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NCCT-ICS NCCT Insurance and Coding Specialist

Test Detail:
The NCCT-ICS (NCCT Insurance and Coding Specialist) exam is a certification exam offered by the National Center for Competency Testing (NCCT). It is designed to assess the knowledge and skills of individuals in the field of medical insurance and coding. The exam evaluates the candidate's understanding of insurance regulations, coding systems, reimbursement processes, and medical documentation requirements.

Course Outline:
The NCCT-ICS course provides comprehensive training on medical insurance and coding. It covers a wide range of topics related to insurance procedures, coding guidelines, and reimbursement practices. While the specific course content may vary, the following is a general outline of the key topics covered:

1. Introduction to Medical Insurance:
- Overview of the healthcare insurance industry.
- Understanding insurance terminology and concepts.
- Introduction to healthcare reimbursement systems.
- Legal and ethical considerations in medical insurance.

2. Medical Coding Fundamentals:
- Introduction to medical coding systems (e.g., ICD-10, CPT, HCPCS).
- Coding guidelines and conventions for accurate code assignment.
- Coding for diagnoses, procedures, and services.
- Coding compliance and auditing processes.

3. Medical Insurance Claims Processing:
- Overview of the insurance claims process.
- Understanding different types of insurance plans (e.g., HMO, PPO).
- Completing insurance claim forms accurately and efficiently.
- Managing claim denials, appeals, and reimbursement issues.

4. Health Information Management:
- Medical record documentation and organization.
- Privacy and security of patient health information (HIPAA).
- Electronic health records (EHR) and health information exchange.
- Data quality and integrity in health information management.

5. Reimbursement and Billing Practices:
- Overview of healthcare reimbursement methodologies.
- Understanding fee schedules, billing codes, and charge capture.
- Insurance verification and pre-authorization processes.
- Managing accounts receivable and collections.

Exam Objectives:
The NCCT-ICS exam assesses candidates' knowledge and skills in medical insurance and coding. The exam objectives include, but are not limited to:

1. Medical Insurance Principles:
- Understanding insurance terminology, policies, and regulations.
- Demonstrating knowledge of insurance claim processing procedures.
- Applying legal and ethical standards in medical insurance practices.

2. Medical Coding and Documentation:
- Applying coding guidelines and conventions for accurate code assignment.
- Demonstrating proficiency in coding diagnoses, procedures, and services.
- Understanding medical record documentation requirements.

3. Insurance Claims Processing:
- Completing insurance claim forms accurately and efficiently.
- Demonstrating knowledge of insurance claim submission and processing.
- Managing claim denials, appeals, and reimbursement issues.

4. Health Information Management:
- Understanding the principles of health information management.
- Complying with privacy and security regulations (HIPAA).
- Demonstrating proficiency in electronic health records (EHR) usage.

5. Reimbursement and Billing Practices:
- Understanding healthcare reimbursement methodologies and fee schedules.
- Applying proper billing codes and charge capture processes.
- Managing insurance verification, pre-authorization, and accounts receivable.

The NCCT-ICS course syllabus provides a detailed breakdown of the topics covered in the training program. It includes specific learning objectives, case studies, practical exercises, and hands-on coding practice. The syllabus may cover the following areas:

- Introduction to medical insurance and coding.
- Medical coding systems (ICD-10, CPT, HCPCS).
- Insurance claims processing and reimbursement.
- Health information management and documentation.
- Compliance and ethics in medical insurance.
- Exam preparation and practice tests.
- Final NCCT-ICS Insurance and Coding Specialist Certification Exam.
NCCT Insurance and Coding Specialist
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NCCT-ICS NCCT Insurance and Coding Specialist

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NCCT Insurance and Coding Specialist
Question: 76
In the CPT manual, Appendix C lists clinical examples of:
A. Surgical procedures
B. Radiological procedures
C. Dermatology procedures
D. Evaluation and management procedures
Answer: D
In the CPT manual, Appendix C lists clinical examples of evaluation and
management procedures. In Appendix C, you will find multiple examples of each
level of evaluation and management procedures. Reviewing these examples will
not only help you determine which specific levels of codes should be used in each
coding situation, it will also help you make sure the right code is assigned.
Question: 77
Sylvia was seen in the office and was diagnosed with acute bronchitis with
Chronic Obstructive Pulmonary Disease. What is the correct ICD-9 diagnosis
code for her condition?
A. 466.0
B. 491.22
C. 466.0, 491.22
D. 491.21
Answer: B
The correct ICD-9 diagnosis code for Sylvias condition is 491.22. According to
ICD-9 coding guidelines, only code 491.22 (Obstructive Chronic Bronchitis with
Acute Bronchitis) should be assigned. It is not necessary to also assign code 466.0
(Acute Bronchitis). In addition, code 491.21 (Obstructive Chronic Bronchitis with
Acute Exacerbation) is inappropriate because it only indicates an exacerbation of
the chronic bronchitis, not acute bronchitis.
Question: 78
The external ear contains the:
A. Auricle and Auditory Canal, leading up to the Tympanic Membrane
B. Incus, Stapes, and Malleus
C. Cochlea, Semicircular Canals, and Eustachian Tube
D. Branches of the Vestibulocochlear Nerve and Tympanic Membrane
Answer: A
The external ear contains the auricle and external auditory canal, which leads up
to the tympanic membrane. The tympanic membrane separates the outer ear canal
from the middle and inner ear. The middle ear includes the incus, stapes, and
malleus. The inner ear contains the cochlea, semicircular canals and Eustachian
tube. This is where sounds waves are converted into nerve impulses, which are
read by the brain.
Question: 79
The HCPCS manual includes codes for:
A. Procedures that are also found in the CPT coding manual
B. Supplies, services, and procedures that are not found in the CPT manual
C. Only supplies that you cannot find in the CPT manual
D. All services performed in the office, except for procedures
Answer: B
The HCPCS manual includes codes for supplies, services, and procedures that are
not found in the CPT manual. Although some procedures found in the HCPCS
manual are also found in the CPT manual, the most appropriate answer is B
because HCPCS codes also include supplies and services not found in the CPT
Question: 80
There are four different classifications of a vulvectomy (the removal of the
vulva). What classification should be used for a vulvectomy with the removal of
skin and deep subcutaneous tissues?
A. Simple Vulvectomy
B. Radical Vulvectomy
C. Partial Vulvectomy
D. Complete Vulvectomy
Answer: B
The classification that should be used for a vulvectomy with the removal of skin
and deep subcutaneous tissues is a radical vulvectomy. A simple vulvectomy is
the removal of skin and superficial subcutaneous tissue not deep subcutaneous
tissues. A partial vulvectomy is the removal of less than 80% of the vulvar area,
and a complete vulvectomy is the removal of more than 80% of the vulvar area.
Question: 81
The HCPCS Level II modifier -E1 stands for:
A. Lower Right, Eyelid
B. Upper Right, Eyelid
C. Upper Left, Eyelid
D. Right Hand, Thumb
Answer: C
The HCPCS Level II modifier -E1 stands for Upper Right, Eyelid. Many HCPCS
modifiers indicate anatomical locations, such as the -E series modifiers for
eyelids. Other HCPCS modifiers indicate a section of the vertebral column, and
digits of the hands or feet.
Question: 82
When listing both CPT and HCPCS modifiers on a claim, you:
A. List the HCPCS modifier first
B. Do not list the HCPCS modifier at all
C. Only list the CPT modifier
D. List the CPT modifier first
Answer: D
When listing both CPT and HCPCS modifiers on a claim, you list the CPT
modifier first. When you report a procedure code with more than one modifier,
you must list the modifier that will affect the payment first on the claim.
Typically, CPT modifiers will affect the payment of a claim, but HCPCS
modifiers may not.
Question: 83
When you are searching for a diagnosis code in the ICD-9 manual:
A. You must first locate the diagnosis code description in the index and then
verify the correct code selection in the tabular list
B. You must locate the diagnosis code in the index and then assign the
appropriate code
C. You must determine which procedure you will bill for first, and then find out
which diagnosis codes match the procedure
D. You must first locate the diagnosis code description in the index and then
verify the code in Volume III
Answer: A
When you are searching for a diagnosis code in the ICD-9 manual, you must first
locate the diagnosis code description in the index and then verify the correct code
selection in the tabular list. It is an incorrect coding practice to code directly from
the index. Once you locate your code in the index, it is important to verify the
code in the tabular list to make sure it is the correct code.
Question: 84
HCPCS Level II codes are updated every quarter by:
B. Medicaid
C. Tricare
D. Commercial payers
Answer: A
HCPCS Level II codes are updated every quarter by CMS (Centers for Medicare
and Medicaid Services). Updates to HCPCS Level II codes are published on the
CMS website at the beginning of each new quarter. The HCPCS Level II manual,
however, is only published once per year.
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G. H. Hardy: The Pure Mathematician

Said one mathematician to another: “The number of my taxicab was 1729 . . . rather a dull number.” Said the second: “No, Hardy! No . . . It is the smallest, number expressible as the sum of two cubes in two different ways.”This and many other anecdotes and insights bring to life the great Cambridge mathematician G. H. Hardy as remembered by his friend and pupil C. P. Snow. This is the second of two ATLANTIC excerpts from Lord Snow’s forthcoming book, VARIETY OF MEN.

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Madison, Wisconsin, is best known for being the home of the University of Wisconsin and for being the Badger State’s capital. But is it known for hockey? The Sioux City Musketeers will find out when they take on the Madison for the two-game series at 7:05 p.m. Friday and Saturday at the Tyson Events Center, 401 Gordon Drive.

2 Calling all kid detectives!

Is your rug rat a Sherlock Holmes in the making? From 3 to 5 p.m. Monday, LaunchPAD Children’s Museum, 625 Pearl St., will host a “Top Secret” afterschool event. Participants can make their own disguise and take home their very own spy kit. Is this how James Bond got his start?

Yes, we know we’re wimps. But we’ve never gone tubing at Cone Park, 3800 Line Drive. They’re open every Friday, Saturday and Sunday, so this may be our year. Or maybe not.

Author and illustrator Steve Jenkins will be the attraction during a 10 a.m. Tuesday Nature Tales program at the Dorothy Pecaut Nature Center, 4500 Sioux River Road. Jenkins will discuss how animals move during the winter.

The Sioux City Public Library will host its first Open Book Club session of the year at the Morningside Branch Library from 10 to 11 a.m. and at the Aalfs Downtown Library on Monday. Librarian specialist Michael Maxwell will discuss Yasmine Ali’s “Walk Through Fire: The Train Disaster that Changed America.”

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