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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: CPT Coding | 20-25% | - Category II and III codes - Surgical procedure codes - Modifiers and their appropriate use - Evaluation and Management (E/M) codes - CPT code categories and structure |
| Topic 2: Practice Management | 10-15% | - Patient registration and demographics - Patient responsibility calculations - Collections and payment posting - Accounts receivable management - Insurance verification processes |
| Topic 3: ICD-10-CM Diagnosis Coding | 15-20% | - Secondary diagnosis coding - Chapter-specific guidelines - ICD-10-CM structure and conventions - Code accuracy and specificity - Principal diagnosis selection |
| Topic 4: Healthcare Billing Fundamentals | 15-20% | - Medical terminology basics - Healthcare documentation principles - Revenue cycle overview - Anatomy and physiology for billers |
| Topic 5: Billing Compliance and Regulations | 10-15% | - Stark Law and Anti-Kickback Statute basics - Documentation compliance - HIPAA privacy and security requirements - Fraud, waste, and abuse prevention - Appeal and denial management |
| Topic 6: Insurance and Reimbursement | 20-25% | - Government payers (Medicare, Medicaid, TRICARE) - Workers' compensation and no-fault billing - Claims submission and processing - Commercial insurance policies - Coordination of benefits - Fee schedules and reimbursement methodologies |
Question 1
What does CDT stand for?
A. Civilian Dental Terminology
B. Conversion Dental Terminology
C. Comprehensive Dental Terminology
D. Current Dental Terminology
Question 2
Which part of the body do gaster and gastr refer to?
A. intestine
B. genitals
C. tongue
D. stomach
Question 3
Which of the following suffixes means two?
A. bi
B. demi
C. hemi
Question 4
EFT
A. Electronic funds transfer
B. Electronic Health Record
C. Employer group health plan
D. Electronic Healthcare Network Accreditation Commission
Question 5
Who is a person who performs services for another under an expressed or implied agreement?
A. Healthcare Provider
B. Independent Contractor
C. Health Insurance Specialist
Solutions:
| Question 1 Answer: D | Question 2 Answer: D | Question 3 Answer: A | Question 4 Answer: A | Question 5 Answer: B |
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