Questions from Practice Exam

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Question

Answer

How should one look up "closed reduction, percutaneous pin fixation of right fourth metacarpal fracture?"

Look under reduction OR metacarpal.

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What is vascular stenting?

It involves the placement of a small wire mesh tube called a stent in the newly opened artery. Often performed at the same time as an angioplasty.

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For an existing patient, if the "Review of Systems" is blank, can you count the E&M encounter?

Yes, but only for a low level of E&M visit.

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What would be the most likely compliance, ancillary coding publications, in addition to the CPT, ICD-9, and HCPCS manuals?

Coding Clinic and CPT Assistant

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What is the main authoritative document for ICD-9 code sequencing?

AHA Coding Guideline (published each year) and the Coding Clinic.

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For certain diagnoses, specified payments by CMS are paid to hospitals at:

A lower payment amount if the specified diagnoses were acquired in the hospital.

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What is RAC audit? What does it mean?

Medicare Recovery Audit Contractor. RAC is a nationwide auditing program focusing on improper payments for "duplicate" payments, fiscal intermediaries' mistakes, Medicare necessity and coding.

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The "principal procedure" describes the:

Definitive Treatment

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An E code ______ be a ______ diagnosis.

An E code can never be a principal (first-listed) diagnosis.

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Patients with this condition commonly experience pelvic pain, dysmenorrhea, and heavier menses.

Adenomyosis

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Trichomonas vaginalis is caused by a ______; Code for the detection by immunoassay with direct optical observation:

Tiny parasite; CPT Code:87808

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CPT code 95811 also includes:

CPAP (continuous positive airway pressure)

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What code should a pharmacist report for drug interaction counseling services?

Specific Level 1 CPT codes.

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In 2010, the "office consultation" codes:

Were not deleted in CPT, but are no longer recognized by Medicare.

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Under the PPS (Prospective Payment System), charges for services are established:

In advance.

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How are skin grafts measured?

In square centimeters.

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Which type of hysterectomy removes the cervix as well as the uterus?

Total

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What is not included in a LCD (Local Coverage Determination)?

CPT to ICD-9 procedural codes Crosswalk.

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A one-week-old male has a circumcision. What would be the appropriate DRG assignment?

343 12 SURG CIRCUMCISION AGE 0-17

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What is IPPS and what does it mean?

Known as the Inpatient Prospective Payment System, under the IPPS, each case is categorized into a diagnosis-related group (DRG).

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What is the difference between an EMR, EHR and Computerized Medical records?

None, they all refer to the same thing.

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Epitheliomas are?

A rare, malignant, cutaneous neoplasm. They are also occasionally referred to as sebaceous adenomas or basal cell tumors.

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Which is not one of the seven compliance components recommended by the OIG?

ERISA (Employee Retirement Income Security Act of 1974)

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Code for the removal of a 2-cm vascular malformation of the soft issue of the left thumb.

CPT Code: 26111-FA

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Which components are part of Medicare Part B?

CPT codes, CMS-1500, ICD-9

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The "Privacy Rule" specifies how many circumstances in which the parent is not the "personal representative" with respect to certain health information about his or her minor child?

Three (3)

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Under HIPAA, which of the choices is not one of the three circumstances in which the parent is not the "personal representative"?

If the parent is a convicted felon or sex offender.

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Who would investigate HIPAA complaints?

The Office of Civil Rights (OCR) and the Department of Health and Human Services (HHS).

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There are two broad categories of HIPAA Implementation. They are:

The Insurance Reform Provision of HIPAA and the Administrative Simplification Provisions

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Under HIPAA, the "Data Use Agreement" must:

Establish the permitted uses of protected information, and the appropriate safeguards to protect, and limit who can use or receive the data.

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The parasympathetic nervous system is part of the nervous system that serves to:

Slow the heart rate, increase the intestinal and gland activity, and relax the sphincter muscle.

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The rotator cuff is:

A group of flat tendons that fuse together and surround the front, back and top of the shoulder joint like a cuff on a shirt sleeve.

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Code for a trans-anal approach for the excision of a partial thickness rectal tumor.

CPT Code: 45171

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Hospital Discharge Codes 99238 and 99239 include:

Only those E&M services performed by the discharging physician.

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For radiological code 71022, the type is ____, the number of views is _____, and the views are _____.

The type is radiologic or X-ray The number of views is 4 The views are AP (anteroposterior) or frontal, lateral and oblique or right and left angled.

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The surgeon deftly entered through the middle fossa and removed a tumor from the temporal bone from the patient's left ear. The correct procedure code is:

CPT Code: 69970-LT

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Code the V code for a traumatic fracture:

ICD-9 Code: V15.51

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The principal procedure is one that was:

Performed for definitive treatment.

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Revenue codes are used on:

Only the UB-04 form.

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Which code involves the manipulation of the TMJ (temporomandibular joint), therapeutic, requiring an anesthesia service?

CPT Code: 21073

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Autosomal deletion syndromes are associated with?

Deletions of certain portions of a chromosome.

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What is SNOMED and what is it used for?

Systematized Nomenclature of Medicine, a systematically organized computerized collection of medical terminology that is accessible for research. It covers clinical areas such as diseases, findings, procedures, microorganisms & pharmaceuticals.

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What is a common term for software that reviews claims for errors?

Claim scrubber.

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Which medical specialties would most likely require a specialized EMR (Electronic Management System)?

Neurology, Psychiatry, Ophthalmology.

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Medicare Part A health insurance companies are currently called?

Fiscal Intermediaries.

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CPT code 93503 is used only to describe the:

Placement of a flow-directed catheter, such as a Swanz-Ganz.

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CPT codes 49000-49010 are ______ and codes 49320-49329 are _____?

CPT codes 49000-49010 are Laparotomy codes while 49320-49329 are laparoscopy codes.

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Which modifier would you consider the opposite of Modifier -22, Increased Procedural Services?

CPT Modifier -52, Reduced Services.

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Under HIPAA, is "consent" considered the same as "authorization"?

No - they are not considered as meaning the same thing.

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Code for pathologic plica, left knee:

ICD-9 Codes: 727.83, Plica syndrome/plica knee

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Dr. Avery performed a bilateral breast reconstruction, immediate, with subsequent tissue expansion (using a tissue expander). Code for the procedure.

CPT Code: 19357-50

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Carcinoma in axillary lymph nodes and lung metastatic from breast. ICD-9 Code:

ICD-9 Codes: 174.9, 196.3, 197.0

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The diagnosis code for a malignant tumor of the breast in a male patient is?

ICD-9 Code: 175.9

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In the medical chart, any loose notes or documentation are:

Considered part of the medical record, even if it is not clasped or affixed.

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A "principal diagnosis" (Dx) is found in _____ and the "first-listed" diagnosis (dx) is found in ______?

A principal diagnosis is found in an inpatient chart, Medicare Part A, and the UB-04 form. A first-listed diagnosis is found in an outpatient chart, Medicare Part B, and the CMS-1500 form.

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Which "central venous access device" code would be correct for the insertion of a PICC line, for a child less than five years of age, non-tunneled, without a pump or port?

While the correct answer, per the CPT book is 36555, for the purposes of this test the correct answer is CPT Code: 36568

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Cushing's Syndrome due to malignant pheochromocytoma is coded to:

ICD-9 Code: 194.0, 255.0

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When adding multiple repair sites:

Add only the same type, same anatomical site grouping (per CPT codes)

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A patient presents to the clinic seeking AIDS testing since a former partner has been diagnosed with AIDS and the patient has been exposed. What diagnosis code should be reported?

ICD-9 Code: V01.7

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A living will, personal directive, advance directive, or advance decision are all examples of what?

An Advance Health Care Directive

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Code for malignant hypertensive nephropathy with uremia:

ICD-9 Code: 403.01

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Reporting the wrong CPT code but getting paid means:

You should always match your documentation to the codes you report. The wrong CPT code is never a good thing.

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Code for Diverticular disease of the sigmoid colon and appendix, with resolving diverticulitis of the sigmoid colon:

ICD-9 Code: 543.9, 562.11

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What is an example of an orthotic device?

Orthotics is a specialty within the medical field concerned with the design, manufacture & application of orthoses. An orthotic is "an externally applied device to modify structural & functional characteristics of the neuromuscular & skeletal system."

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Code for: aseptic meningitis due to AIDS:

ICD-9 Code: 042; 047.8

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Code for the insertion of an implant outside the muscular cone, after evisceration of the ocular contents:

CPT Code: 67550

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Charging for services that are not medically necessary, do not conform to professionally recognized standards, or are unfairly priced is known as:

Abuse

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What is a "Cross-Coder" most likely used for?

ICD-9 Procedure Codes to CPT Codes.

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Code for the destruction of hemorrhoids by cryosurgery.

Use unlisted CPT Code: 46999

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The surgeon performed arthrodesis of the vertebral bodies, L1, L2 and L3 (total 3), using a lateral extracavitary approach technique of L1 (lumbar). A minimal diskectomy was performed to prepare the interspace.

CPT Codes: 22533, (+Add-on code) 22534x2

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Under HIPAA, what is needed to justify access to the entire medical record?

The covered entity's policies and procedures must state so explicitly and include a justification.

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In an inpatient setting, when no procedure is performed, the coder takes into account:

The patient's age; any secondary codes for any comorbidities and complications; discharge status and applies these to the MDC.

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Code for Cushing's Syndrome due to malignant pheochromocytoma:

ICD-9 Codes: 194.0; 255.0 We are coding the malignant neoplasm followed by the manifestation, in this case, Cushing's Disease.

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Code for head and neck carcinoma with metastases of the tonsils.

ICD-9 Code: 196.0

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Carcinoma in axillary lymph nodes and lung metastatic from breast.

ICD-9 Codes: 174.9; 196.3; 197.0 Code the breast cancer first as primary followed by the secondary sites of lymph nodes and lung.

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Volume 3 ICD-9 procedure codes are:

About the same level of difficulty as CPT codes to learn. (?)

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The False Claims Statute:

Makes it illegal for any health care provider to submit to Medicare or Medicaid bills that contain charges for items or services furnished substantially in excess of its "usual charges."

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Code the removal and replacement of a permanent pacemaker, pulse generator, single chamber, atrial.

CPT Codes: 33233, 33212-51

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What is an example of hardware integrity?

Raid Hard Disk Drive, Diesel Generator, Remove services in another city.

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What is not allowed in the medical record?

Erasures, adding notes at a later date, without properly noting the change, and post-it notes.

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Which components below are part of Medicare Part B?

CMS-1500, CPT Codes, ICD-9 codes.

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What is an electronic clearinghouse?

An organization that routes electronic claims to the appropriate insurance company.

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What is considered an exception to the business associate standard?

Disclosures by a covered entity to a health care provider for treatment of the individual.

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A 35-year-old female undergoes an excision of a 3.0-cm tumor of her forehead. An incision is made through the skin & subcutaneous tissue. The tumor is dissected free of surrounding structures. The wound is closed in layers & interrupted sutures.

CPT Codes: 21012, 12052

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What is the correct CPT code assignment for hysteroscopy with lysis of intrauterine adhesions?

CPT Code: 58559

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What coding system is used for physician inpatient or outpatient procedures?

CPT: Current Procedural Terminology

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Patient had a laparoscopic incisional herniorrhaphy for a recurrent reducible hernia. The repair included insertion of mesh. What is the correct code assignment?

CPT Code: 49656

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Identify the correct ICD-9 diagnosis codes for metastatic carcinoma of the colon to the lung.

ICD-9 Codes: 153.9, 197.0

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With the "prospective payment system"

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Code for head and neck carcinoma with metastases of the tonsils:

ICD-9 Code: 196.0 (?)

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Code for a fracture of the right fibula due to osteogenesis imperfecta:

ICD-9 Codes: 733.16, 756.51

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