Medicare and Coding Exam Questions and Answers, Exams of Medicine

Download Medicare and Coding Exam Questions and Answers and more Exams Medicine in PDF only on Docsity! CPC Exam Questions And Answers. medicare part A - \The part of the Medicare program that pays for hospitalization, care in a skilled nursing facility, home health care, and hospice care. Medicare Part B - \the part of medicare that helps cover madically necessary physician services outpatient care and other medical services full services not covered under medicare part a part B is an optional benefit for which the patient must pay a premium in which generally requires a yearly deductible and co insurance Medicare Part C (Medicare Advantage) - \combines benefits of part A and B, sometimes D. Medicare—Part D - \Prescription drug coverage medical coding - \The process of translating this written or dictated medical record into a series of numeric and alpha numeric codes 2 primary types of insurers - \commercial insurance plans and government insurance plans Medicare - \provides coverage for people over the age of 65, bling or disabled individuals, and people with permanent kidney failure or end stage renal disease (ESRD) Medicaid - \a health insurance assistance program for low income people Advanced Beneficiary Notice (ABN) - \Document that informs covered patients that Medicare may not cover a certain service and the patient will be responsible for the bill required before billing the patient if coverage is denied HITECH - \Health Information Technology for Economic and Clinical Health Act - allows patients to request an audit trail of their disclosures of their health info made through the electronic health record - requires that an individual be notified if their is an unauthorized disclosure of their health info compliance plan - \A written set of instructions outlining the process for coding and submitting accurate claims, and what to do if mistakes are found. The AAPC was founded in what year? - \1988 can a word have more than one root? - \yes blephar/o - \eyelid bucc/o - \cheek cholecyst/o - \gallbladder colp/o - \vagina cyst/o - \A fluid sac or pouch, urinary bladder derm/o - \skin encephal/o - \brain enter/o - \intestine hem/o, hemat/o - \blood my/o - \muscle myel/o - \spinal cord, bone marrow onych/o - transverse plane (horizontal) (axial) - \cuts horizontally through the body and separates the body into upper (superior) and lower (inferior) sections Basic unit of all living things - \cell (4) connective tissue groups: - \adipose tissue, cartilage, bone, blood what does muscle tissue do? - \causes movement What are organs? - \two or more kinds of tissue together performing special body functions What are systems? - \a group of organs working together to perform a complex body function what is the cranial cavity? - \space in the skull or cranium that contains the brain what is the spinal (vertebral) cavity? - \space inside the spinal column containing the spinal cord what is the thoracic cavity? - \Space containing the heart, lungs, esophagus, trachea, bronchi, and thymus. what is the abdominal cavity? - \The space containing the lowest portion of the esophagus, the stomach, intestines (excluding the sigmoid colon and rectum), kidneys, liver, gallbladder, pancreas, spleen, and ureters. what is the pelvic cavity? - \The space containing the urinary bladder, certain productive organs, part of the large intestine, and the rectum. mucus membranes - \Line the interior walls of the organs and tubes that open to the outside of the body, such as those of the digestive, respiratory, urinary, and reproductive systems. serous membranes - \line cavities, including the thoracic cavity and internal organs. synovial membranes - \• line joint cavities • composed of connective tissue • secrete synovial fluid into joint cavities meninges - \Composed of 3 connective tissue membranes found within the dorsal cavity and serve as a protective covering of the brain and spinal cord. cutaneous membrane - \another name for skin largest organ system of the body? - \integumentary system the integumentary system is composed of? - \skin, hair, nails skin consists of ___ layers - \2 epidermis and dermis hair has ___ structures - \2 follicle and shaft Nails are composed of ___ parts - \6 root, nail bed, nail plate, cuticle, perionychium, hyponychium musculoskeletal system is composed of? - \muscles, joints, tendons and joints Bone Classification - \long bones, short bones, flat bones, irregular bones, and sesamoid. closed fracture - \Does not involve a break in the skin compound fracture - \Projects through the skin with a possibility of infection comminuted fracture - \more than 2 pieces transverse fracture - \bone break with fracture line straight across shaft of bone across longitudinal axis. greenstick fracture - \only one side of the shaft is broken and the other is bent; common in children spiral fracture - \Spread along length of bone and produced by twisting stress Colles fracture - \fracture of the distal radius at the wrist compression fracture - \Occurs in vertebrae and is subject to extreme stress epiphyseal fracture - \Occurs where the matrix is undergoing calcification and chondrocytes are dying; usually seen in children Cartilage - \A connective tissue that is more flexible than bone and that protects the ends of bones and keeps them from rubbing together. there are ___ types of joints - \3 fibrous, cartilaginous, and synovial skeletal muscle - \striated and voluntary smooth muscle - \involuntary muscle found in hollow organs cardiac muscle - \wall of the heart the human body contains ___ types of blood vessels - \3 arteries, veins, and capillaries the heart is composed of ___ layers - \3 \Instructs the coder to select a code to represent the etiology that caused the manifestation. list etiology 1st and manifestation 2nd eponym - \a disease, structure, operation, or procedure named for the person who discovered or described it first the main term is: - \a term identifying disease or conditions do not code a term when it is listed as: outpatient - \probable, suspected, questionable, working, differential, consistent with, and rule out. When a definitive diagnosis has not been determined: outpatient - \Signs, symptoms, abnormal test results, and other reasons for the visit are acceptable for reporting purposes true or false: in the inpatient settings report suspected or ruled out diagnoses as if the condition exists - \true which is sequenced first? acute or chronic - \acute condition confirmed cases of HIV should be coded to - \Z21 treatment for HIV related illnesses should be coded to - \B20 types of neoplasms excluded from the table of neoplasms - \lipomas melanomas neuroendocrine tumors Merkel cell carcinomas for malignant neoplasms, code first - \the site requiring care and then the other site 1st trimester of pregnancy - \less than 14 weeks 0 days 2nd trimester of pregnancy - \14 weeks to less than 28 weeks 0 days 3rd trimester of pregnancy - \28 weeks until delivery encounter for full term uncomplicated delivery is code - \O80 when there are multiple burns, code: - \code the deepest level of burn first How to code poisoning - \1. the first code is from the Table of Drugs and Chemicals identifies the drug 2. the second code indicates the conditions and manifestations that resulted from the poisoning TRUE OR FALSE: codes for underdosing are NEVER used as the primary diagnosis? - \True MODIFIER 22 (Increased procedural services) - \when the services provided is greater than usually required MODIFIER 23 (unusual anesthesia) - \when a procedure that usually requires local/no anesthesia must be performed under general anesthesia due to unusual circumstances Modifier-26 Professional Component - \use when the professional component is reported separately Modifier -32 Mandated Services - \mandatory consultation requested by insurance MODIFIER 91 (repeat clinical diagnostic laboratory test) - \used when its necessary to repeat the same lab test on the same day to obtain subsequent test results autologous - \Obtained from the patient allograft - \obtained from another human donor xenograft - \obtained from an animal can external cause codes be a first listed diagnosis? - \no "articular" fracture refers to? - \a movable joint "extra-articular" fracture means? - \the fracture does not does not extend into the joint "intra-articular" fracture means? - \the fracture extends into the joint a bunion is AKA - \hallux valgus deformity the upper chambers of the heart are the? - \atria What do the atria do? - \receive blood the lower chambers of the heart are the? - \ventricles What do the ventricles do? - \pump blood out of the heart the most muscular chamber of the heart is? - \left ventricle 3 methods of circulation: - \systemic, pulmonary, and coronary incisors - \front teeth cupids - \the pointy teeth immediately behind the incisors molars - \Back teeth that grind food duodenum - \first portion of the small intestine, connected to the stomach jejunum - \the middle third of the small intestine