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| Section | Weight | Objectives |
|---|---|---|
| Billing Compliance and Regulations | 10-15% | - Appeal and denial management - Documentation compliance - Stark Law and Anti-Kickback Statute basics - Fraud, waste, and abuse prevention - HIPAA privacy and security requirements |
| ICD-10-CM Diagnosis Coding | 15-20% | - Chapter-specific guidelines - Secondary diagnosis coding - Code accuracy and specificity - ICD-10-CM structure and conventions - Principal diagnosis selection |
| Practice Management | 10-15% | - Patient responsibility calculations - Collections and payment posting - Patient registration and demographics - Insurance verification processes - Accounts receivable management |
| Insurance and Reimbursement | 20-25% | - Coordination of benefits - Commercial insurance policies - Fee schedules and reimbursement methodologies - Claims submission and processing - Workers' compensation and no-fault billing - Government payers (Medicare, Medicaid, TRICARE) |
| Healthcare Billing Fundamentals | 15-20% | - Revenue cycle overview - Anatomy and physiology for billers - Healthcare documentation principles - Medical terminology basics |
| CPT Coding | 20-25% | - CPT code categories and structure - Modifiers and their appropriate use - Evaluation and Management (E/M) codes - Category II and III codes - Surgical procedure codes |
Care plan oversight services cover the physician's time supervising a complex and multidisciplinary care treatment program for specific patient who is under the care of a home health agency, hospice, or nursing facility.
Correct Answer: A 🗳️
Which entity is responsible for enforcing HIPAA privacy regulations?
Correct Answer: A 🗳️
Explanation: Only visible for VCEPrep members. You can sign-up / login (it's free).
FMAP stands for Federal Medical Assistance Percentage.
Correct Answer: A 🗳️
DRG
Correct Answer: B 🗳️
Adverse Effect is also called adverse reaction; the appearance of a pathologic condition due to ingestion r exposure to a chemical substance properly administered or taken.
Correct Answer: A 🗳️
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