COC 2020 - FINAL EXAM STUDY QUESTIONS (SET 12) STUDY GUIDE QUESTIONS AND ANSWERS (2022/202, Exams of Health sciences

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COC 2020 - FINAL EXAM STUDY QUESTIONS (SET 12) STUDY GUIDE

QUESTIONS AND ANSWERS (2022/2023) (VERIFIED ANSWERS BY

EXPERT)

1. Which HCPCS Level II code category allows for pass-through payment devices? - Correct answer C codes
2. Which is the correct statement regarding AAPC members per AAPC's Code of Ethics? - Correct answer Conduct themselves in all professional activities in a manner consistent with ethical principles of professional conduct.
3. Which is the ICD-10-CM code for GERD? - Correct answer K21.
4. Which is the unit of measurement for documenting the size of a skin graft? - Correct answer Square centimeters
5. Which is true about the role of a co-surgeon? - Correct answer Handles a particular area of expertise.
6. Which layer is the middle layer of the eyeball? - Correct answer Choroid
7. Which layer of the epidermis is normally found on the palms of the hands and the soles of the feet? - Correct answer Stratum Lucidum
8. Which layer of the heart covers the heart's outer surface? - Correct answer Epicardium
9. Which leukocyte does the body use to protect against allergic reactions and parasites? - Correct answer Eosinophils
10. Which leukocyte is the body's second line of defense against infection? - Correct answer Monocytes
11. Which leukocyte protects the body from viral infections? - Correct answer Lymphocytes
12. Which medical term refers to the cheek? - Correct answer Buccal
13. Which of the following are also known as the lesser vestibular glands? - Correct answer Skene's glands
14. Which of the following belongs to the appendicular skeleton as opposed to the axial skeleton? - Correct answer Pelvic Girdle
15. Which of the following best describes constituent components of the human lymphatic system? - Correct answer Lymph nodes, lymphatic vessels, spleen, thoracic duct

16. Which of the following charges are NOT excluded from Medicare payment based on statutory exclusions? - Correct answer Hip replacement
17. Which of the following conditions are NOT on the 2019 major complications and comorbidities list on the CMS website? - Correct answer D15.0 Benign neoplasm of thymus
18. Which of the following conditions are on the 2019 complications and comorbidities list on the CMS website?

• Correct answer IO1.0 Acute rheumatic pericarditis

19. Which of the following describes "dystonia"? - Correct answer Neurologic movement disorder causing abnormal postures
20. Which of the following does NOT require documentation for a cause-and-effect relationship to be coded? (Reference guidelines I.C.9.a.2 and I.C.9.a.3) - Correct answer Hypertension and chronic kidney disease
21. Which of the following facilities must have no more than 25 inpatient beds? - Correct answer Answer: CAH Rationale: CAHs can have no more than 25 inpatient beds used for either inpatient or swing bed services.
22. Which of the following is also referred to as the voice box? - Correct answer Larynx
23. Which of the following is an example of a DRG payment sys? - Correct answer All Pt Dx Related Groups (APDRG), Severity Diagnosis Related Groups (SDRG), Medicare Severity Diagnosis Related Groups (MSDRG)
24. Which of the following is not a cardiac valve? - Correct answer Intraventricular septum
25. Which of the following is not a cardiac valve? - Correct answer Intraventricular septum
26. Which of the following is not a cardiac valve? - Correct answer Intraventricular septum
27. Which of the following is NOT a packaged service? - Correct answer Anesthesia professional services Packaged items are: >Costs for operating room (OR), procedure room, treatment room, recovery room, and materials, including supplies and equipment for the administration and monitoring of anesthesia

Observation services Certain pharmaceuticals (except for transitional passthrough), drugs, and biologicals that function as supplies >Medical and surgical supplies and equipment other than those in which separate payment is allowed >Ancillary services >Clinical diagnostic laboratory tests >Procedures described by add- on codes >Implantable medical devices (such as pacemakers) >Inexpensive drugs under a per-day drug threshold packaging amount >Guidance services >Image processing services >Intraoperative services Imaging supervision and interpretation services >Professional services, such as anesthesia professional services are paid by Part B under the Physician Fee Schedule (PFS).

28. Which of the following is NOT used to determine the MS-DRG? - Correct answer Services billed by the Physician
29. Which of the following is the normal pacemaker in the heart? - Correct answer SA node
30. Which of the following is true about the typmpanic membrane? - Correct answer It separates the external ear from the middle ear
31. Which of the following is true of the stratum germinativum? - Correct answer It lies on top of the dermis and has access to a rich supply of blood
32. Which of the following procedures is the removal of the gallbladder? - Correct answer Cholecystectomy
33. Which of the following providers are in their first year after graduation from medical school? - Correct answer Answer: Intern Rationale: Interns are usually in their first year following graduation from medical school and are completing a one-year rotation in various departments of the teaching facility departments of the hospital that depend on specialties. Residents are licensed physicians and depending the specialty, have two to five years of training in that specialty.
34. Which of the following services can be billed as observation services to Medicare? - Correct answer Patients undergoing same-day procedures that have a complication arise from the procedure that requires monitoring beyond the usual recovery room period.
35. Which of the following should be on each page of the patient's medical record? - Correct answer Patient's name or ID number.
36. Which of the following statements does NOT describe the Medicare Outpatient Prospective Payment System? - Correct answer Multiple surgical services are not reimbursed separately. Rationale: Although multiple surgical services may be discounted, the procedures are reimbursed separately unless it is a composite payment.
37. Which of the following statements is NOT true about Medicare paymet for hospice services. - Correct answer The payment is $50 of charges
38. Which of the following statements is true regarding an ED encounter? - Correct answer Answer:Two claims are generated: one for the facility and one for the physician. Rationale: When providers perform procedures in the outpatient facility, two bills (claims) are generated. One claim is for the physician services, which are submitted on a CMS-1500 claim form. The other is for the facility services, which are submitted on a UB- claim form. This includes emergency department services.

39. Which of the following statements is true regarding ASCs? - Correct answer Answer:Independent ASCs are privately funded Rationale: Independent ASCs are privately funded, usually from a private investor, and are not associated directly with a hospital.
40. Which one of the following defines cost-to-charge ratio (CCR)? - Correct answer A ratio of the hospital's costs divided by the charges. Rationale: Cost-to-Charge Ratio (CCR)—A ratio of the cost divided by the charges. An APC is a method by which a hospital is reimbursed based on procedures performed instead of a cost-to-charge ratio (a ratio of the hospital's expenses [costs] divided by what the hospital charges [charges]).
41. Which one of the following is a requirement of Type B EDs? - Correct answer It is held out to the public as a place for emergency care without requiring a scheduled appointment.
42. Which option is NOT included in a written plan for care for outpatient therapy? - Correct answer CPT® codes.
43. Which organ produces bile to assist in digestion? - Correct answer Liver
44. Which part is considered the foundation of a word? - Correct answer Root
45. Which part of the brain conrols blood pressure, heart rate and respiration? - Correct answer Medulla
46. Which part of the large intestine is between the hepatic flexure and the splenic flexure? - Correct answer Transverse colon
47. Which payment indicator is assigned to ASC services to indicate a packaged service/item and no separate payment is made? - Correct answer N
48. Which procedures are approved by OPPS to be performed as outpatient hospital procedures? - Correct answer Hysteroscopies
49. Which regulation marked the congressional request for an OPPS to be developed? - Correct answer The Omnibus Budget Reconciliation Act of 1986 Rationale: The Omnibus Budget Reconciliation Act of 1986 (OBRA 86) marked the congressional request for an outpatient prospective payment system to be developed. The Balanced Budget Act included the CMS requirement to move from a cost-based reimbursement for hospital outpatient services to the implementation of an OPPS.
50. Which respiratory structure is comprised of cartilage and liagaments? - Correct answer Trachea
51. Which service is reimbursed based on the APC payment method? - Correct answer Patient X-ray of left foot in the outpatient department Rationale: The APC system is a payment methodology for outpatient, or ambulatory, facility services. It does not include the professional component of ambulatory care, which is

paid under the Resource-Based Relative Value Scale (RBRVS) methodology. Also it does not include services and procedures that require inpatient care and/or procedures paid under an existing fee schedule.

52. Which SI is assigned to procedure or services not discounted when multiple? - Correct answer S
53. Which statement does NOT fall within CMS requirements for electronic signature in the hospital medical record? - Correct answer D. A system in which a physician allows the nurse to review the documentation and signs off on the documentation with the provider's key code.
54. Which statement is FALSE? During the same operative session, multiple procedures are coded if: - Correct answer The same root operation is repeated at different body sites, but different body part value
55. Which statement is true about the 3-day rule? - Correct answer The 3-day rule indicates all diagnostic services performed 3 days prior to an admission that are related to the admission are considered inpatient services.
56. Which statement is TRUE regarding diagnosis codes on the CMS-1500 claim form? - Correct answer ICD- 10-CM codes are reported with the ICD Indicator 0.
57. Which statement is true regarding external cause codes? - Correct answer External cause codes are never sequenced first.
58. Which statement is TRUE regarding inPt admissions? - Correct answer An order must be written for a Pt to be admittes and an inPt
59. Which statement is TRUE regarding the CPT ® Assistant? - Correct answer The CPT ® Assistant is considered an official resource.
60. Which statement is TRUE regarding the differences between ASC and Hospital Outpatient billing? - Correct answer ASCs report modifier TC when indicated and outpatient hospitals do not.
61. Which statement is true regarding the perinatal period? - Correct answer It ends at 28 days
62. Which statement is TRUE regarding Type A emergency departments? - Correct answer The facility must be open 24 hours a day, 7 days a week.
63. Which statement is true regarding Type B emergency department visits? - Correct answer Type B emergency departments can be located on or off campus of the hospital.
64. Which statement is TRUE when a CPT code is identified with the status indicator of T? - Correct answer The procedure or service is discounted when another procedure or service is performed on the same day.

65. Which structure allows urine to exit the body? - Correct answer Urethra
66. Which structure contracts to allow the lungs to expand and fill with air? - Correct answer Diaphragm
67. Which structure holds the testis outside of the body? - Correct answer Scrotum
68. Which structure is an internal organ of the male genital system? - Correct answer Cowper's glands
69. Which structure is excised during circumcision? - Correct answer Prepuce
70. Which structure is not a true endocrine structure? - Correct answer Carotid body
71. Which structure is responsible for moistening, warming, and filtering inspired air? - Correct answer Nose
72. Which structure is the outer layer of the pleura? - Correct answer Parietal pleura
73. Which structure of the ear is considered the inner ear? - Correct answer Labyrinth
74. Which structure transports semen from the epididymis into the pelvis? - Correct answer Vas deferens
75. Which suffix means breathing? - Correct answer -pnea
76. Which type of membrane is found lining the interior walls of the digestive system? - Correct answer Mucous membrane
77. Which valve is located between the right atrium and right ventricle? - Correct answer Tricuspid
78. Which vessel(s) transport blood from the body to the heart? - Correct answer Coronary arteries
79. While walking through a construction site, a young male stepped on a nail. He went to the ED to have it removed. The ED physician removed the nail from deep in the right foot creating a puncture wound. The patient had not had a tetanus vaccine in the past five years. A tetanus shot was given IM. What CPT® and ICD-10-CM codes are reported by the facility? - Correct answer 28192, 90714, 90471, S91.341A, Z23, W45.0XXA, Y92.69, Y93.
80. Who is responsible for creating the medical documentation? - Correct answer Clinician Rationale: Clinicians (for example, nurses, technicians, physicians, etc.) document services rendered during the patient encounter as well as all diagnostic information.
81. Who was contracted to develop ICD-10-PCS? - Correct answer 3M HIS

82. Why is documentation important? - Correct answer Enhances communication and promotes continuity of care among physicians and other health care professionals involved in the patient's care. Rationale: The medical record chronologically documents patient care to: Enable the physician and other health care professionals to plan and evaluate the patient's immediate treatment, and to monitor his or her health care. - Enhance communication and promote continuity of care among physicians and other health care professionals involved in the patient's care.- Facilitate claims review and payments.- Assist in utilization review and quality of care evaluations - Reduce complicated medical reviews.- Provide clinical data for research and education.- Serve as a legal document to verify the services provided (for example, in defense of an alleged professional liability claim).
83. Wound repair codes are determined by what criteria? - Correct answer Location, size in cm, and classification