Medical Coding Practice Test

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What is the primary characteristic of covered services in medical coding?

They are not eligible for reimbursement

They are funded by insurance

The primary characteristic of covered services in medical coding is that they are funded by insurance. Covered services refer to medical procedures, treatments, or supplies that an insurance plan agrees to pay for as part of its benefits. When a patient seeks care that falls under the umbrella of covered services, the insurance provider is responsible for covering the costs associated with those services, either in full or in part, depending on the policy. This means that patients can receive necessary medical care without the burden of exorbitant out-of-pocket expenses for services that their insurance recognizes as necessary and appropriate.

The other options provide different contexts that do not align with the fundamental definition of covered services. The idea that covered services are not eligible for reimbursement contradicts the concept itself. Similarly, while patient consent might be relevant in certain cases, it is not a defining factor for what constitutes a covered service. Finally, the notion that covered services can only be provided in a hospital is too restrictive, as these services can also occur in outpatient settings, clinics, or other healthcare environments.

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They require patient consent

They can only be provided in a hospital

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