CPMA PRACTICE EXAM QUESTIONS WITH CORRECTLY SOLVED ANSWERS., Exams of Nursing

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CPMA PRACTICE EXAM

QUESTIONS WITH CORRECTLY

SOLVED ANSWERS.

Which below is NOT one of the CAT I subsections: a. Anatomic b. Procedural c. Condition d. Service Type - Correct Answer-d. Service Type Code for influenza immunization status assessed (CAP) a. 1030F b. 1031F c. 1026F d. 1040F - Correct Answer-a. 1030F. Influenza immunization status assessed (CAP) What are Category II HCPCS codes? a. These are also known as CPT codes b. E & M Codes c. Category I codes are supplemental tracking codes that can be used for performance measurement. d. CMS Tracking codes. - Correct Answer-c. Category I codes are supplemental tracking codes that can be used for performance measurement. Code for community-acquired bacterial pneumonia assessment. a. 0012F b. 0005F c. 0014F d. 0015F - Correct Answer-a. 0012F: Community-acquired bacterial pneumonia assessment (includes all of the following components). (CAP): Co-morbid conditions assessed (1026F) Vital signs recorded (2010F) Mental status assessed (2014F) Hydration status assessed (2018F) Code for screening mammography results documented and reviewed. a. 3006F b. 3011F

c. 3014F d. 3017F - Correct Answer-c. 3014F: Screening mammography results documented and reviewed. Code for hypertension plan of care documented as appropriate (HTN) a. 4060F b. 4050F c. 4051F d. 4052F - Correct Answer-b. 4050F: Hypertension plan of care documented as appropriate (NMA - No Measure Associated) The main function of Category III CPT codes is: a. To allow data collection for these services b. Provide reimbursement for new procedures c. Bill the patient for procedures not covered by insurance. d. Charge for supplies and injections - Correct Answer-a. CAT III CPT codes main function is to allow data collection for experimental or transitional procedures or services. Which procedure below is included in a normal baby delivery? a. Fetal umbilical cord occlusion. b. Fetal fluid drainage. c. Fetal shunt placement. d. None of the answers are correct. - Correct Answer-d. None of the answers are correct. 59071: fetal umbilical cord occlusion 59074: fetal fluid drainage 59076: fetal shunt placement These procedures alls have specific CPT codes. How are skin grafts measured? a. Inches b. Centimeters c. Square centimeters d. Skin grafts are always handled in laceration repairs and not reported separately. - Correct Answer-c. Square centimeters. Lacerations are measured in centimeters. The definition of outpatient for procedures includes: a. Ambulatory surgeries, ER visits, and observation only patients b. Ambulatory surgeries and observation only patients. c. Only Ambulatory surgeries d. Ambulatory surgeries, ER visits, and observation only patients, Critical Care and all neo-natal visits - Correct Answer-a. The US definition of Outpatient for procedures includes: Ambulatory surgeries, ER visits, and observation only patients

The physician forgot to ask the emergency room patient if he was new or established. How would this be coded? a. It cannot be coded without further information b. Typically in this situation, a nurse or billing specialist will call the doctor c. Since it is unknown, AMA CPT coding guidelines require the patient reported as New. d. None of the answers are correct. - Correct Answer-d. There are no new or established designations or codes for ER visits. What is the difference between a foreign body and a loose body in CPT? a. A loose body is a pin or implant that is now loose and floating or moving freely within the body. b. A foreign body is something foreign to the body but not an implant. c. A loose body is most often found in a joint and originally part of the persons body (i.e., cartilage). d. One is an ICD-10 concept and the other relates to specific removal CPT codes. - Correct Answer-d. A foreign body does not refer to a screw or pin or something implanted in the body. A loose body is cartilage or bone or some other body tissue most often found in or near a joint. Alos, foreign body is an IVD-10 code (and there are FB removal codes in CPT); loose body removal is a CPT code. Insertion of aqueous drainage device, without extraocular reservoir, internal approach, into subconjunctival space; initial device. a. 0191T b. 0253T c. 0449T d. 0450T - Correct Answer-c. 0449T: these are CAT III codes. Straightforward. Rarely paid. Considered experimental and temporary. This code was added in 2017. CPT codes: a. Are part of the code set standard selected by HIPAA, used to describe health care services in electronic transactions. b. Were developed by the AMA. c. Are organized into three categories. d. All of the answers are correct. - Correct Answer-d. CPT codes are part of the code set standard selected by HIPAA, used to describe health care services in electronic transactions. When the physician does not specify the method used to remove a lesion during an endoscopy, what is the appropriate procedure? a. Assign the removal by snare technique code as a s default b. Assign the removal by hot biopsy forceps code

c. Ass the ablation code d. Query the physician as to the method used - Correct Answer-d. Query the physician as to the method used Do not report Anticoagulant Management codes if: a. Period is less than 30 days. b. Period is less than 60 days. c. Period is less than 90 days. d. Period is less than 120 days. - Correct Answer-b. Period is less than 60 days. What is the difference between AMA/CPT coding guidelines versus private carrier coding and billing guidelines? a. There is no major difference. Guidelines are guidelines. b. While the majority of private payers will follow Medicare guidelines, neither Medicare nor private carriers must follow all AMA CPT guidelines. They can create their own carrier-specific rules and even violate coding norms. c. All carriers myst follow AMA CPT or Medicare guidelines. d. If a carrier violates an AMA CPT rule or guideline you can appeal and will always win if the AMA CPT or AMA CPT Assistant guideline supports your case. - Correct Answer-b. While the majority of private payers will follow Medicare guidelines, neither Medicare nor private carriers must follow all AMA CPT guidelines. They can create their own carrier- specific rules and even violate coding norms. The doctor removed the neoplasm stating "I have seen a hundred like these. I just know it's benign." Is this allowed? a. A professional doctor can remove any lesion he or she desires. There is no problem with this. b. The problem is that, without a pathology report, the coder cannot report the correct excision code. c. The could have his/her license revoked for removing a lesion without a biopsy. d. This is considered a state-specific rule and does not apply to all states.

• Correct Answer-b. This is an AMA CPT guideline and the coder should never report a lesion removal without first getting a pathology report. It could be malignant, benign, or uncertain behavior. These are legal issues as well as coding guidelines. What is a foreign body (FB)? a. Anything found or left in the body that does not belong. b. Wood glass, stone, metal, dirt, or other material not intentionally put in the eye. c. It is not something put into the body or the body creates (conjunctival concretion)

d. The first two answers above are correct. - Correct Answer-b. Wood glass, stone, metal, dirt, or other material not intentionally put in the eye. A suture is not a FB. A calculus is not either. This is a coding definition and most medical professionals consider anything foreign to be a FB. But don't code removal of a stent, plug, or suture as the removal of a FB. The AMA CPT Assistant is a: a. Widely acclaimed certification title b. Valuable coding resource c. Applies only to primary care d. Person who assists with coding - Correct Answer-b. Valuable coding resource available from the AMA online. Very valuable for large clinics. Which area below would most likely be outside the range of a coding audit? a. Inpatient services b. Nursing home visits c. Laboratory services d. Level I E&M visits - Correct Answer-c. Laboratory services. Labs are certified by CLIA and typically not part of a coders' responsibility. But they would be the managers responsibility. What is a RAC audit? What does it mean? a. Medicare Recovery Audit Contractor; RAC is a nationwide auditing program focusing on improper payments, duplicate payments, Fiscal Intermediaries' mistakes, medical necessity and coding. b. Medicare Reimbursement Advisory Consultant: RAC is a nationwide auditing program focusing on Hospital inpatient and outpatient, Skilled nursing facility, Physician, Ambulance and laboratory, and DME c. Medicare Recovery APC Contractor; RAC is a nationwide program that in 2008, CMS reported that the RACs has succeeded in correcting more than $1.03 billion in Medicare improper payments. d. Medicare Recovery Audit Contractor; in 2010 RAC has been expanded to 25 states. - Correct Answer-a. Medicare Recovery Audit Contractor; RAC is a nationwide auditing program focusing on improper payments, duplicate payments, Fiscal Intermediaries' mistakes, medical necessity and coding. It was expanded to all fifty states. The acronym description is correct for (a) and the explanation is correct for (a), (b) and (c), but not (d). (a) is the best answer.