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AAPC-CPC exam study
**Important guidelines etc**
| Question | Answer |
|---|---|
| Not included in global package: E/M service on the same day as minor surgery or ______, unless separately identifiable service performed, it's not _____ and considered separate. | endoscopy, payable |
| Global package: Major surgery- pre op is day before or day ____ surgery. Minor surgery- pre op on the ____ day of surgery. | of, same |
| Global fee: Major surgery- pre op is 1 day post op is _____ days. | 90 |
| Global package not included: critical care services unrelated to the ____, Immunosuppressant therapy for organ ______. | surgery, transplants |
| AAPC was founded in ______ | 1988 |
| Inpatient and outpatient hospital form: _____ | UB-04 |
| OIG compliance plan: created to help Dr offices with ______ of compliance manuals. | development |
| OIG work plan: referred to for potential _______ areas identified of services for the ______ year, by government. | problem, coming |
| Global package not included: treatment for underlying ______ or that's not part of ____ recovery. | condition, normal |
| When procedure reported with add on code and done _____, the add on code is reported _____. | bilaterally, twice |
| Pt had surgery and develops septic shock: first code ______ following procedure, then post procedural septic _____. | infection, shock |
| Inconclusive HIV testing for pt without symptoms or signs: ______ | R75 |
| Surgical endoscopy always includes ______ endoscopy. | diagnostic |
| Processes non standard health info into standard format: | Clearinghouse |
| Adverse effect and drug correctly prescribed: the adverse effect is _____ | primary |
| Global package not included: less extensive procedure fails and more extensive procedure required- the ____ procedure is payable separately. | second |
| Global package not included: initial _____ to determine need for surgery and critical care services not ____ to the surgery where seriously injured or burned pt needs constant doctor attendance. | consultation, related |
| HIPAA became a law in ______ | 1996 |
| Form that doctors submit to charge the insurance carrier: CMS-_____. | 1500 |
| HCPCS is updated _____ | quarterly |
| Global package: E/M modifiers for payable services: 24, 25, ____ | 57 |
| Diseases not classified elsewhere: code 1st the _____ cause. | underlying |
| Treatment for anemia and anemia is from chemo: the ______ trumps chemo and coded 1st. | anemia |
| Treatment for anemia and anemia is caused from cancer: the _____ trumps anemia and coded 1st. | cancer |
| Qualitative: determines presence or _____ of a drug | absence |
| Quantitative: determines presence or absence of a drug and the exact _____ of the drug. | amount |
| CLIA: clinical laboratory ______ ammendments. All lab testing sites/offices must be registered with CLIA or have the _____. | improvement, waiver |
| EGD (upper GI): Rigid or flexible. If duodenum not examined: use modifier 52 if _____ exam isn't planned and 53 if it's planned. | repeat |
| ERCP: (endoscopic retrograde cholangio pancreatography) Complete: at least one of the _____ systems must be visualized. Guide ____ passage is included. | ductal, wire |
| ERCP: modifier _____ if more than 1 stent placed. | 59 |
| Mekel diverticulum (outpouching bowel) procedures: Excision of mesentary (lining of abd wall), Excision of omphalomesenteric _____, suture of mesentery. | duct |
| Global package not included: _______ procedures and treatment for post-op complication requiring ____ trip to the OR | diagnostic, return |
| Endoscopy: no post-op period for global package except ones requiring ______. | incisions |
| Acute MI still needing care after 4 weeks needs ______ Z code. | aftercare |
| Sepsis: the _____ is primary then sepsis (R65) is second. Septic shock codes are _____ primary. | infection, never |
| Z code for _____ exposure | contact |
| Chemo trumps blood and blood trumps ______ for dehydration. | fluids |
| Treatment for broken bone from cancer: the broken bone is _____ then cancer is second. | primary |
| Pregnant with tobacco and drug use: code from O99 first then ____ code. | F |
| Borderline diagnosis: coded as _____ unless there's a code for borderline. | confirmed |
| Bilateral cataracts but having cataract surgery on one eye: report ______ code. | bilateral |
| Excludes 1: "Not coded here" pt may have ____ diagnosis but not coded with category code above it. | similiar |
| Excludes 2: "Not included here" pt may have _____ diagnosis but that one's not here. Can use both codes. | both |
| Outpatient: only report _____ diagnosis. Inpatient: report suspected or ____ out as if the condition does exist. | confirmed, rule |
| EGD: if it doesn't include proximal duodenum or jejunum it's not a _____ exam. Report modifier ____ for this being incomplete. | full, 52 |
| Xeno or Heterograft: graft from one _____ to another. | species |
| Cancer and dehydration due to this and only dehydration being treated: the _____ coded 1st | dehydration |
| Screening for pre-op evals: 1st code reason for visit (encounter for pre-op evals) then code the reason for _____, next code any _____ from the screenings/tests. | surgery, findings |
| Complications during cancer treatment surgery: code ______ 1st. | complications |
| Reason for encounter is to determine the _____ of cancer: code cancer 1st. | extent |
| IV least than 15 minutes: reported as IV _____. | push |
| CMS controls the ______(National Correct Coding Initiative). | NCCI |
| Admitted only for treatment of anemia from cancer: the _____ is coded 1st. | Cancer |
| Admitted for respiratory symptoms from Covid19: the Covid is coded _____ then manifestations caused by it. | first |
| Removal of bladder tumors: only _____ code reported no matter how many tumors removed. | one |
| Code 1st underlying condition or gangrene then ____ code. | ulcer |
| Known osteoporosis and fracture: code from _____, not traumatic fracture code. | M80 |
| Injury with nerve and blood vessel damage: code 1st primary _____ then vessel/nerve damage. | injury |
| Cancer caused by transplant complication: code 1st ______ of transplant then cancer code. | complications |
| No _____ limit for when sequela can be used. | time |
| Injury due to sequela: type of sequela coded 1st then code for the _____. | injury |
| Post-op complication and pt with pain because of it: 1st code _____ then pain code (G89-). | complication |
| Broken upper jaw and skull: sometimes called Guerin's fracture. Need _____ procedure. | LeFort |
| Endocrine system doesn't circulate fluids throughout the ____. | body |
| Presbyopia: _______ | farsightedness |
| Inside of meninges in this order: dura mater, ______ mater, pia mater. | arachnoid |
| Axial skeleton is made up of the skull, hyoid, _____ spine, ribs, vertebrae, and _____. | cervical, sacrum |
| When reason for admission is management of cancer and pt has pain from it: code the _____ second. | pain |
| Admitted only for chemo, radiation or immunotherapy, code this _____ then the malignancy code. | first |
| If pain not specified as acute or chronic don't assign code from _____ | G89 |
| Catacalysmic events are 1st over all other external causes except: _____ and terrorism. | abuse |
| HIV and unrelated condition: code _____ condition 1st. | unrelated |
| Only simple closure is _____. An intermediate or extensive closure is separate code. | included |
| O80: full term, 40 weeks pregnancy, no complications first, then Single live birth: _____, then gestational ____. | Z37, age |
| Pt admitted and then delivers baby: code first _____ for admission. | reason |
| Doctor must own equipment, ie done in doctors office and ______ there for no ______. | interperated, modifier |
| Impaired renal function from cancer: Code underlying disease _____ then renal impairment only if doctor documented it caused it. | first |
| Report the test panel with the greater _____ of tests to fulfill definition then report remaining tests with individual ____. | number, codes |
| An implant that has moved, broken and doesn't work: it is considered a _____ body. | foreign |
| Small intestine in this order: Duodenum, Jejunum, _____. | Ileum |
| Epithelial: found in lining of blood _____, lining of digestive and urinary tract, skin and lining of _____ tract. | vessels, respiratory |
| Outpatient: code diagnosis in _____ report and no signs and symptoms as secondary. | final |
| Endoscopic procedure changed to open procedure: only code the _____ procedure. | open |
| Personal or family history of neoplasm is coded in ______ to treatment code. | addition |
| Redundant colon: colon is ____ than normal. Radicul/o: ____ nerve root. | longer, spinal |
| Peyer's patches: in lining of _____. Protects against microorganisms. | intestines |
| Trichiasis: ingrown _____ | eyelash |
| Reason for admission: hemolytic uremic syndrome code this _____ then underlying infection 2nd. | first |
| Neoplasm removal and chemo or radiation after, in the same episode of care: the _____ coded first. | neoplasm |
| Allograft: from one person to another who's not ______ identical. | genetically |
| Anastomosis: surgically connecting ____ vessels, intestines, etc. | adjacent |
| Word root Phac/o, Phak/o: _____ | lens |
| Salter-Harris fracture: broken epiphyseal plate, usually in ______ pts. If a fracture isn't stated as displaced or non displaced it's considered ______ | pediatrics, displaced |
| Broken distal radius in wrist: ______ fracture | Colle's |
| Anemia from chemo and treatment if for anemia only: the ____ coded 1st | anemia |
| Cancer and admitted for pain management: code G89.3 (pain associated with cancer) _____ | first |
| Desis: _____ or fusion. Rinne test: bone and air _____ hearing test. | binding, conduction |
| Endoscopy and removing multiple specimens by different techniques: will need to code for _____ procedure and highest _____ first. | each, value |
| Rectocele: herniation of rectum into the ______. | vagina |
| Gas exchaged through ____ at capillaries and ______. | diffusion, alveoli |
| Pressure ulcers: 6th character for _____. Stages 1-4 | stage |
| Removal of lesion and doing adjacent tissue transfer: only code the _____ transfer. | tissue |
| Pregnant and problem not affecting the pregnancy and doctor states it's not: report ____ code. | Z |
| Covid 19 is primary except for: pregnancy, organ ____ complications, sepsis (unless get sepsis after admission) | transplant |
| Under dosing codes are ______ primary diagnosis unless insulin pump _____. | never, malfunction |
| Reason for admission is pain control: pain is first then ____ of pain is secondary. | site |
| E/M services: comorbidities/underlying diseases not considered _____ addressed by doctor. | unless |
| CDC published the ______. CPT is updated _____ | ICD-10, annually |
| Med B covers fees w/o the use of ______ insurer for outpatient that's medically necessary. | private |
| Technical component: preparing of equipment/tests. Professional component: doctor _____ test results. | interperets |
| Still report reason for admission even when treatment not _____ out. | carried |
| Admitted for HIV related condition: _____ is primary except if admitted for _____ condition. | B20, unrelated |
| Sepsis: underlying infection is _____ then sepsis is 2nd. Septic shock codes are _____ primary. | primary, never |
| Which health plan does not fall under HIPAA; ______ _______ | Workers compensation |
| Z codes may be used as either _____ or secondary codes. | primary |
| Modifier ____ for anestesia performed by anesthesiologist. | AA |
| E/M: pt admitted yesterday and doctor seeing them the next day: is not an ______ code! | initial |
| Code 99417 for E/M ______ office visit codes. | prolonged |
| Make sure to read open or _______ procedures correctly. | laporoscopic |
| A unit of time is attained when the mid-point is _____. This means to report 15 minutes the time can be at least 8 minutes (pass the mid-point of 15 minutes) to report the codes. EX: 99606 (15 minutes) + 99607 (8 minutes) = 23 minutes. | passed |
| Lesion excision: add the largest ____ and the margins. Making sure to add _____ margins when it says Ex: "margins on each side of the lesion." | diameter, both |
| Scar revision, extensive undermining and debridement are examples which require ______ repair. | complex |
| Intermediate repair: requires a layered closure of one or more of the ______ structures or dermis. Includes heavily contaminated wound which requires extensive ____ or removal of particulate matter. | deeper, undermining |
| Wound repair: add together the lengths from the same _____ type and same anatomical position. Trunk- arms and _____ are included in this and thus added together. | repair, chest |
| Moh's procedure: doctor acts as pathologist also. Takes a specimen , ____ it into sections and views them under microscope until all ______ are clear. | cuts, margins |
| Complex repair: at least one of the following: exposure of ____, cartilage, _____ or names neurovascular structure. | bone, tendon |
| Status codes indicate pt is either a carrier of a disease or has _____ or residual of a past disease or condition. | sequela |
| Chronic A-fib may be documented as ______. Doctor must document the A-fib is chronic, paroxysmal or _____. | permanent, persistant |
| L89-- Unstageable pressure ulcer ends in _____. L89-- Unspecified ends in 9. | 0 |
| Baby prematurity: 1st code birth ____, then code gestational age. | weight |
| When catheter is inserted into the aorta and stays there (permanent) is is Non- _____. | Selective |
| Defibrillator battery is also called the pulse ______. Single chamber: ____ lead. Dual chamber: _____ leads. | generator, one, two |
| Code cancer being treated ____. Only exception immunotherapy, chemo, _____, external beam therapy. | first, radiation |
| ICD-10: Typically primary cancers are C00-C76.9, the lower end and ______ cancers are C77-C79.9 the higher end of the C codes. | secondary |
| Ear surgery: Myring- the tubes are usually _____ placed. Typanic- usually to place the tube | already |
| HIV: B20 with symptoms. _____ without symptoms. | Z21 |
| Pre existing diabetes in pregnancy: O24.1. Diabetes caused from pregnancy (gestational) code: ______. | O2 4.4 |
| Modifier _____ for Medicare pts for tests performed at a site with a CLIA _______ | QW, waiver |
| No modifier 26 when tests done in doctors _____. | office |
Created by:
mlovest
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