Deck 1: Medical Coding
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Deck 1: Medical Coding
1
When you see the symbol # in front of a CPT code, what does it mean?
A)That the code is listed out of numerical order
B)That the code is listed in numerical order
C)That the code used to be listed with a different number
D)That the code description has changed
A)That the code is listed out of numerical order
B)That the code is listed in numerical order
C)That the code used to be listed with a different number
D)That the code description has changed
That the code is listed out of numerical order
2
What is the appropriate ICD-9 code for a diagnosis of a personal history of heart attacks?
A)V15.9
B)412
C)V12.50
D)V17.3
A)V15.9
B)412
C)V12.50
D)V17.3
412
3
Why are ICD-9 codes necessary to include on a claim?
A)They report the procedures performed on the patient
B)They are the services that are charged for on the claim
C)They indicate the medical necessity of the service
D)They indicate the code linkage on the claim
A)They report the procedures performed on the patient
B)They are the services that are charged for on the claim
C)They indicate the medical necessity of the service
D)They indicate the code linkage on the claim
They indicate the medical necessity of the service
4
In an outpatient setting, what is the primary diagnosis?
A)The reason the patient came in for the visit
B)The diagnosis code that the doctor lists first
C)The problem that causes the patient the most pain
D)The diagnosis that will result in the most reimbursement
A)The reason the patient came in for the visit
B)The diagnosis code that the doctor lists first
C)The problem that causes the patient the most pain
D)The diagnosis that will result in the most reimbursement
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5
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
A)466.0
B)491.22
C)466.0, 491.22
D)491.21
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6
Tricare Prime patients typically must see physicians:
A)Whenever they feel like it
B)At their military treatment facility
C)Whenever their commander asks them to
D)At their typical private practice doctor's office
A)Whenever they feel like it
B)At their military treatment facility
C)Whenever their commander asks them to
D)At their typical private practice doctor's office
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7
Which of the following is a surgery section CPT code?
A)99212
B)85025
C)11000
D)70020
A)99212
B)85025
C)11000
D)70020
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8
A 20-month-old with end-stage renal disease was receiving dialysis twice a week, awaiting a kidney transplant. During the last month of life, the patient received dialysis once per day. Dialysis was administered between June 1 and June 14. The patient's parents received daily face-to-face counseling regarding the patient's care and ESRD status. What is the correct code for the patient's dialysis care?
A)90968 (X14)
B)90960
C)90967 (X14)
D)90964
A)90968 (X14)
B)90960
C)90967 (X14)
D)90964
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9
Jones was examined after a car accident as a requirement of his car insurance claim. Which modifier is appropriate to use on the claim?
A)-22
B)-51
C)-99
D)-32
A)-22
B)-51
C)-99
D)-32
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10
Theodore is an elderly 90-year-old man, who has been unable to leave his bed for the last six months. During his last check-up, the physician noticed a pressure ulcer on the back of his calf muscle. The ulcer was already at an elevated stage, with partial thickness skin loss involving the epidermis of the back of the calf. His physician recommended that Theodore be moved to an upright position to relieve the pressure on his calf muscle and prevent infection. If the pressure ulcer persists, Theodore's physician may recommend using a healing chamber as a way to treat the wound before it gets any worse. What is the appropriate way to code Theodore's pressure ulcer?
A)707.09
B)707.06, 707.20
C)707.09, 707.22
D)707.21, 707.22
A)707.09
B)707.06, 707.20
C)707.09, 707.22
D)707.21, 707.22
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11
What is the purpose of a compliance plan?
A)It makes sure you are properly credentialed
B)It allows your office to defend itself in case of an audit
C)It helps your employees claim worker's compensation
D)It helps your office follow the correct coding and billing protocols
A)It makes sure you are properly credentialed
B)It allows your office to defend itself in case of an audit
C)It helps your employees claim worker's compensation
D)It helps your office follow the correct coding and billing protocols
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12
Which of the following is NOT typically included in a global package?
A)The surgical procedure
B)Follow-up appointments related to the procedure, within the global period
C)Appointments for problems that are not related to the procedure
D)Appointments for problems that are related to the procedure
A)The surgical procedure
B)Follow-up appointments related to the procedure, within the global period
C)Appointments for problems that are not related to the procedure
D)Appointments for problems that are related to the procedure
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13
When a CPT code has the words "separate procedure" in parenthesis after the code description, you:
A)Do not use this code if it is listed as a separate procedure
B)Code for all other elements of the procedure except this one
C)Only code for this procedure if it was the only thing performed
D)Code for this procedure, even if it was not performed
A)Do not use this code if it is listed as a separate procedure
B)Code for all other elements of the procedure except this one
C)Only code for this procedure if it was the only thing performed
D)Code for this procedure, even if it was not performed
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14
A 76-year-old woman visited her dermatologist's office in response to a large suspicious nevus on her back. The dermatologist excised the nevus and sent it to the pathology lab for examination. The patient experienced pain excision site, due to its large size and was prescribed pain medication. What two part of Medicare insurance will the patient need to pay for the dermatologist's office visit and the prescription charges?
A)Medicare Parts A and B
B)Medicare Parts B and C
C)Medicare Parts B and D
D)Medicare Parts D and E
A)Medicare Parts A and B
B)Medicare Parts B and C
C)Medicare Parts B and D
D)Medicare Parts D and E
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15
In the RBRVS calculation, the GPCI takes into account:
A)The geographic location of a practice or provider
B)The type of provider specialty
C)The malpractice risk of a procedure
D)The overhead cost of the practice
A)The geographic location of a practice or provider
B)The type of provider specialty
C)The malpractice risk of a procedure
D)The overhead cost of the practice
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16
PROCEDURAL NOTE PATIENT: Trohoske, Janine
AGE: 62
DATE: 01/13/2017
PREOPERATIVE DIAGNOSIS: Degenerative Disc Disease
POSTOPERATIVE DIAGNOSIS: Degenerative Disc Disease
PROCEDURE: Arthrodesis of L4-L2 utilizing autogenous bone graft
An anesthetized patient was placed in the prone position on the operating table and draped in the usual manner. An incision was made along the spinal column, from the area of the L1 to L5, and skin and subcutaneous tissues were pinned back to allow access to the L4-L2 vertebral spaces. A separate fascial incision was made to obtain morselized bone graft segments for arthrodesis procedure. Posterior arthrodesis was then performed along the L4-L2 vertebrae. No additional fixation or instrumentation was placed. Incision was then closed, stapled together, and dressed with a sterile dressing. What is the appropriate code for this procedure?
A)22612, 20937
B)22612, 22614
C)22612, 22614 (X2), 20937
D)22612, 22614 (X2), 20936
AGE: 62
DATE: 01/13/2017
PREOPERATIVE DIAGNOSIS: Degenerative Disc Disease
POSTOPERATIVE DIAGNOSIS: Degenerative Disc Disease
PROCEDURE: Arthrodesis of L4-L2 utilizing autogenous bone graft
An anesthetized patient was placed in the prone position on the operating table and draped in the usual manner. An incision was made along the spinal column, from the area of the L1 to L5, and skin and subcutaneous tissues were pinned back to allow access to the L4-L2 vertebral spaces. A separate fascial incision was made to obtain morselized bone graft segments for arthrodesis procedure. Posterior arthrodesis was then performed along the L4-L2 vertebrae. No additional fixation or instrumentation was placed. Incision was then closed, stapled together, and dressed with a sterile dressing. What is the appropriate code for this procedure?
A)22612, 20937
B)22612, 22614
C)22612, 22614 (X2), 20937
D)22612, 22614 (X2), 20936
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17
The physician performed a right and left heart catheterization with a left ventriculography on 58-year-old male patient. During catheterization, the patient participated in a physiologic exercise study in the form of a bicycle ergometry. How should you code for this service?
A)93531, 93464
B)93451, 93452, 93464
C)93453, 93464
D)93453
A)93531, 93464
B)93451, 93452, 93464
C)93453, 93464
D)93453
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18
What is the purpose of an internal audit?
A)It allows an outside agency to see your records to make sure that the patients were billed correctly
B)It allows the coders and billers in your office to make sure your claims were billed correctly
C)It allows Medicare to go through your charges to make sure that they are reasonable
D)It allows patients to make sure they were not overcharged for their office visit co pays
A)It allows an outside agency to see your records to make sure that the patients were billed correctly
B)It allows the coders and billers in your office to make sure your claims were billed correctly
C)It allows Medicare to go through your charges to make sure that they are reasonable
D)It allows patients to make sure they were not overcharged for their office visit co pays
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19
The patient presents to the laboratory for suspected heavy metal poisoning. The actual amounts of metals detected were not indicated. What laboratory code(s) are appropriate?
A)83018
B)83015
C)82175, 83825, 83885
D)80050
A)83018
B)83015
C)82175, 83825, 83885
D)80050
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20
What is the difference between biopsy codes located in the integumentary section and those found in the musculoskeletal section?
A)The biopsy codes found in the integumentary section are only for codes related to malignant neoplasms
B)There are no biopsy codes found in the musculoskeletal section
C)The codes in the musculoskeletal system include biopsies for bone only, whereas the biopsy codes found in the integumentary section include codes for biopsies of subcutaneous structures including bone
D)The biopsy codes found in the integumentary section are for biopsies of the skin and subcutaneous structures whereas the biopsy codes found in the musculoskeletal section are for deeper structures
A)The biopsy codes found in the integumentary section are only for codes related to malignant neoplasms
B)There are no biopsy codes found in the musculoskeletal section
C)The codes in the musculoskeletal system include biopsies for bone only, whereas the biopsy codes found in the integumentary section include codes for biopsies of subcutaneous structures including bone
D)The biopsy codes found in the integumentary section are for biopsies of the skin and subcutaneous structures whereas the biopsy codes found in the musculoskeletal section are for deeper structures
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21
A physician sutured 3 digital nerves in the left hand, the common sensory nerve in the left foot and two common sensory nerves in the right foot. What codes need to be reported?
A)64831, 64832 (X2), 64834, 64837 (X2)
B)64831, 64832, 64834, 64837
C)64831, 64832 (X4), 64834
D)64831, 64834, 64837 (X4)
A)64831, 64832 (X2), 64834, 64837 (X2)
B)64831, 64832, 64834, 64837
C)64831, 64832 (X4), 64834
D)64831, 64834, 64837 (X4)
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22
The physician performed an annual examination on a 47-year-old male new patient with a history of congenital heart disease. What is the correct E&M code?
A)99387
B)99386
C)99396
D)99397
A)99387
B)99386
C)99396
D)99397
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23
A physician performed a right lumbar hemilaminectomy with decompression of nerve root, including the excision of two herniated intervertebral discs for three vertebral interspaces. How should the physician code for this service?
A)63030, 63035 (X2)
B)63020, 63035 (X2)
C)63042, 63044 (X2)
D)63042, 63044
A)63030, 63035 (X2)
B)63020, 63035 (X2)
C)63042, 63044 (X2)
D)63042, 63044
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24
A pediatric patient with a history of asthma and pneumonia presented to the office with severe respiratory distress. The pediatrician performed a detailed history and comprehensive examination, and diagnosed the patient with status asthmaticus. A pulse oxygen level was taken and it was determined that the patient's blood oxygen level was at 88%. The patient was started on a nebulizer treatment at 0950 hours, which lasted until 1015 hours. The physician then re-checked the patient and determined that the patient's breathing had only slightly improved. A pulse oxygen level was taken again and it was determined that the patient was at 92%. The physician then ordered another nebulizer treatment, which was started at 1032 and continued until 1054. After this second breathing treatment, an additional pulse oxygen level was taken and the patient's blood oxygen level had risen to 97%. The pediatrician then determined that the patient needed to be sent for chest x-rays to determine whether or not pneumonia was present in the lungs. Due to the resulting amount of data and risk, the pediatrician considered the MDM of high complexity. The total time spent with the patient was 1 hour 45 minutes.
What E&M codes would you use to code for the office visit?
A)99214, 99354, 99355 (X2)
B)99215, 99354, 99355
C)99215, 99355 (X3)
D)99215, 99354, 99355 (X2)
What E&M codes would you use to code for the office visit?
A)99214, 99354, 99355 (X2)
B)99215, 99354, 99355
C)99215, 99355 (X3)
D)99215, 99354, 99355 (X2)
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25
ICD-9-CM diagnosis codes for laboratory services are limited to:
A)Volume 1, Chapter 16: Signs, Symptoms, and Ill-Defined Conditions (780-799)
B)Volume 1, Chapter 1: Infectious and Parasitic Diseases (001-139)
C)None, any chapter in the ICD-9-CM manual may be used
D)Volume 1, Supplementary Classification of Factors Influencing Health Status and Contact with Health Services (V-Codes)
A)Volume 1, Chapter 16: Signs, Symptoms, and Ill-Defined Conditions (780-799)
B)Volume 1, Chapter 1: Infectious and Parasitic Diseases (001-139)
C)None, any chapter in the ICD-9-CM manual may be used
D)Volume 1, Supplementary Classification of Factors Influencing Health Status and Contact with Health Services (V-Codes)
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26
Sheila took her 5-year-old daughter to the pediatrician's office for an annual well-child exam. She has a commercial Blue-Cross Blue-Shield insurance plan, through her work, which covers her daughter. Sheila also has Medicaid coverage on her daughter, due to her low-income status. Which one of her insurances is billed for the well-child exam?
A)You bill Blue-Cross Blue-Shield first and Medicaid second
B)You bill Medicaid only
C)You bill Blue-Cross Blue-Shield only
D)You bill Medicaid first and Blue-Cross Blue-Shield second
A)You bill Blue-Cross Blue-Shield first and Medicaid second
B)You bill Medicaid only
C)You bill Blue-Cross Blue-Shield only
D)You bill Medicaid first and Blue-Cross Blue-Shield second
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27
The patient was seen in the emergency department for a severe laceration to the right forearm, following a work injury. The on-call physician performed an expanded problem-focused history assessment and examination, and then sutured the complicated wound using 25-0 vicryl sutures in three subcutaneous layers. The patient was prescribed prophylactic antibiotics and released from the emergency department. The patient was instructed to return to his PCP in one week for a follow-up appointment. The MDM was moderate. What is the correct level of E&M service?
A)99284
B)99282
C)99283
D)99291
A)99284
B)99282
C)99283
D)99291
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28
Unbundling a code is:
A)Unwrapping a code to open a new code
B)Listing multiple procedures, services and supplies with their own separate, distinct codes
C)Using one code to report a variety of services
D)Using a new code to report previous services
A)Unwrapping a code to open a new code
B)Listing multiple procedures, services and supplies with their own separate, distinct codes
C)Using one code to report a variety of services
D)Using a new code to report previous services
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29
Debbie has Type II diabetes, and has been working with her physician to develop diet and exercise techniques that help control her symptoms. Today her doctor also put her on a new medication, which may help control her blood sugar levels better. What is the correct ICD-9 code for Debbie's diabetes?
A)250.0
B)250.00
C)250.02
D)250.80
A)250.0
B)250.00
C)250.02
D)250.80
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30
The physician saw the disabled patient during a home visit. The patient recently moved to be closer to her family therefore she is considered a new patient. The physician performs a detailed history and an expanded problem-focused examination. Due to the lack of risk and small amount of data to be analyzed, the MDM is of low complexity. What is the correct evaluation and management service code?
A)99342
B)99343
C)99348
D)99349
A)99342
B)99343
C)99348
D)99349
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31
When you include an unlisted service procedure code on a claim, what else must you also include on the claim?
A)A Category III code
B)A Category II code
C)A special report
D)All diagnostic studies
A)A Category III code
B)A Category II code
C)A special report
D)All diagnostic studies
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32
The nurse practitioner returned a phone call from a concerned daughter regarding her ailing mother's health. She spent 20 minutes counseling the daughter on how to provide hospice care during the last stages of her mother's life. It had been three weeks since the patient had been seen in the office, and her next scheduled appointment was in two weeks. What E&M service can be reported for this phone call?
A)You cannot report an E&M service for this phone call
B)99442
C)98967
D)99443
A)You cannot report an E&M service for this phone call
B)99442
C)98967
D)99443
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33
The diaphragm is the major muscle that controls breathing. Is this muscle voluntary or involuntary?
A)Voluntary
B)Involuntary
C)Both
D)Neither
A)Voluntary
B)Involuntary
C)Both
D)Neither
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34
What is the correct code for a complete chest x-ray?
A)71020
B)71034
C)71030
D)71020, 71021, 71022, 71023
A)71020
B)71034
C)71030
D)71020, 71021, 71022, 71023
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35
Which of the following is always the payer of last resort?
A)Medicare
B)Medicaid
C)Worker's Compensation Insurance
D)Commercial Insurance
A)Medicare
B)Medicaid
C)Worker's Compensation Insurance
D)Commercial Insurance
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36
PREOPERATIVE DIAGNOSIS: Cyst of Mediastinal Wall POSTOPERATIVE DIAGNOSIS: Tumor of Mediastinal Wall
A physician removed 1.5 cm mass from mediastinal wall, along with appropriate margins. The tumor was sent to pathology to determine the malignancy status.
What is the correct code for this procedure?
A)39200
B)39220
C)39000
D)39010
A physician removed 1.5 cm mass from mediastinal wall, along with appropriate margins. The tumor was sent to pathology to determine the malignancy status.
What is the correct code for this procedure?
A)39200
B)39220
C)39000
D)39010
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37
Contrast material is introduced into a patient in order to better visualize the area being imaged. What are the three main ways that contrast material can be introduced?
A)Intravascularly, Intrathecally, and with an Angiogram
B)Intrathecally, Intravascularly, or Injected into a Vein
C)Intra-Articulary, Intravascularly, or Injected
D)Intravascularly, Intra-Articulary, or Intrathecally
A)Intravascularly, Intrathecally, and with an Angiogram
B)Intrathecally, Intravascularly, or Injected into a Vein
C)Intra-Articulary, Intravascularly, or Injected
D)Intravascularly, Intra-Articulary, or Intrathecally
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38
Medical billing fraud is:
A)Billing for services at a reduced level
B)Billing correctly for services performed
C)Billing for services that are not medically necessary
D)Billing for services that were not performed
A)Billing for services at a reduced level
B)Billing correctly for services performed
C)Billing for services that are not medically necessary
D)Billing for services that were not performed
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39
Devonne recently experienced a death in her family and has been severely depressed. She went to her psychiatrist and he prescribed a new anti-depressant drug. After Devonne started taking the anti-depressant, she experienced nausea, vomiting, and dizziness. She called her physician, who advised her to stop taking the anti-depressant and come into the clinic so that he could examine her and prescribe a new anti-depressant. What are the appropriate ICD-9 diagnosis codes for Devonne's reaction to the anti-depressant?
A)969.00, 787.01, 780.4, E939.0
B)969.01, 787.01, E854.0
C)969.00, 780.4, 787.01
D)969.09, 787.01, 780.4, E950.3
A)969.00, 787.01, 780.4, E939.0
B)969.01, 787.01, E854.0
C)969.00, 780.4, 787.01
D)969.09, 787.01, 780.4, E950.3
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40
A physician performed a cystourethroscopy with an ejaculatory duct catheterization and irrigation. Duct radiography was also performed to visualize ejaculatory duct system. What CPT codes should be reported?
A)52000, 52010
B)52000, 52010, 74440
C)52010, 74440
D)52010
A)52000, 52010
B)52000, 52010, 74440
C)52010, 74440
D)52010
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41
Beck was recently seen in the hospital by Dr. Johnson, who is his PCP. Dr. Johnson usually treats Mr. Beck for his stomach issues, but he has not had any problems in the last four years, so he has not scheduled any follow-up appointments. Mr. Beck was recently weed-eating in his backyard when a rock flew up and hit him in the eye. Dr. Johnson was the on-call physician, who treated Mr. Beck for his eye injury. He recommended that Mr. Beck schedule a follow-up visit the next week. Will Dr. Johnson bill the follow-up visit as a new patient or as an established patient?
A)New
B)Established
C)Not enough information provided to determine patient status
A)New
B)Established
C)Not enough information provided to determine patient status
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42
HIPAA was created to:
A)Protect patient privacy
B)Enact ways to uncover fraud and abuse
C)Create standards of electronic transactions
D)All of the above
E)Only options A and B
A)Protect patient privacy
B)Enact ways to uncover fraud and abuse
C)Create standards of electronic transactions
D)All of the above
E)Only options A and B
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43
A physician can base the level of an evaluation and management service on the time spent counseling the patient and nothing else.
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44
Steve gets tested regularly for HIV at his local health clinic because he is part of a high-risk group. So far, Steve has not had any positive HIV test results, but his last test came back as inconclusive. What diagnosis code(s) would be assigned for Steve?
A)042
B)795.71, V69.8
C)V73.89, V65.44
D)V08
A)042
B)795.71, V69.8
C)V73.89, V65.44
D)V08
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45
What are the three major components of an intestinal transplant?
A)Cadaver Enterectomy, Backbench Work, and Biopsy of Lesion
B)Living Donor Enterectomy, Preparation of the Intestine, and Transplantation with Enterectomy
C)Cadaver Enterectomy, Biopsy of Intestinal Wall, and Allotransplantation
D)Cadaver Anastomosis, Backbench Work, and Recipient Allotransplantation
A)Cadaver Enterectomy, Backbench Work, and Biopsy of Lesion
B)Living Donor Enterectomy, Preparation of the Intestine, and Transplantation with Enterectomy
C)Cadaver Enterectomy, Biopsy of Intestinal Wall, and Allotransplantation
D)Cadaver Anastomosis, Backbench Work, and Recipient Allotransplantation
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46
Jenny is on dialysis three times a week, 4 hours a day, due to her End-Stage Renal Disease. Yesterday she went into her primary care office and they diagnosed her with anemia, as a side-effect of her ESRD. What are the correct ICD-9 codes for her visit?
A)285.22, 585.1
B)285.21, 585.9
C)585.6, 282.21
D)285.21, 585.6
A)285.22, 585.1
B)285.21, 585.9
C)585.6, 282.21
D)285.21, 585.6
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47
Larry works at a cola bottling company and as one of his job duties, he is required to lift heavy boxes of syrup onto pallets. He is also required, by the safety department, to wear a back brace and hernia belt. Larry was lifting a large box of syrup on to a pallet when he suffered a severe abdominal hernia. Will worker's compensation insurance cover his medical costs?
A)Yes
B)No
C)Only if he was wearing the back brace and hernia belt while he was lifting the box
D)Only if he was clocked in and lifting the box as one of his job duties
A)Yes
B)No
C)Only if he was wearing the back brace and hernia belt while he was lifting the box
D)Only if he was clocked in and lifting the box as one of his job duties
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48
Which of the following steps is NOT needed before an unlisted services procedure code can be included on a claim?
A)Review the CPT manual to make sure a more appropriate code does not exist
B)Review Category II codes to make sure an appropriate code does not exist
C)Review Category III codes to make sure an appropriate code does not exist
D)Check to see if a modifier is appropriate to include with your code
A)Review the CPT manual to make sure a more appropriate code does not exist
B)Review Category II codes to make sure an appropriate code does not exist
C)Review Category III codes to make sure an appropriate code does not exist
D)Check to see if a modifier is appropriate to include with your code
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49
What is the purpose of provider credentialing?
A)To make sure that your provider is performing the correct procedures
B)To make sure that your provider is correctly licensed to perform procedures
C)To make sure your provider pays all the necessary fees to practice medicine
D)To allow your doctor to check the credentials of private insurance companies
A)To make sure that your provider is performing the correct procedures
B)To make sure that your provider is correctly licensed to perform procedures
C)To make sure your provider pays all the necessary fees to practice medicine
D)To allow your doctor to check the credentials of private insurance companies
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50
A new patient was seen in the office complaining of ear pain, headache and a mild fever. The physician performed a problem-focused history assessment and an expanded problem-focused examination on the patient. The physician diagnosed the patient with an acute inner ear infection. This medical diagnosis was considered to be of low complexity. What is the correct E&M code for the service?
A)99212
B)99202
C)99201
D)99211
A)99212
B)99202
C)99201
D)99211
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51
Two weeks ago, a 32-year-old male suffered a thumb injury at work. He was using a belt grinder on a small piece of steel when the belt caught the tip of his left thumb in the grinder. His thumb was ground down to the tip, his thumb nail was removed and a small piece of his anterior phalange bone was broken off. The patient has an appointment scheduled today to see if his nail bed on his left thumb can be reconstructed using a graft from his left great toe. What is code for this procedure?
A)11760-LT
B)11765
C)11762-LT
D)11730, 11732
A)11760-LT
B)11765
C)11762-LT
D)11730, 11732
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52
When selecting an evaluation and management code, what is the first thing that the coder needs to determine?
A)The time the provider spent with the patient
B)The appropriate category of E&M service
C)Whether the patient was new or established
D)How long the discharge took
A)The time the provider spent with the patient
B)The appropriate category of E&M service
C)Whether the patient was new or established
D)How long the discharge took
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53
Walt has metastatic lung cancer. He also has skin melanoma, which is the primary neoplasm. Today he is being seen for treatment and evaluation of his lung cancer. Which of the following is the correct way to code his diagnoses for today's visit?
A)172.8, 197.0
B)162.9, 172.8
C)197.0, 172.8
D)197.0
A)172.8, 197.0
B)162.9, 172.8
C)197.0, 172.8
D)197.0
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54
The ICD-9-CM and CPT manuals recognize three abortions. They are spontaneous, _____________, and missed.
A)Miscarriage
B)Legal
C)Induced
D)Fatality
A)Miscarriage
B)Legal
C)Induced
D)Fatality
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55
In the CPT manual, Appendix C lists clinical examples of:
A)Surgical procedures
B)Radiological procedures
C)Dermatology procedures
D)Evaluation and management procedures
A)Surgical procedures
B)Radiological procedures
C)Dermatology procedures
D)Evaluation and management procedures
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56
According to coding conventions, NEC stands for:
A)Not Elsewhere Code able
B)Never Either Coded
C)Not Elsewhere Classifiable
D)No Other Coding
A)Not Elsewhere Code able
B)Never Either Coded
C)Not Elsewhere Classifiable
D)No Other Coding
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57
A 27-year-old woman in labor presented to the emergency room. Upon admission and evaluation, it was determined that the fetus was in breech position. Due to the severity of the mother's contractions, the OB decided that tocolysis was necessary in order to delay the contractions to allow for an external cephalic version procedure. The OB and the delivery team of nurses carefully performed the external cephalic version and successfully turned the fetus into the appropriate delivery position, at which time the tocolysis was ceased and the patient was given Pitocin to begin contractions again. The baby was successfully delivered vaginally after three additional hours of labor.
How should the OB code for the procedure?
A)59400
B)59412
C)59400 -22
D)59400, 59412 -51
How should the OB code for the procedure?
A)59400
B)59412
C)59400 -22
D)59400, 59412 -51
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58
In order for a physician to appropriately code for a consultation service, three things must be documented. What are those three things?
A)The referral or request from the PCP, the rendering of the opinion by the specialist or consultant, and the written report or findings sent from the specialist to the PCP
B)The rendering of the specialty service to the patient, the referral of the patient from the specialist to an additional specialist, and the written report of the findings provided to the specialist
C)The specialist request of a second opinion regarding the patient, the PCP's advice regarding which second specialist the patient should see, and the second specialist's report or findings
D)The referral from the PCP to the specialist, an additional referral from the specialist to another specialist, and the written report or findings sent from the specialist to the PCP
A)The referral or request from the PCP, the rendering of the opinion by the specialist or consultant, and the written report or findings sent from the specialist to the PCP
B)The rendering of the specialty service to the patient, the referral of the patient from the specialist to an additional specialist, and the written report of the findings provided to the specialist
C)The specialist request of a second opinion regarding the patient, the PCP's advice regarding which second specialist the patient should see, and the second specialist's report or findings
D)The referral from the PCP to the specialist, an additional referral from the specialist to another specialist, and the written report or findings sent from the specialist to the PCP
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59
The physician on duty examined the patient and determined that patient was ready for discharge. The physician spent 25 minutes on the hospital discharge of an inpatient discharge. What is the correct procedure code?
A)99238
B)99239
C)99217
D)99315
A)99238
B)99239
C)99217
D)99315
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60
A physician has been treating a patient with endocarditis for the past two weeks. Due to the patient's chronic inflammation of the heart's lining, the physician sent a blood sample to the lab, which detected trace amounts of the bacteria staphylococcus. Now that the physician knows the bacterium that is causing the endocarditis, he can prescribe an appropriate antibiotic to fight the infection and treat the condition. What are the correct diagnosis codes for this patient's condition?
A)421.0, 041.10
B)041.10, 421.0
C)041.11, 421.0
D)421.0, 041.00
A)421.0, 041.10
B)041.10, 421.0
C)041.11, 421.0
D)421.0, 041.00
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61
Etta has been using corticosteroids for severe hay fever asthma for the last few years, and is now experiencing some eye problems. Her physician told her that she was only in the early stages of glaucoma, which could be treated to ensure her vision for the rest of her life. What is the correct code for the ICD-9 codes for Etta's condition?
A)365.31, 365.71
B)365.32, 365.71
C)365.31, 365.72
D)365.9, 365.71
A)365.31, 365.71
B)365.32, 365.71
C)365.31, 365.72
D)365.9, 365.71
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62
HOSPITAL CHARGE SHEET PATIENT: Carson, Cason
AGE: 10
DATE OF ADMISSION: 01/02/2014
DIAGNOSIS: Coccidiomycosis Meningitis
DATE OF DISCHARGE: 01/08/2014
The patient was admitted on 01/02/2014 complaining of a severe headache and hyperpyrexia. An lumbar puncture determined on 01/02/2014 that the patient was suffering from coccidiomycosis meningitis. The patient was administered antibiotics and admitted to the hospital for observation and management of the condition. The patient's condition improved slowly with a regression on 01/05/2014, at which time the antibiotics were changed. After the change in medication, the patient's condition rapidly improved and by 01/07/2014, the patient no longer developed a fever or headache when not on pain medications. On 01/08/2012, the physician spent 20 minutes managing patient discharge, with instructions to continue antibiotics and pain medications, as needed.
What E&M service codes would be reported for this service?
A)99222 (X2), 99232 (X3), 99231 (X3), 99238 (X2)
B)99232 (X7)
C)99222, 99232, 99231 (X6)
D)99222, 99232 (X3), 99231 (X2), 99238
AGE: 10
DATE OF ADMISSION: 01/02/2014
DIAGNOSIS: Coccidiomycosis Meningitis
DATE OF DISCHARGE: 01/08/2014
The patient was admitted on 01/02/2014 complaining of a severe headache and hyperpyrexia. An lumbar puncture determined on 01/02/2014 that the patient was suffering from coccidiomycosis meningitis. The patient was administered antibiotics and admitted to the hospital for observation and management of the condition. The patient's condition improved slowly with a regression on 01/05/2014, at which time the antibiotics were changed. After the change in medication, the patient's condition rapidly improved and by 01/07/2014, the patient no longer developed a fever or headache when not on pain medications. On 01/08/2012, the physician spent 20 minutes managing patient discharge, with instructions to continue antibiotics and pain medications, as needed.
What E&M service codes would be reported for this service?
A)99222 (X2), 99232 (X3), 99231 (X3), 99238 (X2)
B)99232 (X7)
C)99222, 99232, 99231 (X6)
D)99222, 99232 (X3), 99231 (X2), 99238
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63
What is the correct code for the plastic repair of cleft lip with nasal deformity when utilizing an Abbe-Estlander cross-lip pedicle flap?
A)40527
B)40761
C)42200
D)40700
A)40527
B)40761
C)42200
D)40700
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64
Mastoiditis is inflammation of the middle ear, a condition that can occur when a chronic ear infection goes untreated. If a cholesteatoma develops as a result of a chronic ear infection, the surgeon may elect to remove the inflamed area. This procedure is referred to as which of the following:
A)Cochlear Implantation
B)Ossicular Surgery
C)Mastoidectomy
D)Retrobulbar Injection
A)Cochlear Implantation
B)Ossicular Surgery
C)Mastoidectomy
D)Retrobulbar Injection
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65
There are many types of urinary tract infections. Which of the following diagnosis codes represents an infection of just the urethra?
A)597.80
B)595.0
C)590.80
D)590.10
A)597.80
B)595.0
C)590.80
D)590.10
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66
Jaime is a 9-year-old obese boy. Jaime's pediatrician suspects that he may have hypertension due to his weight, but has not come to a conclusive diagnosis yet. So far, he has had two elevated blood pressure readings, but has not been diagnosed with hypertension. Jaime saw his pediatrician today for a blood pressure reading, which was elevated. What is the correct diagnosis code for Jaime's office visit?
A)401.9
B)401.0
C)405.9
D)796.2
A)401.9
B)401.0
C)405.9
D)796.2
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67
The procedure known as blepharoplasty is performed to:
A)Correct the muscle misalignment caused by strabismus
B)Correct vision loss due to glaucoma
C)Plastic repair a droopy eyelid
D)Repair the lens of the eye caused by cataracts
A)Correct the muscle misalignment caused by strabismus
B)Correct vision loss due to glaucoma
C)Plastic repair a droopy eyelid
D)Repair the lens of the eye caused by cataracts
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68
In the electrical conduction system of the heart, the sinoatrial node is located in the right atrium near the superior vena cava. It serves as the normal pacemaker of the heart. There is another node, which is located in the right atrium on the septal wall. This node slows the impulses of the heart so that the atria can fill with blood before it contracts. What is the name of this node?
A)Sinoatrial Node
B)Bundle of His
C)Purkinje Fibers
D)Atrioventricular Node
A)Sinoatrial Node
B)Bundle of His
C)Purkinje Fibers
D)Atrioventricular Node
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69
Brown, a dermatologist, opened and drained multiple complicated acne pustules and comedones on a 19-year-old patient with severe acne. For one of the more complicated acne pustules, Dr. Brown incised, drained, and marsupialized the acne cyst by suturing the right and left sides, leaving the cyst open for drainage. What is the correct code for the procedure?
A)10060
B)10061, 10040
C)10040
D)10061
A)10060
B)10061, 10040
C)10040
D)10061
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70
Alma is a 32-weeks pregnant, Type I diabetic, who was diagnosed at 10-years-old. She has taken insulin continuously since her diagnosis. So far, Alma' diabetes has not significantly affected her pregnancy, but Alma and her physicians have closely monitored her pregnancy and diabetes. What are the correct ICD-9 diagnosis codes for Alma's condition?
A)648.80, V58.67
B)648.00, 250.00
C)648.00, 250.01, V58.67
D)648.80, 250.01, V58.67
A)648.80, V58.67
B)648.00, 250.00
C)648.00, 250.01, V58.67
D)648.80, 250.01, V58.67
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71
The lymphatic system contains four organs:
A)Spleen, tonsils, bone marrow, and thymus
B)Spleen, Peyer's patches, and tonsils
C)Spleen, tonsils, Peyer's patches, and thymus
D)Tonsils, Peyer's patches, thymus, and bone marrow
A)Spleen, tonsils, bone marrow, and thymus
B)Spleen, Peyer's patches, and tonsils
C)Spleen, tonsils, Peyer's patches, and thymus
D)Tonsils, Peyer's patches, thymus, and bone marrow
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72
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
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
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73
After careful selection and testing of bone marrow donors, a potential candidate was found for a patient with severe leukemia. The physician collected a small sample of the potential donor's bone marrow via aspiration technique. This sample was then sent to pathology to determine whether or not it would be a match for the patient's bone marrow. What is the correct code for the procedure performed by the physician?
A)38221
B)38220
C)38230
D)38232
A)38221
B)38220
C)38230
D)38232
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74
Two weeks ago, James was walking in the mountains and scratched his leg with a large branch on the edge of the trail. Yesterday, he went to the pediatrician's office because his scratch was not healing and was getting worse. Today, he is being seen again by the pediatrician, who diagnosed James with MRSA cellulitis at the site of the wound on his leg. Which of the following represents the correct code(s) for today's visit?
A)682.6, 041.12
B)686.9, 041.11
C)958.3, 041.12
D)041.12
A)682.6, 041.12
B)686.9, 041.11
C)958.3, 041.12
D)041.12
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