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TPA Questions
Questions from Practice Exam
| Question | Answer |
|---|---|
| How should one look up "closed reduction, percutaneous pin fixation of right fourth metacarpal fracture?" | Look under reduction OR metacarpal. |
| 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. |
| 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. |
| 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 |
| What is the main authoritative document for ICD-9 code sequencing? | AHA Coding Guideline (published each year) and the Coding Clinic. |
| 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. |
| 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. |
| The "principal procedure" describes the: | Definitive Treatment |
| An E code ______ be a ______ diagnosis. | An E code can never be a principal (first-listed) diagnosis. |
| Patients with this condition commonly experience pelvic pain, dysmenorrhea, and heavier menses. | Adenomyosis |
| Trichomonas vaginalis is caused by a ______; Code for the detection by immunoassay with direct optical observation: | Tiny parasite; CPT Code:87808 |
| CPT code 95811 also includes: | CPAP (continuous positive airway pressure) |
| What code should a pharmacist report for drug interaction counseling services? | Specific Level 1 CPT codes. |
| In 2010, the "office consultation" codes: | Were not deleted in CPT, but are no longer recognized by Medicare. |
| Under the PPS (Prospective Payment System), charges for services are established: | In advance. |
| How are skin grafts measured? | In square centimeters. |
| Which type of hysterectomy removes the cervix as well as the uterus? | Total |
| What is not included in a LCD (Local Coverage Determination)? | CPT to ICD-9 procedural codes Crosswalk. |
| A one-week-old male has a circumcision. What would be the appropriate DRG assignment? | 343 12 SURG CIRCUMCISION AGE 0-17 |
| 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). |
| What is the difference between an EMR, EHR and Computerized Medical records? | None, they all refer to the same thing. |
| Epitheliomas are? | A rare, malignant, cutaneous neoplasm. They are also occasionally referred to as sebaceous adenomas or basal cell tumors. |
| Which is not one of the seven compliance components recommended by the OIG? | ERISA (Employee Retirement Income Security Act of 1974) |
| Code for the removal of a 2-cm vascular malformation of the soft issue of the left thumb. | CPT Code: 26111-FA |
| Which components are part of Medicare Part B? | CPT codes, CMS-1500, ICD-9 |
| 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) |
| 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. |
| Who would investigate HIPAA complaints? | The Office of Civil Rights (OCR) and the Department of Health and Human Services (HHS). |
| There are two broad categories of HIPAA Implementation. They are: | The Insurance Reform Provision of HIPAA and the Administrative Simplification Provisions |
| 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. |
| 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. |
| 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. |
| Code for a trans-anal approach for the excision of a partial thickness rectal tumor. | CPT Code: 45171 |
| Hospital Discharge Codes 99238 and 99239 include: | Only those E&M services performed by the discharging physician. |
| 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. |
| 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 |
| Code the V code for a traumatic fracture: | ICD-9 Code: V15.51 |
| The principal procedure is one that was: | Performed for definitive treatment. |
| Revenue codes are used on: | Only the UB-04 form. |
| Which code involves the manipulation of the TMJ (temporomandibular joint), therapeutic, requiring an anesthesia service? | CPT Code: 21073 |
| Autosomal deletion syndromes are associated with? | Deletions of certain portions of a chromosome. |
| 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. |
| What is a common term for software that reviews claims for errors? | Claim scrubber. |
| Which medical specialties would most likely require a specialized EMR (Electronic Management System)? | Neurology, Psychiatry, Ophthalmology. |
| Medicare Part A health insurance companies are currently called? | Fiscal Intermediaries. |
| CPT code 93503 is used only to describe the: | Placement of a flow-directed catheter, such as a Swanz-Ganz. |
| CPT codes 49000-49010 are ______ and codes 49320-49329 are _____? | CPT codes 49000-49010 are Laparotomy codes while 49320-49329 are laparoscopy codes. |
| Which modifier would you consider the opposite of Modifier -22, Increased Procedural Services? | CPT Modifier -52, Reduced Services. |
| Under HIPAA, is "consent" considered the same as "authorization"? | No - they are not considered as meaning the same thing. |
| Code for pathologic plica, left knee: | ICD-9 Codes: 727.83, Plica syndrome/plica knee |
| Dr. Avery performed a bilateral breast reconstruction, immediate, with subsequent tissue expansion (using a tissue expander). Code for the procedure. | CPT Code: 19357-50 |
| Carcinoma in axillary lymph nodes and lung metastatic from breast. ICD-9 Code: | ICD-9 Codes: 174.9, 196.3, 197.0 |
| The diagnosis code for a malignant tumor of the breast in a male patient is? | ICD-9 Code: 175.9 |
| In the medical chart, any loose notes or documentation are: | Considered part of the medical record, even if it is not clasped or affixed. |
| 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. |
| 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 |
| Cushing's Syndrome due to malignant pheochromocytoma is coded to: | ICD-9 Code: 194.0, 255.0 |
| When adding multiple repair sites: | Add only the same type, same anatomical site grouping (per CPT codes) |
| 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 |
| A living will, personal directive, advance directive, or advance decision are all examples of what? | An Advance Health Care Directive |
| Code for malignant hypertensive nephropathy with uremia: | ICD-9 Code: 403.01 |
| 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. |
| Code for Diverticular disease of the sigmoid colon and appendix, with resolving diverticulitis of the sigmoid colon: | ICD-9 Code: 543.9, 562.11 |
| 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." |
| Code for: aseptic meningitis due to AIDS: | ICD-9 Code: 042; 047.8 |
| Code for the insertion of an implant outside the muscular cone, after evisceration of the ocular contents: | CPT Code: 67550 |
| Charging for services that are not medically necessary, do not conform to professionally recognized standards, or are unfairly priced is known as: | Abuse |
| What is a "Cross-Coder" most likely used for? | ICD-9 Procedure Codes to CPT Codes. |
| Code for the destruction of hemorrhoids by cryosurgery. | Use unlisted CPT Code: 46999 |
| 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 |
| 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. |
| 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. |
| 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. |
| Code for head and neck carcinoma with metastases of the tonsils. | ICD-9 Code: 196.0 |
| 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. |
| Volume 3 ICD-9 procedure codes are: | About the same level of difficulty as CPT codes to learn. (?) |
| 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." |
| Code the removal and replacement of a permanent pacemaker, pulse generator, single chamber, atrial. | CPT Codes: 33233, 33212-51 |
| What is an example of hardware integrity? | Raid Hard Disk Drive, Diesel Generator, Remove services in another city. |
| What is not allowed in the medical record? | Erasures, adding notes at a later date, without properly noting the change, and post-it notes. |
| Which components below are part of Medicare Part B? | CMS-1500, CPT Codes, ICD-9 codes. |
| What is an electronic clearinghouse? | An organization that routes electronic claims to the appropriate insurance company. |
| 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. |
| 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 |
| What is the correct CPT code assignment for hysteroscopy with lysis of intrauterine adhesions? | CPT Code: 58559 |
| What coding system is used for physician inpatient or outpatient procedures? | CPT: Current Procedural Terminology |
| 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 |
| Identify the correct ICD-9 diagnosis codes for metastatic carcinoma of the colon to the lung. | ICD-9 Codes: 153.9, 197.0 |
| With the "prospective payment system" | |
| Code for head and neck carcinoma with metastases of the tonsils: | ICD-9 Code: 196.0 (?) |
| Code for a fracture of the right fibula due to osteogenesis imperfecta: | ICD-9 Codes: 733.16, 756.51 |
Created by:
Laura Duncan
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