Wednesday, December 16, 2009

Medical Coding Quiz CCS/ CCS-P


1. Complete the following statement, “Medically necessary services are . . . “

a. Consistent with the symptoms or diagnosis of the illness or injury being treated.
b. Reasonable. That is, in line with mainstream medical practice.
c. Reasonable and necessary for the patient’s condition and not performed primarily for the convenience of the patient, the attending physician, or the supplier.
d. All of the above.

2. In the SOAP format of medical record documentation, what term describes the section of the medical record that contains the notes for the physician’s examination of the key components of the E/M codes (what the physician observes)?

a. Subjective
b. Objective
c. Assessment
d. Plan

3. Referring to the SOAP format, the following statement would be found in what section of the medical record: “The patient is a 10-year-old female who has experienced right ear pain starting last night after dinner.”

a. Subjective
b. Objective
c. Assessment
d. Plan

4. In what portion of the medical record would you find the following statement: “Patient to apply ice pack around ankle three times a day to prevent further swelling; Tylenol as needed to relieve pain.”

a. Subjective
b. Objective
c. Assessment
d. Plan

5. The intentional misrepresentation by either providers or beneficiaries to obtain or receive payment for services is referred to as:

a. Unbundling
b. Fraud
c. Limiting Charges
d. All of the above

6. The prefix “path-“ means:

a. System
b. Organ
c. Disease
d. Cell

7. One of the three bones that constitutes the pelvic girdle is called:

a. Ileum
b. Lunette
c. Coccyx
d. Ilium

8. A laryngoscopy is:

a. A visual examination of the larynx
b. The inflammation of the larynx
c. The defective development of the larynx
d. An instrument used to examine the membrane of the larynx

9. The term “carcinoma in situ” refers to:

a. A malignant neoplasm found at the original site
b. A secondary or metastasized neoplasm
c. Malignancies that are confined or noninvasive
d. Tissue that is beginning to exhibit neoplastic behavior

10. A 6-year-old girl fell on the playground at school. An x-ray revealed a distal radial fracture. Where is this located?

a. Thumb side of lower forearm
b. Outside lower leg
c. Just below elbow on the thumb side
d. Lower part of the upper arm

11. Which term describes the most important reason for the care provided to the patient; that is, the first diagnosis code listed on the insurance form?

a. Complications
b. Adverse effect
c. Primary diagnosis
d. Symptoms

12. The term “adverse effect” means:

a. Secondary diagnosis code used to identify the external cause for a condition for which the patient is being seen
b. A morbid phenomenon or departure from the normal structure, function, or sensation experienced by the patient and indicative of the disease
c. The term denoting name of the disease or syndrome a person has or is believed to have
d. None of the above

13. Which of the following is a FALSE statement?

a. When only ancillary services are provided, list the appropriate V code first and the problem or condition second.
b. Code the primary diagnosis code first followed by the secondary, tertiary, and so on. Code any co-existing conditions that affect the treatment of the patient for the visit or procedure as supplementary information.
c. Only code a chronic diagnosis once, as it is not applicable to the patient’s current treatment.
d. Identify the service(s) or visit(s) for circumstances other than the disease or injury such as follow-up care

14. The symbol [ ] indicates:

a. Synonyms, alternate wording, or explanatory phrases
b. Supplementary words that may be present or absent without affecting the code assignment
c. A series of terms, each of which is modified by the statement appearing to the right
d. The code is specified

15. Which reference manual contains a listing of “V” and “E” codes as well as a numerical listing that classifies groups of disease and injury codes according to etiology and organ system?

a. CPT

16. A 16-year-old female was admitted to the ER for abdominal pain, nausea and vomiting, and diarrhea. Upon discharge, she was diagnosed with a ruptured ovarian cyst.

a. 789.0
b. 620.2
c. 789.03
d. 620.2, 789.03

17. A superficial burn to the right shoulder.

a. 942.04
b. 943.40
c. 943.15
d. 692.71

18. A four-week-old infant who is admitted for pyloric stenosis.

a. 750.5
b. 537.0
c. 779.3
d. 536.2

19. HCPCS is the acronym for:

a. Health Care Procedure Coding System
b. Health Coding Procedural Counting System
c. HCFA Common Procedure Coding System
d. Hospital Coding Procedural Care Services

20. Chose the appropriate HCPCS code for a semi-rigid, thermoplastic foam, two-piece cervical collar.

a. L0120
b. E0943
c. E0942
d. L0172

21. What is the HCPCS code for 1 cc of Testosterone Cypionate 50 mg?

a. J1090
b. J1060
c. J0900
d. J3140

22. Which modifier indicates diagnostic mammogram converted from screening mammogram on the same day?

a. –59
b. –58
c. –AT
d. –GH

23. What is the HCPCS code for wound closure using tissue adhesive(s) only?

a. A6250
b. G0168
c. A6265
d. G0170

24. Which of the following is the correct HCPCS code for 250 mg of Cyclosporin, parenteral?

a. J7502
b. J7516
c. K0121
d. J7515

25. Which modifier is used to describe a CLIA waived test?

a. QP
b. QW
c. GA
d. SG

26. In the CPT-4 text, what does the bullet symbol (•) represent?

a. Revised codes
b. New codes
c. Add-on codes
d. Service includes surgical procedure only

27. When two surgeons work together as primary surgeons performing distinct part(s) of a single reportable procedure, each surgeon should report his/her distinct operative work by adding which of the following modifiers?

a. –54
b. –66
c. –59
d. –62

28. When a patient is in a postoperative period and returns to the operating room for an unrelated procedure by the same physician, which of the following modifiers would you attach to the procedure being performed?

a. –59
b. –24
c. –78
d. –79

29. Evaluation and Management services were performed on an established patient in which the decision to perform a major surgery scheduled for the following morning was made. The patient was counseled for 15 minutes regarding treatment options, risks, and projected outcome. Which of the following modifiers would be appended to the service performed?

a. –56
b. –52
c. –50
d. –57

30. In the CPT-4 text, what does the following symbol represent (+)?

a. Revised codes
b. New codes
c. Add-on codes
d. Service includes surgical procedure only

31. The index in the CPT-4 text is arranged with main term entries. These main term entries will fall into one or more of four categories. Identify the four categories.

a. The procedure or service performed; the anatomical site involved; the condition; the modifying term.
b. The procedure or service performed; the organ or anatomical site; the code range; the synonym, eponym, or abbreviation.
c. The procedure or service performed; the organ or other anatomical site; the condition; the synonym, eponym, or abbreviation.
d. The modifying terms; the anatomical site; the disease; the synonyms, eponyms, or abbreviations.

32. A three-year-old established patient presents to her pediatrician for an earache and abdominal pain. The physician documented the chief complaint, a brief HPI, and problem pertinent system review. An examination of the respiratory system and the abdomen was performed. The physician prescribed an antibiotic and clear liquids for gastroenteritis. Select the E/M service code for this visit.

a. 99212
b. 99202
c. 99213
d. 99203

33. An out-of-state patient came to visit a Nephrologist to establish temporary care. The patient filled out a detailed history form, which was reviewed by the MD and his documentation recorded in the patient’s chart. The Nephrologist performed a detailed exam and made arrangements for local dialysis care. This history, exam, and medical decision-making took approximately thirty minutes. In addition, the physician spent 40 minutes with the patient and a family member discussing the new treatment options available for Chronic Renal Failure by addressing the patient concerns regarding the medical treatment he is receiving from his own Nephrologist. Code this encounter.

a. 99244
b. 99203-21
c. 99203, 99354
d. 99291

34. A routine E/M visit to stabilize a patient in ICU/CCU utilizes what code range?

a. 99234-99236
b. 99231-99233
c. 99291-99292
d. 99271-99275
35. The descriptors for the levels of E/M services recognize seven components in defining the levels of E/M services. Which components are considered the key components in selecting an E/M level of service?

a. Counseling, Time, and Examination
b. History, Examination, and Medical Decision Making
c. History, Time, and Medical Decision Making
d. Time, Examination, and Medical Decision Making

36. In the case where a patient is held in observation for more than two calendar dates, the physician must bill subsequent services furnished prior to the discharge utilizing which code range?

a. 99211-99215
b. 99201-99205
c. 99234-99236
d. 99231-99233

37. A physician is requested to stand by during a high-risk delivery of a newborn. The physician was on standby for forty-five minutes. Which code would be billed for this standby service?

a. 99436
b. 99360
c. 99360 x 2
d. 99431

38. What code would be reported for the delivery and discharge of a newborn on the same day?

a. 99431
b. 99432
c. 99435
d. 99238

39. Spinal anesthesia is defined as:

a. An injection of a local anesthetic solution into the subarachnoid space of the lumbar region to block the roots of the spinal nerves
b. The spinal nerves are blocked with injected local anesthetic agent into the epidural space of the spinal cord
c. When muscular relaxation occurs throughout the body, the muscles lose their tone; ocular movements cease; the pupils are centrally fixed.
d. None of the above

40. Continuous epidural analgesia for labor and a cesarean delivery

a. 00857-P1
b. 00955-P1
c. 59514-47
d. 88050-P1

41. Which of the following is not needed when billing for Monitored Anesthesiology Care (MAC)?

a. Modifier –QS
b. Total minutes of anesthesia service
c. Modifier –66
d. Documentation

42. A patient required an epidural in place for four days. The anesthesiologist checked it every day. How would daily visits be coded for an anesthesiologist when the patient’s primary physician also saw the patient?

a. 00700
b. 00850
c. 01996
d. 11760

43. When an anesthesiologist is utilized to provide services to a patient with a broken fibula requiring cast repair, the anesthesia services are reported with code(s):

a. 01462
b. 27780-47
c. 01490
d. 01999

44. Anesthesia complicated by emergency conditions would require the use of what modifier or CPT code?

a. –23
b. P5
c. 99100
d. 99140

45. Code the cryosurgery of a 1.5 cm pre-malignant lesion on the left forearm:

a. 17000
b. 17250
c. 17304
d. 17262

46. What would define the removal of an entire lesion for pathological review:

a. Destruction
b. Biopsy, incisional
c. Biopsy, excisional
d. Shaving

47. A patient, suffering from a hypertrophic breast condition, presents to the surgeon’s office surgical suite to have breast tissue removed due to her back pain this condition has caused. The physician removes 221 grams of tissue from the right breast and 284 grams of tissue from the left breast. Select the appropriate code(s) for this procedure.

a. 19316 x 2
b. 19324-50
c. 19324
d. 19318-50

48. Debridement is the process of removing dead tissue, eschar, dirt, foreign material, or debris from all except:

a. Burns
b. Wounds
c. Orifices
d. Infected skin

49. Code the excision of a 2.5 cm malignant lip lesion and two malignant lesions of the chest, each 1.5 cm in diameter.

a. 11643, 11602-51 x 2
b. 11403, 11402-51 x 2
c. 11643, 11602 x 2
d. 11200

50. Code the destruction of three benign facial lesions.
a. 17000, 17003 x 2
b. 17000 x 3
c. 17260 x 3
d. 11305 x 3
51. “No man’s land” is:

a. the palm of the hand
b. the middle bone of the fingers to the wrist
c. the crease in the palm closest to the fingers and the middle bone of the fingers
d. the crease in the palm closest to the fingers and the wrist

52. Code the closed treatment of a carpal bone fracture (not scaphoid), with manipulation.

a. 25635
b. 25624
c. 25645
d. 25628

53. Code a repeat closed treatment of a femoral shaft fracture with manipulation by the same physician who performed the initial treatment.

a. 27502-77
b. 27506-76
c. 27507-77
d. 27502-76

54. Code a knee amputation of the right leg just above the knee.

a. 27598
b. 27590
c. 27290
d. 28825

55. Code an arthocentesis into the acromioclavicular joint of the left shoulder.

a. 20550
b. 20610
c. 20605
d. 20600

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