Medical Coding Practice Exam Questions and Answers, Exams of Nursing

Download Medical Coding Practice Exam Questions and Answers and more Exams Nursing in PDF only on Docsity! 1 [Date] COC Practice Exam 6 Latest Questions and Answers 2023 2 [Date]  Where is a retrobulbar injection delivered? a. Testis b. eye c. ovary d. medulla - Correct answer b. eye  Which of the following is part of the appendicular skeleton? A. The cervical spine B. The scapula C. The sternum D. The zygomatic arch - Correct answer B. The scapula 5 [Date]  Mrs. Jones is diagnosed with a simple goiter. This is a disorder of which system?  Nervous  Endocrine  Respiratory  Circulatory - Correct answer B. Endocrine  Which of the following most accurately describes the difference between Type 1 and Type 2 diabetes? 6 [Date]  Type 1 diabetes affects children. Type 2 diabetes affects adults.  Type 1 diabetes requires insulin. Type 2 diabetes does not.  Type 1 diabetes is controlled. Type 2 diabetes is uncontrolled.  Type 1 diabetes is autoimmune disease. Type 2 diabetes is not. - Correct answer D. Type 1 diabetes is autoimmune disease. Type 2 diabetes is not.  What are cataracts? 7 [Date]  A defect in the management of intraocular pressure  Opacities or other defects in the lens of the eye  Proliferation of abnormal vessels at the back of the eye  A drooping of eyelids that occurs with age - Correct answer B. Opacities or other defects in the lens of the eye 10 [Date]  Endotracheal intubation  Lumbar puncture  None of the above - Correct answer D. None of the above  Which of the following status indicators is paid under OPPS?  C  A  N  Y - Correct answer C. N  Condition 20 is reported when: 11 [Date]  The item or service is not covered under statute, but the patient or other payer request the services billed for denial  The patient demands for a claim to be submitted.  The service may not be covered but the facility is not certain.  The service is typically covered. - Correct answer B. The patient demands for a claim to be submitted. 12 [Date]  What is the reimbursement rate for two procedures with status indicator S performed at the same surgical session?  Both services are paid at 100 percent  The service with the highest reimbursement is paid at 100 percent and the second procedure is paid at 50 percent.  Both services are paid at 50 percent 15 [Date]  When coding for E/M services in a facility, select the code based on:  The 1995 or 1997 CMS Documentation Guidelines.  The policy developed by the facility to determine the E/M services.  The E/M guidelines developed by the AMA.  The policy developed in the OPPS final rule. - Correct answer B. The policy developed by the 16 [Date] facility to determine the E/M services.  Mr. Jayd is a 92 year-old patient of Mensa Nursing Home, complaining of right hip pain. X-ray confirms right hip pathological fracture at the base of the neck of the femur due to secondary adenocarcinoma of the bone. He has moderate Alzheimer's disease with dementia. He will be admitted. 17 [Date]  M84.551A, C79.51, C80.1, G30.9, F02.80  M84.451A, C79.51, C80.1, G30.9, F02.80  M84.351A, C79.51, C80.1, G30.9, F02.81  S72.041A, C79.51, C80.1 G30.9, F02.81 - Correct answer A. M84.551A, C79.51, C80.1, G30.9, F02.80  The patient just turned 50 and is here today for a screening 20 [Date]  The patient was diagnosed with adenoma of the prostate and underwent transurethral destruction via radiofrequency thermotherapy. Code the diagnosis.  D29.1  C61  N40.0  D49.59 - Correct answer A. D29.1 21 [Date]  Mrs. Bixby is an 83 year-old being admitted for dehydration and anorexia. Probable cause, dementia. She was brought in by her daughter who is visiting from out of town. Her daughter will take her from our office to St. Mary's Hospital. The gerontology unit will evaluate her mental condition tomorrow after she is stabilized. How would you code the diagnoses?  F50.00, E86.0 22 [Date]  R63.0, E86.0  F50.00 E86.0, F06.8  R63.0, E86.0, F06.8 - Correct answer B. R63.0, E86.0  A patient presents with nausea and vomiting after taking a course of Amoxicillin (penicillin) that was prescribed by her primary care physician. She followed the instructions for the proper use of the medication.Select the diagnosis code(s). 25 [Date]  J03.X9, E10.10  E10.69, J11.89 - Correct answer A. E10.10, J09.X9  Provide the correct ICD-10-CM code for choledocholithiasis with obstruction.  K80.81  K80.51  K80.71  K80.6 - Correct answer B. K80.51 26 [Date]  The patient is being treated for acute-on-chronic pansinusitis.  J01.40  J32.4  J32.4, J01.40  J01.40, J32.4 - Correct answer D. J01.40, J32.4  A patient presents to the ER with crushing chest pain radiating down the left arm and up under the chin. There are elevated S-T segments on EKG. The cardiologist orders 27 [Date] three serial CPK enzyme levels with instructions that the tests are also to be done with isoenzymes if the initial tests are elevated for that date of service. The CPK enzyme levels were elevated, therefore, the lab codes would be:  82550, 82552, 82550-76 x 2 units, 82552-76 x 2 units  82550, 82552, 82552-91 x 2 units  82550, 82550-91 x 2 units, 82552, 82552-91 x 2 units 30 [Date] room air X-ray right hip: Positive hip dislocation. Dr. M was notified of the patient's physical exam findings and test results. The patient was prepared and agreed to conscious sedation to include placement on continuous EKG monitoring, 02, suction and bag- valve-mask ready, pulse oximetry in place. Fentanyl 50 mg IV and Versed 2 mg IV was given by Dr. M who supervised the MCS for 30 minutes. The patient's right hip 31 [Date] was easily reduced using gentle traction performed by Dr M. Post reduction X-ray showed right hip in good location with no obvious fracture. The patient tolerated the procedure very well.Code the procedure(s).  27257, 99151  27257  27250, 01200  27250, 99152, 99153 - Correct answer D. 27250, 99152, 99153 32 [Date]  The patient was brought in severely dehydrated. She received one hour and 32 minutes of hydration therapy with 1000 cc of normal saline.Code the services provided.  96360, J7030  96360, 96361 x 2, J7030  96360, 96361, J7030  96365, 96366, J7030 - Correct answer C. 96360, 96361, J7030 35 [Date]  44143 - Correct answer A. 44141  What is the appropriate code to report an injection of 150 mg of Leucovorin Calcium?  J0641  J0640  J0640 x 3  J0641 x 3 - Correct answer C. J0640 x 3  Select the appropriate code for a pediatric motorized wheelchair. 36 [Date]  E1239  K0010  K0011  K0012 - Correct answer A. E1239  Which code reports 400 ml of low osmolar contrast material?  Q9951  Q9965  Q9966  Q9967 - Correct answer A. Q9951 37 [Date]  What is the appropriate code for a CPAP full face mask?  A7030  A7031  A7044  E0601 - Correct answer A. A7030  OPERATIVE REPORT PREOPERATIVE DIAGNOSIS: Right knee medial meniscus tear and lateral meniscus 40 [Date] starting from day two. Patient stated that about 90 percent of her pain is improved. Patient denied any complications or side-effects from the first injection.Patient decides to have second injection done today. Informed consent was obtained.DESCRIPTION OF PROCEDURE: The patient was positioned in the prone position, Betadine solution prep, localized the skin over the area of foraminal of L5-S1, C-arm is oblique and 41 [Date] slightly caudad. Using fluoroscopy as guide for needle position, using patient paraesthesia to confirm needle position, 25 gauge spinal needle was inserted, and the patient experienced paraesthesia into her left lower extremities. Negative aspiration, injecting 1 ml of 0.2 percent Sensorcaine MPF with 40 mg of Depo-Medrol, I did not inject Isovue due to patient's allergies to iodine. The patient tolerated the procedure well and 42 [Date] returned to the recovery room outpatient without any difficulty.PLAN: Plan is to see the patient back for follow-up in about two-three weeks. What are the correct codes for this encounter?  64483, J1030  64483, 64484, 77003, J1030  64483, 64484, J1030  64483, 77003, J1030 - Correct answer A. 64483, J1030 45 [Date] procedure were reviewed with the patient and the patient's voiced concerns addressed. The printed consent form was signed and witnessed.The patient was placed in the prone position on the fluoroscopy table and automated blood pressure cuff and pulse oximeter applied. The skin entry point for approaching left sacroiliac joint was identified under the most advantageous fluoroscopic view and marked. 46 [Date] Following thorough Chloraprep preparation of the skin and draping and 1 percent Lidocaine infiltration of the skin entry point and subcutaneous tissues, a 22 gauge spinal needle was placed under fluoroscopic guidance into left sacroiliac joint. Intra-articular placement was confirmed by a clear arthrogram resulting from the injection of 0.5 ml of Isovue 200 M. 1ml of 0.5 percent Bupivacaine and 80 mg of Depo-Medrol was 47 [Date] injected into the sacroiliac joint with an initial reproduction of a significant component of the usual pain.Code the procedure(s):  20610, 77002  20611  20552  27096 - Correct answer D. 27096 oAngina pectoris.2. Severe ostial disease of the posterior descending artery.OPERATIONS:1. 50 [Date] performed. The patient was given sedation by a member of the anesthesia department. A 120 J of synchronized shock was delivered but atrial fibrillation appeared to persist after a few sinus beats. Therefore, a 200 J of synchronized biphasic shock was delivered. Once again, sinus rhythm was restored but only for a few 50 seconds. Then, delivered a second 200 J of synchronized biphasic shock and then this time 51 [Date] sinus rhythm was restored and persisted.CONCLUSIONS: Successful direct current cardioversion after a few attempts with restoration of normal sinus rhythm.What is the first-listed CPT® code for this patient encounter?  92960  92961  92971  92950 - Correct answer A. 92960 52 [Date]  PREOPERATIVE DIAGNOSIS: DysphagiaPOSTOPERATIVE DIAGNOSES: Antral gastritis, H. pylori, Varix, distal esophagusOPERATIVE PROCEDURE: Esophagogastroduodenoscopy with biopsiesSURGEON: JP, MDINDICATIONS: Mr. I is a 46 year-old white male referred to us from Dr. S's office with a history of dysphagia. He is also a heavy ETOH consumer and complains of 55 [Date] suggestion of a singular varix in the distal esophagus. There was no sign of reflux esophagitis or structuring, etc.The scope was advanced into the gastric pouch, which was insufflated. There was found to be modest amount of inflammation in the distal stomach. The scope was advanced through the pylorus and into the first and the second portion of the duodenum which was unremarkable. The scope was 56 [Date] withdrawn, multiple biopsies taken of the antrum. The fundus of the stomach was viewed on inversion. No additional findings. The scope was withdrawn into the distal esophagus where a sharply defined squamocolumnar junction was noted. The scope was then removed. The patient tolerated the procedure well and was transferred to the recovery area in stable condition.What is the correct procedure code? 57 [Date]  43202  43235  43236  43239 - Correct answer D. 43239  OPERATIVE PROCEDURE: Ventral herniorrhaphy with mesh INDICATIONS: The patient is a 68 year-old white female referred to our office with a history of upper abdominal discomfort and pain with certain types of movements due to what she describes as a 60 [Date] small, being roughly 4 to 5 cm in length. However, there was very poor quality tissue on all sides of the defect, with very thin linea alba superior and inferior to the defect. It was decided at this point to reinforce this area of the anterior abdominal wall and therefore the rectus sheath was opened at is medial most aspect on both sides of the midline. The posterior rectus sheath was then sutured from side to side to itself to close the midline 61 [Date] defect. This was done for roughly two-thirds of the distance from the umbilicus to the xiphoid process. Then a medium size Kugel patch was placed posterior to the rectus muscles and secured in place with suture of 0 Vicryl. At this point, the anterior rectus fascia and the rectus muscle were then closed over the Kugel patch with multiple interrupted figure-of-eight sutures of #1 Vicryl. The mesh was then unable to be seen as it was 62 [Date] located within this somewhat of a "sandwich" of tissue of the anterior abdominal wall. At this point then, the subcutaneous tissue was examined. There was found to be an excess of midline skin, which was then excised. The subcutaneous tissues were then closed with multiple interrupted sutures of 0 Vicryl and the skin was closed with a continuous running subcuticular closure of 3-0 Monocryl. Dry gauze dressing was 65 [Date] biopsyINDICATIONS FOR PROCEDURE: Mr. Doe is a pleasant, middle-aged gentleman referred to us for evaluation of myopathy with the specific request of performing left deltoid muscle biopsy. After explaining the risks and benefits of the procedure, we proceeded.OPERATIVE FINDINGS: UnremarkableDESCRIPTION OF PROCEDURE: The patient was taken to the operating room and 66 [Date] placed in the supine position. A time out was performed to confirm the patient's identity and the procedure to be performed. We prepped and draped the left shoulder sterilely. We infiltrated the tissues overlying the left deltoid muscle with a mixture of Lidocaine and Bupivacaine. We made a small vertical incision dissecting down to the deltoid muscle and sharply excised two pieces of this. The wound was 67 [Date] irrigated and then closed in layers with absorbable suture. We applied Dermabond as a sterile dressing. The patient tolerated the procedure well.SPECIMENS REMOVED: Left deltoid muscle specimen was sent to Dr. Jane Doe's lab for analysis on moist Telfa. ADDENDUM: PATHOLOGY CONFIRMS MYOPATHY What is the CPT® code for this procedure?  20200 70 [Date] excision for definitive diagnosis. He presents today for that purpose.OPERATIVE FINDINGS: The patient had a left chest wall mass excised without difficulty. The mass measured approximately 7 centimeters and had the benign appearance of a lipoma.DESCRIPTION OF PROCEDURE: Mr. C was brought to the operating room and placed supine on the operating room table. Because this was a sedation 71 [Date] case, no sequential compression devices were applied. However, a single dose of Ancef 1 gram was administered intravenously 10 minutes prior to the incision time. Sedation was then initiated with Propofol and Fentanyl and the patient was prepped and draped in the standard surgical fashion. The left chest wall mass was palpated and an incision directly over it along the Langer's line was planned. This was infiltrated with a 72 [Date] mixture of 1 percent plain lidocaine and 0.5 percent plain Marcaine. The incision was then made and carried down through the dermis with electrocautery. We then opened the subcutaneous tissue of the skin and immediately encountered an organized mass that has a benign appearance of a lipoma. Using careful blunt and sharp dissection, we were able to completely excise this mass around its entire circumference 75 [Date] loss was minimal. Intravenous fluids were 700 milliliters of crystalloid. Sponge, instrument, and needle counts were correct at the end of the case. The condition of the patient on discharge from the operating room was stable.SPECIMENS REMOVED: Left chest wall mass measuring 7 cmWhat is the correct CPT® code?  11406  21555 76 [Date]  19120  21552 - Correct answer D. 21552