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Medical Coding Practice Exam: CPT and ICD-10-CM Coding Exercises, Exams of Nursing

Harvard UniversityNursing

A comprehensive set of practice questions and answers covering key concepts in medical coding using cpt and icd-10-cm systems. it includes scenarios related to various medical procedures, diagnoses, and reimbursement practices, making it an excellent resource for students and professionals seeking to improve their medical coding skills. The questions test knowledge of procedural coding, diagnostic coding, and the application of coding guidelines in different clinical settings. the detailed answers offer valuable insights into the rationale behind each code selection, enhancing understanding and improving coding accuracy.

Typology: Exams

2024/2025

Available from 04/30/2025

Tutor-Josephine
Tutor-Josephine 🇺🇸

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CCA Mock Practice Exam Questions and Answers 2024
Patient undergoes a posterior L1-L5 spinal fusion for scoliosis with placement of a Harrington rod.
Code using CPT.
22800, 22840
D&C for missed abortion, first trimester. (Code CPT for procedures.)
59820
You would expect to find documentation regarding the assessment of an obstetric patient's
lochia, fundus, and perineum on the
• postpartum record.
Procedure-to-Procedure (PTP) Edits review claims for codes that report
• procedures that cannot or should not be provided to the same patient on the same day.
It is September 15th, and you have just received the upcoming year’s ICD-10-PCS code set updates. The next
step is to .
• put in a change ticket for the hospital’s chargemaster to be updated
Hysteroscopy with D&C and polypectomy. (Code CPT for procedures.)
• 58558
Patient came to the hospital ambulatory surgical center for repair of incisional inguinal hernia. This
is the second time the patient has developed this problem. The hernia was repaired with Gore-Tex
graft. Choose the appropriate ICD-10-CM and CPT codes.
• K40.91, 49565, 49568
You are conducting an educational session on benchmarking. You tell your audience that the key
to benchmarking is to use the comparison to
• improve your department's processes.
A physician has come to the HIM department because he wants a new smartphone to be able to
access patient records. This way he can enter orders when he is outside of the hospital. You need
to direct the IT department to
• encrypt the phone so access is protected.
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Download Medical Coding Practice Exam: CPT and ICD-10-CM Coding Exercises and more Exams Nursing in PDF only on Docsity!

CCA Mock Practice Exam Questions and Answers 2024

Patient undergoes a posterior L1-L5 spinal fusion for scoliosis with placement of a Harrington rod. Code using CPT. 22800, 22840 D&C for missed abortion, first trimester. (Code CPT for procedures.) 59820 You would expect to find documentation regarding the assessment of an obstetric patient's lochia, fundus, and perineum on the

  • postpartum record. Procedure-to-Procedure (PTP) Edits review claims for codes that report
  • procedures that cannot or should not be provided to the same patient on the same day. It is September 15th, and you have just received the upcoming year’s ICD-10-PCS code set updates. The next step is to.
  • put in a change ticket for the hospital’s chargemaster to be updated Hysteroscopy with D&C and polypectomy. (Code CPT for procedures.)
  • 58558 Patient came to the hospital ambulatory surgical center for repair of incisional inguinal hernia. This is the second time the patient has developed this problem. The hernia was repaired with Gore-Tex graft. Choose the appropriate ICD-10-CM and CPT codes.
  • K40.91, 49565, 49568 You are conducting an educational session on benchmarking. You tell your audience that the key to benchmarking is to use the comparison to
  • improve your department's processes. A physician has come to the HIM department because he wants a new smartphone to be able to access patient records. This way he can enter orders when he is outside of the hospital. You need to direct the IT department to
  • encrypt the phone so access is protected.

The APC payment system is based on what coding system(s)?

  • CPT/HCPCS codes The Joint Commission requires that all medical records be completed within following patient discharge.
  • 30 days Patient has breast carcinoma and is now undergoing complete axillary lymphadenectomy. (Code for physician using CPT procedure codes only.) 38745 You have been hired to work with a computer-assisted coding (CAC) initiative. The technology that you will be working with is natural language processing External audits may be conducted by several organizations in the federal government as well as the private sector, including.
  • any of these Patient has a year history of mitral valve regurgitation and now presents for a mitral valve replacement with bypass. (Code for physician using CPT procedure codes only.)
  • 33430 When writing a query to a physician regarding ambiguous details in the documentation, one must be careful to never let the question
  • imply an answer that will lead to a higher reimbursement rate. If the National Coverage Determination indicates that Medicare will not pay for a specific procedure, you may have to have the patient sign
  • an Advance Beneficiary Notice (ABN Patient arrives in the emergency room via a medical helicopter. The patient has sustained multiple life- threatening injuries due to a multiple car accident. The patient goes into cardiac arrest upon

Cesarean delivery with antepartum and postpartum care. (Code CPT for procedures.) 59510 NCCI stands for

  • National Correct Coding Initiative. While CAC systems are convenient, the codes they determine must be validated to ensure accuracy. One method to do this would be
  • a prospective audit. The outpatient method for reimbursement from CMS for Medicare is
  • Ambulatory Patient Classification (APC). All of these are acceptable destruction methods when health records are no longer required, EXCEPT
  • deleting files from the server. Excision 2 cm subcutaneous soft tissue lipoma of the back. (Code for diagnoses using ICD-10- CM. Code for procedure using CPT.)
  • D17.1, 21930 A patient with lung cancer and bone metastasis is seen for complex treatment planning by a radiation oncologist. 77263 Patient with carpal tunnel comes in for an open carpal tunnel release, right hand. (Code ICD-10- CM for diagnoses and CPT for procedures.)
  • G56.01, 64721 An established patient was seen by physician in her office for DTaP-IPV/Hib. 90471, 90698 One excellent source to guide you to perform ethical coding is.
  • AHIMA Patient has tear of the medial meniscus with loose bodies in the medial compartment of the left knee that was repaired by arthroscopic medial meniscectomy, shaving and trimming of meniscal rim,

resection of synovium, and removal of the loose bodies. (Code using CPT procedure codes.)

  • 29881-LT Which of the following contains a list of coding edits developed by CMS in an effort to promote correct coding nationwide and to prevent the inappropriate unbundling of related services?
  • National Correct Coding Initiative (NCCI) Which of the following could influence a facility's case mix?
  • all answers apply The patient was brought in by ambulance to the Emergency Department. An EKG and bloodwork were completed, and the patient was discharged, with a recommendation to see his cardiologist. The next day, the cardiologist admitted this patient to the surgery ward to prepare for a valve replacement procedure. The EKG performed in the ED the day before should
  • be reported as an outpatient procedure. The special form that plays the central role in planning and providing care at nursing, psychiatric, and rehabilitation facilities is the
  • interdisciplinary patient care plan. As part of a concurrent record review, you need to locate the initial plan of action based on the attending physician's initial assessment of the patient. You can expect to find this documentation either within the body of the history and physical or in the
  • doctor's admitting progress note Patient was seen for excision of two interdigital neuroma from the left foot. 28080, 28080 Patient was seen today for regular hemodialysis. No problems reported; patient tolerated procedure well. 90935 Office visit for 43-year-old male, new patient, with no complaints. Patient is applying for life insurance and requests a physical examination. A detailed health and family history was obtained, and a basic physical was done. Physician completed life insurance physical form at patient's request. Blood and urine were collected. 99450

Medically Unlikely Edits (MUE) are a claims review looking for incorrect units of service of any procedure, service, or treatment. The practice of using a code that results in a higher payment to the provider than the code that more accurately reflects the service provided is known as

  • upcoding. Your organization is sending confidential patient information across the Internet using technology that will transform the original data into unintelligible code that can be re-created by authorized users. This technique is called
  • data encryption. Which diagnosis should be listed first when sequencing inpatient codes using the UHDDS?
  • principal diagnosis Diagnosis codes update every year on
  • October 1 The are the organizations that contract with Medicare to perform reviews of medical records with the corresponding Medicare claims to detect and correct improper payments.
  • recovery audit contractors (RACs) An ethical physician’s query cannot include.
  • a recommendation for an answer An HIM professional was tasked with analyzing a group of medical records qualitatively for deficiencies. This would include
  • reviewing medical records for missing or ambiguous details. Provide the CPT code for a patient that had a complicated removal of a wrist prosthesis.
  • 25251

A staff member, Louis, in Admissions, occasionally brings his nephew to work after school and permits him to access social media on his computer. He posts selfies and sometimes shares what he sees and hears in the office. As the HIM manager, you must

  • require Louis to go through HIPAA training again and explain to him the illegality of posting any protected information on social media A claim may be returned by the third-party payer unpaid because it was denied or rejected. If eligibility and coverage was checked prior to the patient being seen, the denial may be due to any of these reasons EXCEPT
  • the claim submitted is clean. When patient records are no longer required and deemed unnecessary, they must be destroyed, regardless of the format (paper, EHR, etc.). The guidance states that the destruction must be
  • documented as to method and date. Lumbar laminectomy (one segment) for decompression of spinal cord. (Code CPT for procedures.) 63005 Patient health care records can be released for research purposes or education, without patient permission, if they have been de-identified. This means all details have been removed that may
  • lead to one specific person. Total transcervical thymectomy. (Code CPT for procedures.) 60520 The chargemaster relieves the coders from coding repetitive services that require little, if any, formal documentation analysis. This is called
  • hard coding One week's productivity information is shown in the table above. What percentage of the coders is meeting the productivity standards?
  • 100% A document that acknowledges patient responsibility for payment if Medicare denies the claim is a(n) advance beneficiary notice.

CAC software is used to analyze health care documents and produce appropriate medical codes. This may be used by some health care facilities when there are an insufficient number of certified medical coding candidates. CAC stands for

  • Computer-Assisted Coding. Patient presents to the GI lab for a colonoscopy. During the colonoscopy, polyps were discovered in the ascending colon and in the transverse colon. Polyps in the ascending colon were removed via hot biopsy forceps, and the polyps in the transverse colon were removed by snare technique.
  • D12.2, D12.3, 45384, 45385- The patient was seen by the physician on September 30. By the time the documentation reached the medical coder, it was October 2. The code set required to report the appropriate diagnosis is
  • the 2022 ICD-10-CM code set. Provide the CPT code(s) for anesthesia services for the transvenous insertion of a pacemaker.
  • 00530 The patient was admitted through the Emergency Department and she is anxious about notifying her spouse and her sister. Her spouse is out of town on business and her sister lives in another state. The patient is worried about how they can get updates when she is in surgery, when they cannot prove how they are related to her to clear HIPAA limitations. You tell her not to worry, because.
  • the hospital can assign special pass codes. Based on the sample MS-DRG report above, what is the case-mix index for this facility?

Which of the following are considered sequela regardless of time?

  • nonunion The primary purpose for keeping a patient health record is
  • continuity of care. Querying a physician is required by the coder when it is found that the documentation, written by a physician, is any of these EXCEPT:
  • misspelled in places that do not interfere with the medical information included

CDSS is an add-on function included in most electronic health records (EHR). This enables physicians to review evidence-based medical articles and other current industry knowledge. CDSS stands for

  • Clinical Decision Support System. One expert medical coder in your department is responsible for reviewing the codes determined by the other coders before the claims are submitted to third-party payers. This is known as conducting .
  • internal audit HIPAA requires covered entities to retain patient health records for at least , from either the date of creation, or the last “effective date,” whichever date is later.
  • six years The patient had a thrombectomy, without catheter, of the peroneal artery, by leg incision.
  • 34203 Which of the following is classified as a poisoning in ICD-10-CM?
  • syncope due to Contac pills and a three-martini lunch Based on the following documentation in an acute care record, where would you expect this excerpt to appear?

With the patient in the supine position, the right side of the neck was

appropriately prepped with betadine solution and draped. I was able to

pass the central line, which was taped to skin and used for

administration of drugs during resuscitation.

operative record In most situations the person who authorizes release of medical information is the

  • patient.