Chiropractic Billing & Coding Summit Quiz Survey

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* 3. Which CPT codes are Medicare-covered chiropractic manipulative treatment (CMT) codes?

97010–97014

98940–98942

99202–99205

97110–97112

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* 4. Which modifier indicates active/corrective treatment for Medicare chiropractic claims?

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* 5. Which oversight body prosecutes False Claims Act violations?

CMS

OIG

DOJ

OSHA

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* 6. What is considered non-covered by Medicare in chiropractic care?

Active treatment

Subluxation correction

Maintenance care

CMT codes 98940–98942

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* 7. What must exist for Medicare chiropractic medical necessity?

Cosmetic concern

Subluxation of the spine

Patient preference only

Verbal pain complaint only

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* 8. Which documentation element is critical during an audit?

Color-coded notes

Objective findings

Marketing materials

Staff schedules

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* 9. CERT documentation requests must generally be returned within how many calendar days?

15 days

30 days

45 days

60 days

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* 10. Medicare prioritizes improvement of what over pain reduction?

Patient satisfaction

Function

Revenue

Frequency of visits

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* 11. Once a patient’s condition becomes stable with no expected improvement, treatment is considered:

Acute care

Emergency care

Maintenance therapy

Surgical care

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* 12. Which acronym is commonly used to support Medicare medical necessity documentation?

SOAP

OATS

HIPAA

MACRA

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* 13. ICD-10 diagnosis sequencing guidelines state the first-listed diagnosis should be:

The oldest condition

The least expensive condition

The most serious condition treated

The patient’s preferred diagnosis

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* 14. ICD-10-CM updates occur:

Every 10 years

Quarterly only

Annually

Every 5 years

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* 15. Which diagnosis element is important for medical necessity in chiropractic claims?

Generic symptoms only

Accurate diagnosis hierarchy

Patient income

Referral source

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* 16. What is the purpose of modifiers in chiropractic billing?

Replace CPT codes

Add specificity to services billed

Eliminate documentation

Increase visit frequency

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* 17. Which modifier is commonly used to separate E/M services from treatment?

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* 18. Which modifier indicates a distinct procedural service?

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* 19. Which modifier indicates a waiver of liability/ABN is on file?

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* 20. Which modifier is associated with a physical therapy plan of care?

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* 21. Insurance claim algorithms generally default toward:

Automatic approval

Denial or bundling edits

Manual review first

Patient refunds

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* 22. Which form is commonly associated with ASH prior authorization?

ABN

MNR Form

PSF Form

CMS-855I

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* 23. Traditional Medicare generally requires prior authorization for chiropractic services.

True

False

Only in emergencies

Only for new patients

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* 24. Which payer type often requires prior authorization?

Traditional Medicare

Commercial payers

Self-pay only

Workers comp only

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* 25. What is a common prior authorization pitfall?

Verifying eligibility

Exceeding approved visits

Maintaining tracking logs

Using alerts

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* 26. “No auth = no pay” best describes what type of payer?

Retro-auth payer

Hard-lock payer

Medicaid payer

Secondary payer

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* 27. Which item should be included in a prior authorization checklist?

Vacation schedule

Goals and plan of care

Payroll reports

Marketing budget

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* 28. Which process is considered a front-end revenue cycle activity?

Appeals

ERA posting

Eligibility verification

Collections litigation

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* 29. Claim denials occurring after payer processing are called:

Rejections

Edits

Denials

Exceptions

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* 30. Which denial prevention strategy helps achieve a clean claim rate above 95%?

Ignoring edits

Monitoring daily rejections

Billing without verification

Reducing documentation

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* 31. According to the presentation, many denials are:

Unavoidable

Caused only by providers

Avoidable

Required by CMS

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* 32. Which of the following is a common front-end demographic error issue?

Incorrect patient information

Surgical complications

Provider credentialing expiration only

Tax filing issues

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* 33. Chiropractic philosophy primarily refers to:

Insurance contracts

How a doctor believes the body heals and their goal of care

Medicare fee schedules

Coding software

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* 34. Billers do more than submit claims; they also interpret:

Legal cases

Provider behavior and documentation patterns

Surgical pathology

Employment law

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* 35. Some chiropractic patients may come three times per week because:

All patients require identical care

Treatment philosophies and goals vary

Insurance always mandates it

Providers prefer longer schedules

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* 36. Which best describes a cash-based healthcare trend?

Declining patient interest

Reduced out-of-pocket costs nationwide

Growth due to dissatisfaction with insurance systems

Elimination of compliance rules

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* 37. Discussions among competitors about pricing may violate:

HIPAA

Stark Law

Sherman Antitrust Act

OSHA regulations

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* 38. Which activity is considered unlawful “per se” under antitrust laws?

Patient scheduling

Fee discussions among competitors

Eligibility verification

Documentation audits

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* 39. Medicare covers chiropractic services for which patient population?

Only patients over age 80

Only active-duty military

Eligible beneficiaries including some disabled individuals under 65

Only pediatric patients

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* 40. Medicare Advantage plans often differ from Traditional Medicare because they:

Never require authorization

May have additional rules and restrictions

Eliminate modifiers

Cover all maintenance care

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* 41. Which statement best supports medical necessity?

“Patient enjoys treatment”

“Pain level unchanged for years”

“Objective functional improvement documented”

“Patient requested unlimited visits”

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* 42. What is one major goal of chiropractic compliance programs?

Maximizing visit frequency regardless of outcome

Reducing audit risk and improving clean claims

Eliminating documentation requirements

Avoiding all payer communication

Chiropractic Billing & Coding Summit Quiz

Question Title

* 1. Name

Question Title

* 2. Email

Question Title

* 3. Which CPT codes are Medicare-covered chiropractic manipulative treatment (CMT) codes?

Question Title

* 4. Which modifier indicates active/corrective treatment for Medicare chiropractic claims?

Question Title

* 5. Which oversight body prosecutes False Claims Act violations?

Question Title

* 6. What is considered non-covered by Medicare in chiropractic care?

Question Title

* 7. What must exist for Medicare chiropractic medical necessity?

Question Title

* 8. Which documentation element is critical during an audit?

Question Title

* 9. CERT documentation requests must generally be returned within how many calendar days?

Question Title

* 10. Medicare prioritizes improvement of what over pain reduction?

Question Title

* 11. Once a patient’s condition becomes stable with no expected improvement, treatment is considered:

Question Title

* 12. Which acronym is commonly used to support Medicare medical necessity documentation?

Question Title

* 13. ICD-10 diagnosis sequencing guidelines state the first-listed diagnosis should be:

Question Title

* 14. ICD-10-CM updates occur:

Question Title

* 15. Which diagnosis element is important for medical necessity in chiropractic claims?

Question Title

* 16. What is the purpose of modifiers in chiropractic billing?

Question Title

* 17. Which modifier is commonly used to separate E/M services from treatment?

Question Title

* 18. Which modifier indicates a distinct procedural service?

Question Title

* 19. Which modifier indicates a waiver of liability/ABN is on file?

Question Title

* 20. Which modifier is associated with a physical therapy plan of care?

Question Title

* 21. Insurance claim algorithms generally default toward:

Question Title

* 22. Which form is commonly associated with ASH prior authorization?

Question Title

* 23. Traditional Medicare generally requires prior authorization for chiropractic services.

Question Title

* 24. Which payer type often requires prior authorization?

Question Title

* 25. What is a common prior authorization pitfall?

Question Title

* 26. “No auth = no pay” best describes what type of payer?

Question Title

* 27. Which item should be included in a prior authorization checklist?

Question Title

* 28. Which process is considered a front-end revenue cycle activity?

Question Title

* 29. Claim denials occurring after payer processing are called:

Question Title

* 30. Which denial prevention strategy helps achieve a clean claim rate above 95%?

Question Title

* 31. According to the presentation, many denials are:

Question Title

* 32. Which of the following is a common front-end demographic error issue?

Question Title

* 33. Chiropractic philosophy primarily refers to:

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* 34. Billers do more than submit claims; they also interpret:

Question Title

* 35. Some chiropractic patients may come three times per week because:

Question Title

* 36. Which best describes a cash-based healthcare trend?

Question Title

* 37. Discussions among competitors about pricing may violate:

Question Title

* 38. Which activity is considered unlawful “per se” under antitrust laws?

Question Title

* 39. Medicare covers chiropractic services for which patient population?

Question Title