Question 1

There is a question concerning a claim for a procedure submitted last year. Where will you look to double-check the codes in question?

Accepted Answer

A)  The current CPT 
B)  Last year's CPT 
C)  ICD-9-CM for last year 
D)  ICD-9-CM for this year 
E)  ICD-10-CM

Question 2

HCPCS Level I codes ____.

Accepted Answer

A)  duplicate ICD-9-CM codes 
B)  duplicate ICD-10-CM codes 
C)  supplement CPT codes 
D)  are also known as CPT codes 
E)  modify CPT codes

Question 3

When coding a surgical code, where should you look to be sure you find the correct code?

Accepted Answer

A)  Go directly to the E/M section in the front of the CPT manual 
B)  Use the alphabetic listing of procedures at the back of the CPT manual 
C)  Consult the Introduction to the CPT manual 
D)  Use the numeric index to find the code 
E)  Use the superbill that describes the patient encounter

Question 4

The ________ of the medical decision making is a key factor in determining the level of E/M codes selected.

Accepted Answer

The answer of The ________ of the medical decision making...

Question 5

The extent of the patient ________ taken is a key factor in determining the level of E/M codes selected.

Accepted Answer

The answer of The extent of the patient ________ taken...

Question 6

A(n) ________ patient is one that has been seen by the physician within the past three years.

Accepted Answer

The answer of A(n) ________ patient is one that has...

Question 7

Billing for a moderate level evaluation and management service when only a simple BP check and injection were carried out is an example of ____.

Accepted Answer

A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice

Question 8

If a laboratory bills for a general health panel but fails to perform one of the tests, it is guilty of which of these fraudulent coding and billing practices?

Accepted Answer

A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice

Question 9

Which of the following items is not required for a service to be considered a consultation?

Accepted Answer

A)  Request from another physician 
B)  Documentation of the findings 
C)  Record of recommendations 
D)  Revision of the initial diagnosis 
E)  Report to the referring physician

Question 10

For reporting purposes, CPT considers a patient "new" if the patient has not received professional services within the past ____ year(s).

Accepted Answer

A)  one 
B)  two 
C)  three 
D)  four 
E)  five

Question 11

A healthcare provider who practices under false qualifications or credentials is guilty of ____.

Accepted Answer

A)  slander 
B)  defamation 
C)  assault 
D)  libel 
E)  fraud

Question 12

How many codes are required for an injection of a vaccine?

Accepted Answer

A)  0 
B)  1 
C)  2 
D)  3 
E)  Depends on the type of vaccine

Question 13

Which subsection of the surgery section include procedures on the spleen and bone marrow?

Accepted Answer

A)  Cardiovascular System 
B)  Digestive System 
C)  Hemic/Lymphatic Systems 
D)  Endocrine System 
E)  Laboratory Procedures

Question 14

An add-on code describes ____.

Accepted Answer

A)  special circumstances that apply to a procedure 
B)  surgical or other supplies that were used during a procedure 
C)  other procedures done in addition to a main procedure 
D)  medications used during a procedure 
E)  the type of anesthetic that was used during a procedure

Question 15

Any code that includes more than one procedure in its description is considered a(n) ________ code.

Accepted Answer

The answer of Any code that includes more than one...

Question 16

Which of the following best describes HCPS Level II codes?

Accepted Answer

A)  The codes have five characters: numbers, letters, or a combination of both. 
B)  The codes have six characters, including two initial letters followed by four numbers. 
C)  The codes have five numeric digits. 
D)  The codes have six alphabetic characters (letters). 
E)  The codes have five alphabetic characters (letters).

Question 17

What symbol appears next to a code that appears out of numerical sequence?

Accepted Answer

A)  Red dot 
B)  Blue triangle 
C)  Lightning bolt 
D)  Pound (#) sign 
E)  Green arrows

Question 18

_______ codes are the most frequently used of all CPT codes because they are used by all physicians in any medical specialty.

Accepted Answer

The answer of _______ codes are the most frequently used...

Question 19

A physician bills separately for a comprehensive metabolic panel and a quantitative glucose test, which is normally included in the metabolic panel. This is an example of which of the following fraudulent coding and billing practices?

Accepted Answer

A)  Reporting services that were not performed 
B)  Reporting services at a higher level than was carried out 
C)  Performing procedures not related to the patient's condition 
D)  Billing separately for services that are bundled in a single procedure code 
E)  Reporting the same service twice

Question 20

To find information regarding prefixes and suffixes used in the CPT manual, you would look in the ____.

Accepted Answer

A)  Evaluation and Management section of the manual 
B)  general index for the manual 
C)  Introduction to the manual 
D)  office procedures manual 
E)  beginning of each section of the manual

Exam 19: Procedure Coding

There is a question concerning a claim for a procedure submitted last year. Where will you look to double-check the codes in question?

HCPCS Level I codes ____.

When coding a surgical code, where should you look to be sure you find the correct code?

The ________ of the medical decision making is a key factor in determining the level of E/M codes selected.

The extent of the patient ________ taken is a key factor in determining the level of E/M codes selected.

A(n) ________ patient is one that has been seen by the physician within the past three years.

Billing for a moderate level evaluation and management service when only a simple BP check and injection were carried out is an example of ____.

If a laboratory bills for a general health panel but fails to perform one of the tests, it is guilty of which of these fraudulent coding and billing practices?

Which of the following items is not required for a service to be considered a consultation?

For reporting purposes, CPT considers a patient "new" if the patient has not received professional services within the past ____ year(s) .

A healthcare provider who practices under false qualifications or credentials is guilty of ____.

How many codes are required for an injection of a vaccine?

Which subsection of the surgery section include procedures on the spleen and bone marrow?

An add-on code describes ____.

Any code that includes more than one procedure in its description is considered a(n) ________ code.

Which of the following best describes HCPS Level II codes?

What symbol appears next to a code that appears out of numerical sequence?

_______ codes are the most frequently used of all CPT codes because they are used by all physicians in any medical specialty.

A physician bills separately for a comprehensive metabolic panel and a quantitative glucose test, which is normally included in the metabolic panel. This is an example of which of the following fraudulent coding and billing practices?

To find information regarding prefixes and suffixes used in the CPT manual, you would look in the ____.