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Ch. 16 Procedure Coding Questions
with Correct Answers
What part of the CPT coding manual lists procedures and services alphabetically by main term? A. Appendix B. Modifying terms C. Index D. Tabular list - ANSWERSC. Index Offices should ______ bills on a regular basis. A. mail B. file C. audit D. categorize - ANSWERSC. audit. Auditing is a detailed process that verifies that every detail of the E&M code is clearly documented. Medical assistants abstract procedural information from the _________ to code for services and the reasons they were provided. A. medical record B. HCPCS manual C. medical dictionary D. CPT index - ANSWERSA. medical record Medical assistants must be sure that all patient care information is properly documented in the patient's __________. A. index B. chart C. tabular list D. HIPAA mandates - ANSWERSB. chart Which of the following legislation was passed in 1996 that required that uniform standards be established for electronic transactions? A. HCPCS B. CMS- C. HIPAA D. CPT - ANSWERSC. HIPAA The first edition of ________primarily contained surgical procedures with limited sections on medicine, radiology, and laboratory. A. E&M
B. HIPAA
C. CMS
D. CPT - ANSWERSD. CPT
Each CPT code must be __________ to one or more diagnosis codes that identify the medical necessity. A. related B. indexed C. cross-referenced D. matched - ANSWERSC. cross-referenced Which of the following is an example of Medicare abuse? A. Unbundling B. Billing for services not documented C. Altering documentation to receive a higher payment amount D. Charging excessively high fees for services or supplies - ANSWERSD. Charging excessively high fees for services or supplies Reporting an incorrect procedure code that results in higher reimbursement is A. resequenced coding. B. upcoding. C. endented coding. D. downcoding - ANSWERSB. upcoding. Where in the CPT® coding manual would you find CPT symbols? A. Appendices B. Tabular List C. Introductory Matter D. Index - ANSWERSC. Introductory Matter For each procedure, the medical assistant would use what section in the CPT® coding manual to locate the preliminary code(s)? A. Appendices B. Index C. Tabular List D. Introductory Matter - ANSWERSB. Index ________terms and modifying terms contain instructional notes, such as see or see also. A. Key B. Add-on C. Clinical D. Main - ANSWERSD. Main The proper use of modifiers can speed up _____________.
To report a portion of the surgical package provided by other than the primary surgeon, which of the following would be used? A. Modifiers B. Bundling C. Quantity edits D. Add-on codes - ANSWERSA. Modifiers Which of the following services would the surgical package not include? A. Writing orders B. Evaluating the patient in the postanesthesia recovery area C. Care for coexisting conditions or injuries D. One related E&M encounter on the date immediately prior to or on the date of procedure, subsequent to (following) the decision for surgery - ANSWERSC. Care for coexisting conditions or injuries CPT codes are HCPCS Level I codes for _____________. A. professional services B. drugs C. supplies D. non-physician providers - ANSWERSA. professional services Modifiers are __________codes appended to CPT or Level II codes to further describe circumstances. A. two-digit alphanumeric B. two-digit numerical C. three-digit alphanumeric D. five-digit numerical - ANSWERSA. two-digit alphanumeric What is the HCPCS modifier used for a clinical social worker in medical office services? A. GA B. AJ C. LT D. AH - ANSWERSB. AJ Physicians are paid for _________codes. A. HCPCS Level I B. HCPCS Level II C. CMS D. CPT - ANSWERSD. CPT Christian is being treated at Twin Oaks Care Partners. He is opting to proceed with a service even though he has been advised it will likely be denied by his health insurance. While coding the procedure, the coder includes the Healthcare Common Procedure Coding System (HCPCS) modifier -GA while billing his latest visit. In this context, which of the following is true?
A. Christian used an ambulance from his residence to the hospital. B. Christian signed a Medicare Advanced Beneficiary Notice (ABN) form. C. Christian received the services of a nurse practitioner and a physician. D. Christian consulted a clinical psychologist. - ANSWERSB. Christian signed a Medicare Advanced Beneficiary Notice (ABN) form. A medical assistant is trying to determine which set of codes would be used to bill durable medical equipment for a patient. Which of the following code sets would the medical assistant use? A. Category II codes B. Category I codes C. Healthcare Common Procedure Coding System Level I codes D. Healthcare Common Procedure Coding System Level II codes - ANSWERSD. Healthcare Common Procedure Coding System Level II codes Highland Medical Center includes multiple medical specialists. Sonya visited the center two years ago and was seen by Dr. Hoyer, an OB/GYN. She returned last week and was seen by Dr. Granger, an orthopedic surgeon. The coder codes Sonya's latest visit to the orthopedist as a new patient instead of an established patient because Sonia________. A. is diabetic who requires new records with each visit B. has not consulted Dr. Hoyer in two years C. is consulting a new doctor from a different specialty D. has not visited the center for two years - ANSWERSC. is consulting a new doctor from a different specialty Joann is a medical assistant who is moving from Dr. Johansson's solo practice to Jacobson Clinic Group, a network of 20 physicians in multiple specialties. With regards to procedure coding, which task will most likely remain the same in Joann's job description when switching jobs? A. She will still need to assign procedure codes to specialized procedures and services that the physicians perform outside the clinic. B. She will still be responsible for assigning procedure codes to basic procedures and services performed in the clinic. C. She will still be responsible for submitting claims with appropriate procedural codes to the insurance company. D. She will still need to be sure that all patient care information is properly documented in the patient's chart - ANSWERSD. She will still need to be sure that all patient care information is properly documented in the patient's chart Both Rex and Sheila recently joined the Hopewell Medical Center as medical assistants. At work, Rex is coding the medical records of a newborn infant who weighs less than 4 kg. While coding, Rex wonders whether he should use modifier 63 with the CPT code to report a certain procedure performed on the infant. Sheila, on the other hand, is assigned the case of a cardiac patient who has returned for follow-up after a year.
B. HIPAA
C. CMS
D. CPT - ANSWERSD. CPT
Each CPT code must be __________ to one or more diagnosis codes that identify the medical necessity. A. related B. indexed C. cross-referenced D. matched - ANSWERSC. cross-referenced Which of the following is an example of Medicare abuse? A. Unbundling B. Billing for services not documented C. Altering documentation to receive a higher payment amount D. Charging excessively high fees for services or supplies - ANSWERSD. Charging excessively high fees for services or supplies Reporting an incorrect procedure code that results in higher reimbursement is A. resequenced coding. B. upcoding. C. endented coding. D. downcoding - ANSWERSB. upcoding. Where in the CPT® coding manual would you find CPT symbols? A. Appendices B. Tabular List C. Introductory Matter D. Index - ANSWERSC. Introductory Matter For each procedure, the medical assistant would use what section in the CPT® coding manual to locate the preliminary code(s)? A. Appendices B. Index C. Tabular List D. Introductory Matter - ANSWERSB. Index ________terms and modifying terms contain instructional notes, such as see or see also. A. Key B. Add-on C. Clinical D. Main - ANSWERSD. Main The proper use of modifiers can speed up _____________.
A. claims processing B. selecting a procedure code C. downcoding D. auditing - ANSWERSA. claims processing E&M codes are selected based on the category of _________. A. insurance benefits B. patient status C. service D. patient history - ANSWERSC. service How would you classify the complexity of a physical assessment of a patient if it was a general multisystem examination? A. Comprehensive B. Detailed C. Expanded problem focused D. Problem focused - ANSWERSA. Comprehensive What service provided in the office may be billed in addition to the E&M code? A. Scheduling procedures B. Venipuncture C. Obtaining preapproval or preauthorization D. Physical examination - ANSWERSB. Venipuncture The radiology modality that shows a real-time, moving X-ray image, usually viewed on a monitor, is known as_____________. A. computerized tomography (CT) B. ultrasound C. x-ray D. fluoroscopy - ANSWERSD. fluoroscopy All CPT surgery codes include the surgical package, also known as the _______ surgical concept. A. total B. medical C. clinical D. global - ANSWERSD. global The __________ period refers to the number of days surrounding a surgical procedure. A. follow-up B. global C. surgical D. postoperative - ANSWERSB. global
A. Christian used an ambulance from his residence to the hospital. B. Christian signed a Medicare Advanced Beneficiary Notice (ABN) form. C. Christian received the services of a nurse practitioner and a physician. D. Christian consulted a clinical psychologist. - ANSWERSB. Christian signed a Medicare Advanced Beneficiary Notice (ABN) form. A medical assistant is trying to determine which set of codes would be used to bill durable medical equipment for a patient. Which of the following code sets would the medical assistant use? A. Category II codes B. Category I codes C. Healthcare Common Procedure Coding System Level I codes D. Healthcare Common Procedure Coding System Level II codes - ANSWERSD. Healthcare Common Procedure Coding System Level II codes Highland Medical Center includes multiple medical specialists. Sonya visited the center two years ago and was seen by Dr. Hoyer, an OB/GYN. She returned last week and was seen by Dr. Granger, an orthopedic surgeon. The coder codes Sonya's latest visit to the orthopedist as a new patient instead of an established patient because Sonia________. A. is diabetic who requires new records with each visit B. has not consulted Dr. Hoyer in two years C. is consulting a new doctor from a different specialty D. has not visited the center for two years - ANSWERSC. is consulting a new doctor from a different specialty Joann is a medical assistant who is moving from Dr. Johansson's solo practice to Jacobson Clinic Group, a network of 20 physicians in multiple specialties. With regards to procedure coding, which task will most likely remain the same in Joann's job description when switching jobs? A. She will still need to assign procedure codes to specialized procedures and services that the physicians perform outside the clinic. B. She will still be responsible for assigning procedure codes to basic procedures and services performed in the clinic. C. She will still be responsible for submitting claims with appropriate procedural codes to the insurance company. D. She will still need to be sure that all patient care information is properly documented in the patient's chart - ANSWERSD. She will still need to be sure that all patient care information is properly documented in the patient's chart Both Rex and Sheila recently joined the Hopewell Medical Center as medical assistants. At work, Rex is coding the medical records of a newborn infant who weighs less than 4 kg. While coding, Rex wonders whether he should use modifier 63 with the CPT code to report a certain procedure performed on the infant. Sheila, on the other hand, is assigned the case of a cardiac patient who has returned for follow-up after a year.
Sheila needs to update all his records and codes based on the current year's revised codes. Both Rex and Sheila will have to refer to different appendices in the coding manual. Based on the information provided in this scenario, which of the following is most likely true? A. Rex will have to refer to Appendix I, whereas Sheila will have to refer to Appendix J. B. Rex will have to refer to Appendix L, whereas Sheila will have to refer to Appendix K. C. Rex will have to refer to Appendix C, w - ANSWERSD. Rex will have to refer to Appendix F, whereas Sheila will have to refer to Appendix B.
