let our professional handle your class.

    Guaranteed A or B

    100% Confidential

    Experienced Tutors

    24/7 Support

Fill in free quote request

Tell us about your online class and what help you need. Try to give us the maximum information.

Agree on price

Our representative will contact you to discuss the details of your order and the rates for our assistance.

Pay and get help

When everything is agreed, you will receive an email with the invoice. After you pay, we start working on your task.