Question 1

What is the correct code for the plastic repair of cleft lip with nasal deformity when utilizing an Abbe-Estlander cross-lip pedicle flap?

Accepted Answer

A)  40527
B)  40761
C)  42200
D)  40700 A

Question 2

There are many types of urinary tract infections. Which of the following diagnosis codes represents an infection of just the urethra?

Accepted Answer

A)  597.80
B)  595.0
C)  590.80
D)  590.10 A

Question 3

Jones was examined after a car accident as a requirement of his car insurance claim. Which modifier is appropriate to use on the claim?

Accepted Answer

A)  -22
B)  -51
C)  -99
D)  -32 D

Question 4

The procedure known as blepharoplasty is performed to:

Accepted Answer

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

Question 5

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?

Accepted Answer

A)  Sinoatrial Node
B)  Bundle of His
C)  Purkinje Fibers
D)  Atrioventricular Node

Question 6

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?

Accepted Answer

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

Question 7

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?

Accepted Answer

A)  93531, 93464
B)  93451, 93452, 93464
C)  93453, 93464
D)  93453

Question 8

The diaphragm is the major muscle that controls breathing. Is this muscle voluntary or involuntary?

Accepted Answer

A)  Voluntary
B)  Involuntary
C)  Both
D)  Neither

Question 9

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?

Accepted Answer

A)  63030, 63035 (X2) 
B)  63020, 63035 (X2) 
C)  63042, 63044 (X2) 
D)  63042, 63044

Question 10

Which of the following steps is NOT needed before an unlisted services procedure code can be included on a claim?

Accepted Answer

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

Question 11

What is the purpose of an internal audit?

Accepted Answer

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

Question 12

Which of the following is NOT typically included in a global package?

Accepted Answer

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

Question 13

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?

Accepted Answer

A)  52000, 52010
B)  52000, 52010, 74440
C)  52010, 74440
D)  52010

Question 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?

Accepted Answer

A)  Medicare Parts A and B
B)  Medicare Parts B and C
C)  Medicare Parts B and D
D)  Medicare Parts D and E

Question 15

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?

Accepted Answer

A)  90968 (X14) 
B)  90960
C)  90967 (X14) 
D)  90964

Question 16

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?

Accepted Answer

A)  99214, 99354, 99355 (X2) 
B)  99215, 99354, 99355
C)  99215, 99355 (X3) 
D)  99215, 99354, 99355 (X2)

Question 17

According to coding conventions, NEC stands for:

Accepted Answer

A)  Not Elsewhere Code able
B)  Never Either Coded
C)  Not Elsewhere Classifiable
D)  No Other Coding

Question 18

When selecting an evaluation and management code, what is the first thing that the coder needs to determine?

Accepted Answer

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

Question 19

In order for a physician to appropriately code for a consultation service, three things must be documented. What are those three things?

Accepted Answer

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

Question 20

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?

Accepted Answer

A)  New
B)  Established
C)  Not enough information provided to determine patient status

Exam 1: Medical Coding