1. Which of the following terms describes this payment?
A. Coinsurance
B. Copayment
C. Deductible Correct
D. Fee-for-service
E. Premium
Explanation
A deductible is the amount a patient must pay out-of-pocket annually before insurance coverage begins. Coinsurance is a percentage of costs shared with the insurer after the deductible is met. Copayment is a fixed fee per service. Fee-for-service is a payment model for provider services. Premium is the regular payment for insurance coverage.
2. Which of the following terms represents a group of tissues arranged to accomplish a specific function?
A. Cell
B. Epithelium
C. Fascia
D. Membrane
E. Organ Correct
Explanation
An organ is a group of tissues working together to perform a specific function. A cell is the basic unit of life. Epithelium is a tissue type covering surfaces. Fascia is connective tissue supporting structures. A membrane is a thin layer of tissue with specific functions.
3. To prevent excessive bleeding, a patient should stop taking which of the following medications 5 to 7 days before undergoing a surgical procedure?
A. Atorvastatin (Lipitor)
B. Clopidogrel (Plavix) Correct
C. Levofloxacin (Levaquin)
D. Lisinopril (Zestril)
E. Potassium chloride (K-Dur)
Explanation
Clopidogrel (Plavix) is an antiplatelet medication that inhibits clotting, increasing bleeding risk during surgery, so it should be stopped 5-7 days prior. Atorvastatin manages cholesterol, Levofloxacin is an antibiotic, Lisinopril treats hypertension, and Potassium chloride supplements potassium, none of which primarily affect bleeding.
4. Which of the following steps is most important for the medical assistant when scheduling this appointment?
A. Ask if the patient is taking any medications for diabetes mellitus
B. Check to be sure the procedure room is available at the same time as the appointment Correct
C. Ensure that there is enough anesthetic on hand throughout the procedure
D. Look for a time slot when one of the other physicians is out of the office
E. Offer the patient the last appointment of the day
Explanation
Checking procedure room availability is critical to ensure the excision can be performed as scheduled. Asking about diabetes medications is relevant but less urgent. Ensuring anesthetic availability is the provider’s responsibility. Scheduling around other physicians or offering the last slot is less critical than room availability.
5. The assignment of a higher level of Evaluation and Management service when a lesser service is rendered in an attempt to increase reimbursement is known as which of the following?
A. Bundling codes
B. Coordinating
C. Filing a dirty claim
D. Upcoding Correct
E. Using modifiers
Explanation
Upcoding involves assigning a higher-level service code than provided to increase reimbursement. Bundling codes combines services into one code. Coordinating is unrelated to coding. Filing a dirty claim refers to errors in claims. Using modifiers adjusts codes for specific circumstances.