Comprehensive Coding and Billing Practices, Exams of Nursing

Download Comprehensive Coding and Billing Practices and more Exams Nursing in PDF only on Docsity!

AAPC CPC FINAL EXAM 2024/

When coding in operative report what action would NOT be recommended? - Precise Answer ✔✔Coding from the header with out reading the body of the report If an NCD doesn't exist for a particular service/procedure performed on a Medicare patient who determines coverage? - Precise Answer ✔✔Medicare administrative contractor (MAC) MAC stands for what!? - Precise Answer ✔✔Medicare administrative contractor What is the definition of coding? - Precise Answer ✔✔Translating documentation into numerical/alphabetical codes used to obtain reimbursement. How many components should be included in an effective compliance plan? - Precise Answer ✔✔ 7 Which of the following is NOT a function of the skin? - Precise Answer ✔✔Acts as a gland by synthesizing vitamin A. What is affected by myasthenia gravis? - Precise Answer ✔✔Neuromuscular junction

The term "episiotomy" Best describes a procedure of what type? - Precise Answer ✔✔An incision made into the perineum to enlarge the passage for the fetus during delivery A patient is diagnosed with inflammation of the testes and epididymis. The medical term for this condition is: - Precise Answer ✔✔Orchiepididymitis A condition where the thyroid is overactive is called: - Precise Answer ✔✔Thyrotoxicosis What does ICD 10 CM stand for? - Precise Answer ✔✔International classification of diseases - 10th revised - clinical modification What is the sequencing order when coding a sequela (late effect)? - Precise Answer ✔✔The residual condition is coded first, in the code(s) for the cause of the late effect are coded as secondary What is the ICD 10 CM code for hives? - Precise Answer ✔✔L50. 20-year-old comes into the ED with symptoms of a severe headache, vomiting, stiff neck, and fever. The ED physician suspects that the meningitis is bacterial and performs a lumber puncture. The ED physician reviews the results in the patient is admitted in the hospital for meningitis. The ED physician suspects that the meningitis is bacterial.

Which ICD 10 CM code is reported by the ED physician? - Precise Answer ✔✔G03. 45 year old female with malignant Mullerian duct cancer is receiving her first treatment of chemotherapy. What diagnosis codes are reported? - Precise Answer ✔✔Z51.11, C57. The patient is a 12 month old with a history of muscle weakness. Unfortunately his etiology is unknown and to help delineate the diagnosis neurology has consulted us to obtain a right biceps muscle biopsy. What diagnosis code is reported? - Precise Answer ✔✔M62. The provider orders the following serum blood tests as part of a pre- employment physical exam. The patient goes to the local hospital for the following tests: CBC automated and automated differential WBC count (85025), comprehensive metabolic panel (80053), and a thyroid stimulating hormone assay (84443), all part of the general health panel. A drug screen for multiple drug classes was also collected (80100). What diagnosis code is reported? - Precise Answer ✔✔Z02. What ICD 10 CM code is reported for a patient who is a habitual abuser of cannabis? - Precise Answer ✔✔F12. What codes, according to ICD 10 CM sequencing guidelines, describe a patient that has heart disease due to malignant hypertension with left heart failure? - Precise Answer ✔✔I11.0, 150.

A 45-year-old male patient has developed in ulcer on his upper back. He has had diabetes for many years and is on insulin. The physician determines that the ulcer is due to his diabetes. What ICD 10 CM code are reported? - Precise Answer ✔✔E11.622, L98.429, Z79. What does the root word cool/o stand for? - Precise Answer ✔✔Vagina What does the abbreviation CKD stand for? - Precise Answer ✔✔Chronic kidney disease The patient is in for in initial replacement of a leaking dialysis catheter. What ICD 10 CM code is reported? - Precise Answer ✔✔T82.43XA What is/are the external cause code(s) for a passenger involved in a MVA that lost control on the highway and hit a guardrail? - Precise Answer ✔✔Y92. A patient was admitted three weeks following a normal vaginal delivery with a postpartum breast abscess. What ICD 10 code should be reported? - Precise Answer ✔✔O91. A 28-year-old male was rushed to the ED after being found unconscious. Information from family members indicated that the patient had left a suicide note and taking a large amount of LSD (a hallucinogenic). What ICD 10 CM codes are reported? - Precise Answer ✔✔T40.8X2A, R40.

A 63-year-old fractured her scaphoid bone in her right wrist three months ago in an accident. She now presents with a non-union of the scaphoid bone. What ICD 10 CM code is reported? - Precise Answer ✔✔S62.001K What three components are considered when relative value units are established? - Precise Answer ✔✔Physician work, practice expense, malpractice insurance What is the correct HCPCS Level II code for a removable metatarsal foot arch support which is pre-molded? - Precise Answer ✔✔L What is another term for hives? - Precise Answer ✔✔Urticaria The patient has a suspicious lesion of the left Jolle line. Clinical diagnosis of this lesion is unknown but due to the appearance malignancy is a realistic concern. The lesion was excised into the suspicious that measuring .8 cm and margins of .1 cm on each side. Hemostasis was achieved using light pressure. The wound was closed in layers using 5.0 Monocryl and 6.0 Prolene. Pathology revealed a benign nevus with clear margins. What CPT and ICD 10 CM codes are reported? - Precise Answer ✔✔12051, 11441-51, D23. 44-year-old male with biplanar deformity acquired limb length discrepancies in tibial nonunion has undergone deformity correction. He now requires exchange of an external fixation strut 45 days postoperatively. The intraoperative mounting parameter 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 should reported? - Precise Answer ✔✔ 20697 A young female patient was taken to the operative suite, and was placed under appropriate anesthesia. She has been suffering from pain and a potential rotator cuff tear of the right shoulder. The right arm was sterilely draped and prepped. Arthroscopic portals were created anteriorly- posteriorly. The joint line was carefully examined. The biceps insertion was noted to be normal. The middle and inferior glenohumeral ligaments were visualized in noted to be normal. The undersurface of the rotator cuff was clearly visualized and also noted to be normal. There was a large anterior spur formation. The blur was introduced through a lateral portal and the anterior lip of the acromion was resected. The undersurface of the clavicle was noted to be quite prominent and part of the impinging process. There was intense bursitis and a bursectomy was performed, allowing for acromial decompression and release. Spurs were removed fr - Precise Answer ✔✔23415-RT What modifier must always be applied to medicare claims for test performed in a site with CLIA Waived certificate? - Precise Answer ✔✔QW What does "in vivo" mean? - Precise Answer ✔✔in the living body what is the code for gross and microscopic examination (surgical pathology) of the breast tissue from a simple mastectomy? - Precise Answer ✔✔ 88307

A patient presents with worries she is at risk for cancer. She asks for tests to verify whether she has cancer. The test comes back normal. What type of service is this considered? - Precise Answer ✔✔screening services If the findings on examination of a pap smear are normal and described as "negative for intraepithelial lesion or malignancy" this is a example of what type of results reporting? - Precise Answer ✔✔Bethesda What ICD-10-CM code is reported for elevated blood sugar? - Precise Answer ✔✔R73. What ICD-10-CM code is reported for an abnormal cervical pap smear?

• Precise Answer ✔✔R87. A lab test reveals an excessive level of alcohol in the blood. What ICD- 10-CM code is reported? - Precise Answer ✔✔R78. What do the services in the Reproductive Medicine Procedures section of the Pathology and Laboratory chapter of CPT report? - Precise Answer ✔✔Services related to in vitro fertilization What is usually found in the blood if a person has or used to have an infecting virus? - Precise Answer ✔✔Antibody

A patient with AIDS presents for follow up care. The total T-cell count is ordered to evaluate any progression of the disease. What CPT code is reported? - Precise Answer ✔✔86359- Code 86359 is for total T-cell count. If other studies were performed and they were not ordered they may not be billed, no matter how seemingly appropriate. In the CPT Index, look for T Cells/Count. A patient with AIDS presents for follow up care. An NK (natural killer cell) total count is ordered. What CPT code is/are reported? - Precise Answer ✔✔86357- Although there are a number of cells that attack viruses and other infectious organisms, NK cells are specifically identified by code 86357. In the CPT Index, see Natural Killer (NK) Cells. A virus is identified by observing growth patterns on cultured media. What is this type of identification is called? - Precise Answer ✔✔Presumptive- Presumptive identification identifies microorganisms like by viruses by observing growth patterns and other characteristics. CPT stands for: - Precise Answer ✔✔Current Procedure Terminology Which term reflects the technologic advances made in medicine that are incorporated into the CPT manual? - Precise Answer ✔✔special reports How man sections is the CPT manual divided into? - Precise Answer ✔✔ 6

Where is specific coding information about each section located? - Precise Answer ✔✔Guidelines In which CPT appendix would modifiers be found? - Precise Answer ✔✔Appendix A In which CPT appendix would additions, deletions, and revisions be found? - Precise Answer ✔✔Appendix B A list of the unlisted procedures for use in a specific section of the CPT manual is contained in: - Precise Answer ✔✔Guidelines Who requires a special report with the use of unlisted codes? - Precise Answer ✔✔Third-party payers Which of the following represents three of the six elements that a special report must contain? - Precise Answer ✔✔nature, extent, need Which punctuation mark between codes in the index of the CPT manual indicates a range of codes is available? - Precise Answer ✔✔hypen Which punctuation mark between codes in the index of the CPT manual indicates two codes are available? - Precise Answer ✔✔comma The words that follow a code number in the CPT manual are called: - Precise Answer ✔✔procedure/ service descriptor

A code that has all the words that describe the code following it is called what type of code? - Precise Answer ✔✔stand alone According to surgery guidelines, is surgical destruction part of a surgical procedure? - Precise Answer ✔✔yes First division in the CPT - Precise Answer ✔✔SECTION Second division in the CPT - Precise Answer ✔✔SUBSECTION Third division in the CPT - Precise Answer ✔✔SUBHEADING Fourth division in the CPT - Precise Answer ✔✔CATEGORY What is the largest single mass of lymphatic tissue? - Precise Answer ✔✔Spleen Which main coronary artery bifurcates into two smaller ones? - Precise Answer ✔✔Left What is the term for the divider between the heart chamber walls? - Precise Answer ✔✔Septum

______ is a term standing for enlargement of the heart - Precise Answer ✔✔Cardiomegaly cardio= heart megaly= enlargement repair of coronary vessel is called: - Precise Answer ✔✔Angioplasty angio= vessel plasty= repair Where is the hypertension table located in ICD-10-CM? - Precise Answer ✔✔there is no hypertension table in ICD-10-CM Which statement is true regarding codes for hypertension and heart disease in ICD-10-CM? - Precise Answer ✔✔Hypertension and heart disease without a stated casual relationship must be coded separately. What information is needed in order to accurately code hypertension retinopathy in ICD-10-CM? - Precise Answer ✔✔The affected eye(s) What is the default code for coronary artery atherosclerosis? - Precise Answer ✔✔1125. How many layers of tissue does an artery have? - Precise Answer ✔✔ 3 The conduction system contains pacemaker cells, nodes, the ____, and the _____. - Precise Answer ✔✔Purkinje fibers and Bundle of His

What part of the cardiovascular system is responsible for the one-way flow of blood through the chambers of the heart? - Precise Answer ✔✔Heart valves What information is required to accurately code PVD due to diabetes in ICD-10-CM? - Precise Answer ✔✔Whether the patient has gangrene Bile empties into the duodenum through what structure? - Precise Answer ✔✔Common bile duct Which of the following is not a function on the skin? - Precise Answer ✔✔Acts as a gland by synthesizing vitamin A. What ICD-10-CM code is reported for spontaneous pneumothorax? - Precise Answer ✔✔J93. When a patient has a blood test for HIV that is inconclusive, what ICD- 10-CM code is assigned? - Precise Answer ✔✔R What does MRSA stand for? - Precise Answer ✔✔Methicillin resistant Staphylococcus Aureus When do you code acute respiratory failure as a secondary diagnosis? - Precise Answer ✔✔When it occurs after admission

When the type of diabetes mellitus is not documented in the medical note, what is used as the default type? - Precise Answer ✔✔Type 2 If a patient uses insulin, what type of diabetic does it mean the patient is? - Precise Answer ✔✔The use of insulin doesn't specify the patient is a certain type of diabetic According to ICD-10-CM Guidelines, when a patient is seen for management of anemia due to malignancy, how is it reported? - Precise Answer ✔✔The malignancy is reported first, followed by the code for the anemia. First episode of an acute myocardial infraction - Precise Answer ✔✔I21. secondary neoplasm of the descending colon - Precise Answer ✔✔C78. In which circumstances would an external cause code be reported? - Precise Answer ✔✔causes of injury or health condition adverse effect - Precise Answer ✔✔rash developing when taking oenicillin colp/o - Precise Answer ✔✔vagina

CKD stand for: - Precise Answer ✔✔Chronic Kidney Disease Which statement is TRUE for reporting burn codes? - Precise Answer ✔✔The highest degree of burn is reported as primary code codes for diseases and disorders of the nails - Precise Answer ✔✔chapter 12 Skin What does the 7th character A indicate in Chapter 19? - Precise Answer ✔✔initial encounter What codes are reported voluntarily to payers to provide evidence-based performance-measure data? - Precise Answer ✔✔CPT Category II codes CPT Category III codes are reimbursable at what level of reimbursement? - Precise Answer ✔✔Reimbursement, if any, is determined by the payer HCPCS stands for: - Precise Answer ✔✔Healthcare Common Procedures Coding System How many days does it take for CMS to implement HCPCS Level II Temporary Codes that have been reported as added, changed, or deleted? - Precise Answer ✔✔ 90

OPPS - Precise Answer ✔✔C codes Which statement is TRUE regarding the Instruction for use of the CPT codebook? - Precise Answer ✔✔select the name of the procedure or service that accurately identifies the service performed.