Medical Coding Exam Questions and Answers, Exams of Nursing

Download Medical Coding Exam Questions and Answers and more Exams Nursing in PDF only on Docsity! BC3030X exam Question 1m question and answer verified 0.6 out of 0.6 points Patient with genital warts has cryotherapy of an extensive number of lesions on her mons pubis, labia, and perineum. How is this procedure coded? Selecte d Answer: 565 15 Correct Answer: 565 15  Question 2 0.6 out of 0.6 points A 32-year-old woman with a previous cesarean delivery presents in spontaneous labor with the baby in cephalic presentation. She has had an uneventful pregnancy and after laboring for 10 hours she delivers a single female child with brief use of a vacuum extractor over an episiotomy that is repaired by the delivering physician. There are no complications. What are the diagnosis codes for this delivery? Selected Answer: O75.89, O34.21, Z3A.00, Z37.0 Correct Answer: O75.89, O34.21, Z3A.00, Z37.0  Question 3 0.6 out of 0.6 points If a woman is hospitalized with severe pre-eclampsia in the 30th week of her pregnancy what is the diagnosis code for her daily visits? Selecte d Answer: O14.13, Z3A.30 Correct Answer: O14.13, Z3A.30  Question 4 0.6 out of 0.6 points What ICD-10 -CM code is reported for carcinoma of the bladder dome? Selecte d Answer: C67 . 1 Correct Answer: C67 . 1 Question 5 0 out of 0.6 points Preoperative diagnosis: Cytologic atypia and gross hematuria Postoperative diagnosis: Cytologic atypia and gross hematuria Procedure performed: Cystoscopy and random bladder biopsies and Green Light laser ablation of the prostate. Description: Bladder biopsies were taken of the dome, posterior bladder wall and lateral side walls. Bugbee was used to fulgurate the biopsy sites to diminish bleeding. Cystoscope was replaced with the cystoscope designed for the Green Light laser. We introduced this into the patient's urethra and performed Green Light laser ablation of the prostate down to the level of verumontanum (the prostatic crest near the wall of the urethra). There were some calcifications at the left apex of the prostate, causing damage to the laser but adequate vaporization was achieved. What CPT® code(s) is/are reported for this service? Selected Answer: 52648, 52204 Correct Answer: 52648, 52224-59 Respons e Feedback : Laser vaporization is coded using CPT® 52648. In the CPT® Index look for Prostate/Vaporization/Laser directing you to 52648. A biopsy is usually not reported at the same time of the laser procedure. In this case, the operative report clearly states that this procedure is a distinct procedure; it is a different procedure from the Green Light laser ablation and is reported separately using modifier 59. CPT® 52224 describes cystourethroscopy, with fulguration, with or without biopsy. In the CPT® Index look for Cystourethroscopy/Biopsy. 44-year-old male with biplanar deformity, acquired limb length discrepancies and tibial nonunion has undergone deformity correction. He now requires exchange of an external fixation strut 45 days postoperatively. The intraoperative mounting parameters, deformity parameters, and initial strut settings are inserted into the computer prior to Jim’s discharge and a daily schedule is generated for him to perform the gradual deformity correction necessary. What CPT® code(s) should be reported? Selected Answer: 206 96 Correct Answer: 206 97 Response The exchange of a computer assisted external strut is coded with 20697. Feedback: There is a parenthetical note under code 20697 that it is not to be used in combination with 20672 or 20696. 20697 can be found in the CPT ® Index under External Fixation /Application/Stereotactic Computer Assisted directing you to 20696-20697. Question 12 0.6 out of 0.6 points The acronym BKA means: Selected Answer: below- knee amputation Correct Answer: below- knee amputation Question 13 0.6 out of 0.6 points In ICD-10-CM, what classification system is used to report open fracture classifications? Selected Answer: Gustilo Classification for open fractures Correct Answer: Gustilo Classification for open fractures  Question 14 0 out of 0.6 points Which statement is true regarding code selection for lumbago in ICD-10-CM? Selected Answer: Codes for lumbago with sciatica do not further specify laterality. Correct Answer: Codes exist to indicate whether the sciatica is present with the low back pain. Response Feedback: In ICD-10-CM, there are codes to indicate when sciatica is present with the low back pain, or low back pain due to intervertebral disc disorder or displacement of intervertebral disc. Question 15 0.6 out of 0.6 points A 42-year-old with chronic right trochanteric bursitis is scheduled to receive an injection at the Pain Clinic. A 22-gauge spinal needle is introduced into the trochanteric bursa, and a total volume of 8 cc of normal saline and 40 mg of Kenalog was injected. What CPT® code should be reported? Selected Answer: 20610-RT, J3301 x 4 Correct Answer: 20610-RT, J3301 x 4  Question 16 0.6 out of 0.6 points A 63-year-old man sustained a gunshot wound through the right maxillary sinus penetrating through the right neck. CT scan revealed no hard evidence of arterial injury but a bullet was directly in line with the internal jugular vein. He was sent to the operating room for neck exploration to rule out vascular injury and injury to the aero digestive tract. A sternocleidomastoid incision was performed and carried down through the platysma muscle. There was no penetration of the internal jugular vein, but a foreign body was identified resting on the internal jugular vein at approximately the level of the angle of the mandible and removed. The parotid gland was noted to have a blast injury near the tail. This was not surgically repaired or resected. Once all bleeding was controlled, a 10 French round drain was placed in the wound. The wound was copiously irrigated. The platysma muscle was closed and the skin was closed with subcuticular closure. What CPT® code is reported? Selected Answer: 201 00 Correct Answer: 201 00  Question 17 0.6 out of 0.6 points What information is required to accurately code osteoarthritis in ICD-10-CM? Selected Answer: Whether the osteoarthritis is primary, secondary, post-traumatic, the site and laterality. Correct Answer: Whether the osteoarthritis is primary, secondary, post-traumatic, the site and laterality.  Question 18 0 out of 0.6 points Most of the codes in ICD-10-CM Chapter 13 Diseases of the Musculoskeletal System and Connective Tissue have site and laterality designations. What is considered the site? Selected Answer: The site may be the region, bone, joint, or muscle involved. Correct Answer: The site may be the bone, joint, or muscle involved. Response Feedback: According to ICD-10-CM Guideline I.C.13.a., the site may be the bone, joint, or muscle involved. Question 19 0 out of 0.6 points 68-year-old female with long-standing degenerative arthritis in her right knee presented. Risks and benefits were discussed. She was agreeable to surgery. After adequate anesthesia, the patient was prepped and draped in usual sterile fashion with Dura Prep and Betadine scrub. The leg was exsanguinated and tourniquet inflated. An anterior incision was made and carried through the skin and bursa, cauterizing all bleeders. The bursa was elevated medially and a medial parapatellar incision was made. The proximal tibia was cleaned. The knee had an 18° flexion contracture. The cruciate ligaments were debrided along with the menisci. The proximal tibial cutting guide was placed and the proximal tibial cut made. The femoral canal was entered and a 6° cut was made for the anterior jig. The distal cut was made at 6°. The K81.0  Question 24 0 out of 0.6 points In ICD-10-CM, how is Crohn’s disease of the small intestine with intestinal obstruction reported? Selected Answer: Crohn’s disease of the small intestine is reported as regional enteritis of the small intestines. Correct Answer: One combination code is reported to indicate Crohn’s disease of the small intestine with intestinal obstruction. Response In ICD-10-CM, there are combination codes to include the anatomic site (i.e., Feedback: small intestine, large intestine) as well as the associated complications of Crohn’s disease. Example: K50.012 Crohn’s disease of small intestine with intestinal obstruction. Question 25 0 out of 0.6 points A four-year-old patient who accidentally ingests valium found in his mother’s purse is found unconscious and rushed to the ED. The child is treated by the ED physician, inserting a tube orally down to the stomach and performing a gastric lavage removing the stomach contents. What CPT® and ICD-10-CM codes are reported? Selected Answer: 43754, R40.20, T42.71XA Correct Answer: 43753, T42.4X1A, R40.20 Respons e Feedback : Code 43753 is the correct CPT® code for gastric lavage performed for the treatment of ingested poison and is found in the CPT® Index and Diseases under Gastric Lavage, Therapeutic/Intubation. The ICD-10-CM code for the poisoning is found in the Table of Drugs and Chemicals, by looking for Valium/Poisoning, Accidental (unintentional) column, referring you to code T42.4X1-. In the Tabular List a seventh character is needed to complete the code. A is reported as the seventh character because the patient was treated in the ED setting. The next code is the manifestation of ingesting the Valium – unconsciousness R40.20. This is found in the Index to Diseases and Injures under Coma. Tabular List confirms this code is reported for unconsciousness. Question 26 0.6 out of 0.6 points 33-year-old male patient presents to the endoscopy suite to determine if he has an ulcer. The physician performs a diagnostic scope through the esophagus, stomach and into the duodenum and jejunum. During the scope the patient has a severe drop in blood pressure and the physician discontinues the procedure, but not before observing and diagnosing a bleeding ulcer on the stomach lining as well a perforated ulcer in the jejunum. A repeat examination is planned. What CPT® and ICD-10-CM codes are reported? Selected Answer: 43235-53, K25.4, K28.5 Correct Answer: 43235-53, K25.4, K28.5  Question 27 0.6 out of 0.6 points What CPT® and ICD-10-CM codes are reported for diagnosis of a recurrent unilateral reducible femoral hernia repair? Selected Answer: 49555, K41.91 Correct Answer: 49555, K41.91  Question 28 0.6 out of 0.6 points A patient is seen to have an esophageal motility with acid perfusion study performed. What CPT® code(s) is/are reported? Selected Answer: 91010, 91013 Correct Answer: 91010, 91013  Question 29 0.6 out of 0.6 points When reporting an encounter for screening of malignant neoplasms of the intestinal tract, what does the fifth character indicate? Selected Answer: Anatomic location being screened in the intestinal tract. Correct Answer: Anatomic location being screened in the intestinal tract.  Question 30 0.6 out of 0.6 points 45-year-old patient with liver cancer is scheduled for a liver transplant. The patient’s brother is a perfect match and will be donating a portion of his liver for a graft. Segments II and III will be taken from the brother and then the backbench reconstruction of the graft will be performed, both a venous and arterial anastomosis. The orthotropic allotransplantation will then be performed on the patient. What CPT® codes are reported? Selected Answer: 47140, 47146, 47147, 47135 Correct Answer: 47140, 47146, 47147, 47135 Question 31 0.6 out of 0.6 points What ICD-10-CM code(s) is/are reported for bilateral cataracts? Selected Answer: H26. 9 Correct Answer: H26. 9  Question 32 0.6 out of 0.6 points What are the four lobes of the brain? Selected Answer: Frontal, Parietal, Temporal, Occipital vitreous into the anterior chamber with corneal touch and adhesion to the graft host junction, and early corneal edema. The patient is admitted for anterior vitrectomy. PROCEDURE: The patient was prepped, and draped in the usual manner after first undergoing retrobulbar anesthetic. A lid speculum was inserted. An incision was made at approximately the 10 o’clock meridian 3 mm in length, 2 mm posterior to the limbus, and grooved forward into clear cornea with a 3.2 mm anterior chamber. An anterior vitrectomy was carried out, placing a visco-elastic substance in the anterior chamber to maintain it. A Sinskey hook was used to sweep vitreous away from the corneal wound and this was removed with the disposable vitrectomy instrument. The patient’s pupil is noted to be round. There was no vitreous to the wound. The wound self-sealed without aqueous leak. Cautery was used to close the conjunctiva. Subconjunctival Decadron and Gentamicin was given. The patient tolerated the procedure well and was discharged to the recovery room in good condition. What CPT® code(s) is/are reported? Selected Answer: 67015, 67028, 65810, 67025 Correct Answer: 67010 Response Feedback : In the CPT® Index, look for Vitrectomy/Anterior Approach/Subtotal. This was a subtotal removal using a mechanical tool to sweep the vitreous away. Subtotal using a mechanical tool is reported with 67010. Question 39 0.6 out of 0.6 points What does contralateral mean? Selected Answer: Affecting or originating in the opposite side. Correct Answer: Affecting or originating in the opposite side.  Question 40 0.6 out of 0.6 points 53-year-old woman with scarring of the right cornea has significant corneal thinning with a high risk of perforation and underwent reconstruction of the ocular surface. The eye is incised and an operating microscope is used with sponges and forceps to debride necrotic corneal epithelium. Preserved human amniotic membrane is first removed from the storage medium and transplanted by trimming the membrane to fit the thinning area of the cornea then sutured. This process was repeated three times until the area of thinning is flushed with surrounding normal-thickness cornea. All of the knots are buried and a bandage contact lens is placed with topical antibiotic-steroid ointment. What CPT® code is reported? Selected Answer: 657 80 Correct Answer: 657 80  Question 41 0 out of 0.6 points An operative report lists excisional bilateral biopsies of deep cervical nodes and biopsy of right deep axillary nodes as the procedures performed. The pathology report comes back confirming lymphadenitis. What CPT® codes are reported? Selected Answer: 38520-50, 38505-59, 38740-59-RT Correct Answer: 38510-50, 38525- 51-RT Response Feedback : In the CPT® Index, look under Lymph Nodes/Biopsy and you are directed to a series of codes. Turn to codes 38500 and 38510-38530. Code 38510 represents the deep cervical nodes and the 50 modifier indicates that they were excised bilaterally. Next, look to code 38525. This code is appropriate for reporting the deep axillary nodes excised. The RT modifier indicates these lymph nodes were taken only from the right side and modifier 51 indicates multiple procedures performed at the same session. Question 42 0.6 out of 0.6 points A 35-year-old patient presented to the ASC for PTA of an obstructed hemodialysis AV graft in the venous anastomosis and the immediate venous outflow. The procedure was performed under moderate sedation administered by the physician performing the PTA. The physician performed all aspects of the procedure, including radiological supervision and interpretation. Code for all services performed. Selected Answer: 35476, 75978-26 Correct Answer: 35476, 75978-26  Question 43 0.6 out of 0.6 points Where is the hypertension table located in ICD-10-CM? Selected Answer: There is no hypertension table in ICD-10-CM. Correct Answer: There is no hypertension table in ICD-10-CM.  Question 44 0.6 out of 0.6 points What is the largest single mass of lymphatic tissue? Selected Answer: Sple en Correct Answer: Sple en  Question 45 0 out of 0.6 points Which statement is true regarding coding COPD with asthma in ICD-10-CM? Selected Answer: COPD with bronchitis is reported for COPD with asthma. Correct Answer: The type of asthma is reported along with the COPD. Response Feedback: For COPD with asthma, ICD-10-CM provides instructional notes to code also type of asthma, if applicable (J45.-) and use additional code for certain type of external causes listed in the Tabular List. Question 46 0.6 out of 0.6 points Most nasal passages have how many turbinates present on the lateral wall of each nasal cavity? Selected Answer: 3 Correct 5 Response Feedback : The pathology report indicates the lesion is an uncertain, which is classified in the ICD-10-CM Table of Neoplasms under Neoplasm/nose (external)/skin/Uncertain Behavior (column) referring you to code D48.5. Question 53 0.6 out of 0.6 points What is another term for hives? Selecte d Answer : Urtica r ia Correct Answer : Urtica r ia Question 54 0.6 out of 0.6 points The patient is here to follow-up for a keloid excised from his neck in November of last year. He believes it’s coming back. He does have a recurrence of the keloid on the superior portion of the scar. Because the keloid is still small, options of an injection or radiation to the area were discussed. It was agreed our next course should be a Kenalog injection. Risks associated with the procedure were discussed with the patient. Informed consent was obtained. The area was infiltrated with 1.5 cc of medication. This was a mixture of 1 cc of Kenalog-10 and 0.5 cc of 1% lidocaine with epinephrine. He tolerated the procedure well. What codes are reported? Selecte d Answer: 11900, J3301, L91.0 Correct Answer: 11900, J3301, L91.0  Question 55 0.6 out of 0.6 points A 63-year-old patient arrives for skin tag removal. As previously noted in her other visit, she has 3 located on her face, 4 on her shoulder and 15 on her back. The physician removes all the skin tags with no complications. What CPT® code(s) should be reported for this encounter? Selected Answer: 11200, 11201 Correct Answer: 11200, 11201  Question 56 0.6 out of 0.6 points What is used for a placeholder when a code that does not have six characters to keep the seventh character extender in the seventh position? Selected Answer: The letter x Correct Answer: The letter x  Question 57 0 out of 0.6 points A 50-year-old female has telangiectasias of the face on both cheeks. She is very bothered by this and presents to have them destroyed via laser. The physician lasers one cutaneous vascular lesion on each cheek; each lesion measuring 2 square cm. What CPT® code(s) is/are reported? Selected Answer: 17000, 17003 Correct Answer: 17106 Respons e Feedback : Telangiectasias are small dilated blood vessels, commonly referred to as “spider veins,” or acne rosacea—a benign lesion. In the CPT® Index, look for Destruction/Lesion/Vascular, Cutaneous and you are referred to code range 17106 – 17108. Code selection is based on size. Each lesion is 2cm2, making the total size 4 cm2. Question 58 0 out of 0.6 points Patient is a 69-year-old woman with a biopsy proven squamous cell carcinoma of her left forearm measuring 2.3 cm in greatest diameter. The area was marked with 4 mm gross normal margins. This area was removed as drawn, and the surgeon then incised his planned rhomboid flap, elevating the full-thickness flap into the defect and closing the sites in layers using 3-0 Monocryl, 4-0 Monocryl and 5-0 Prolene. The patient tolerated the procedure well. Final measurements were 2.7 cm x 2.1 cm. What CPT® code(s) is/are reported? Selected Answer: 15100, 11603-51 Correct Answer: 14020 Respons e Feedback : Rhomboid flap is a flap in the shape of a rhomboid used for a rotation flap skin graft. A rotation flap is considered an adjacent tissue transfer. In the CPT® Index, see Skin Graft and Flap/Tissue Transfer, you are directed to code range 14000-14350. Code selection is based on location and flap size. The size of the flap is calculated in square cm and includes both the size of the primary defect and secondary defect created by the flap. The final measurements in this case are 2.7 cm x 2.1 cm which equals 5.67 cm2 (2.7 x 2.1 = 5.67). 14020 is the correct code. Question 59 0.6 out of 0.6 points What CPT® codes are reported for the destruction of 16 premalignant lesions and 10 benign lesions using cryosurgery? Selected Answer: 17004, 17110 Correct Answer: 17004, 17110 Question 60 0.6 out of 0.6 points Operative Report Pre-Operative and Post-Operative Diagnosis: Squamous cell carcinoma, left leg Open wound, right leg Personal history of squamous cell carcinoma, right leg INDICATIONS FOR SURGERY: The patient is an 81-year-old white man with biopsyproven squamous cell carcinoma of his left leg. I marked the areas for excision with gross normal margins of 5 mm, and I drew my planned skin graft donor site from his left lateral thigh. He also had an open wound of his right leg from a squamous cell carcinoma excised four months ago, the skin graft had not taken. We plan on re-skin grafting the area. The patient is aware of all of these markings, and understands the surgery and location.