Medical Coding and Billing Practices, Exams of Advanced Education

Download Medical Coding and Billing Practices and more Exams Advanced Education in PDF only on Docsity!

NCCT Certified Insurance & Coding – 4

Exam With 100% Correct Answers 2024

Which of the following is an example of unethical or illegal coding? a. Dividing services provided into separate codes when a single code is available. b. Inclusion of all the relevant complications as documented in the patient's medical record c. Using code numbers for the minimum payment allowed d. Strict adherence to coding for only procedures performed at your facility - Correct Answer-a. Dividing services provided into separate codes when a single code is available. The transformation of verbal descriptions of diseases, injuries, and procedures into numbers is called _______. a. indexing b. posting c. tabulation d. coding - Correct Answer-d. coding Two coding systems are used by physicians' offices. One is for diagnoses and the other is for _______. a. symptoms b. computer directories c. services and procedures d. appointments - Correct Answer-c. services and procedures Physicians' Current Procedural Terminology (CPT) is revised _______. a. annually b. when necessary c. every 6 months d. every 2 years - Correct Answer-a. annually CPT codes use _______. a. 3 to 5 digits b. 5 digits c. 2 digits d. 3 digits - Correct Answer-b. 5 digits Modifier -26 indicates the _______. a. service is significant and separately identifiable b. unusual nature of the service or procedure c. technical component d. professional component - Correct Answer-d. professional component

Codes 99281 through 99285 refer to _______. a. counseling services b. outpatient consultations c. office surgery d. emergency department services - Correct Answer-d. emergency department services In some billing cases it is necessary to add a 2 digit modifier in order to _______. a. indicate usual charges b. prevent miscoding c. give a more accurate description d. meet carrier criteria - Correct Answer-c. give a more accurate description CPT codes, descriptions and 2 digit modifiers are copyrighted by the _______. a. American Medical Association b. Blue Cross and Blue Shield Organization c. CPT Assistant d. World Hospital Organization - Correct Answer-a. American Medical Association When transferring codes to claim forms be careful to _______. a. include descriptions b. write out all abbreviations c. keep from transposing numbers d. write neatly - Correct Answer-c. keep from transposing numbers Unbundling, exploding, or a la carte coding are _______. a. common b. fraudulent c. necessary d. complex - Correct Answer-b. fraudulent If multiple lacerations are repaired under the same classification and in the same group of anatomic parts a billing and coding specialist should _______. a. add the sum of lengths and report one code b. report a code for each laceration c. include a printed report d. report only the longest laceration - Correct Answer-a. add the sum of lengths and report one code Modifier code -66 indicates _______. a. procedure performed on infants b. surgical team c. assistant physician d. two surgeons - Correct Answer-b. surgical team Modifier code -99 indicates _______.

a. laboratory work b. surgical tray c. universal application d. multiple modifiers - Correct Answer-d. multiple modifiers Which of the following is NOT needed when coding a laceration repair? a. Depth of wound b. Size of wound c. Location of wound d. Cause of wound - Correct Answer-d. Cause of wound The modifier for a repeat procedure by the same physician is _______. a. - b. - c. - d. -76 - Correct Answer-d. - The purpose of CPT is to _______. a. revise technologic advances b. simplify the CMS-1500 form c. convert medical descriptions into 5 digit codes d. organize insurance billers' work - Correct Answer-c. convert medical descriptions into 5 digit codes The CPT coding system is used by all of the following EXCEPT _______. a. doctor's offices and clinics b. outpatient departments c. third party payers d. patients - Correct Answer-d. patients The CPT coding system was developed by the _______. a. American Medical Association b. federal government c. state government d. Social Security Administration - Correct Answer-a. American Medical Association In the CPT manual, a round bullet symbol indicates a _______. a. bundled code b. new code c. revised code d. deleted code - Correct Answer-b. new code A triangle symbol in the CPT manual indicates a _______. a. minor surgical procedure b. decision for surgery c. new code

d. revised description - Correct Answer-d. revised description In the CPT manual, where is a complete summary of additions, deletions and revisions located? a. In Appendix B b. In Appendix A c. In the Index d. In the Table of Contents - Correct Answer-a. In Appendix B Which of the following is NOT one of the sections in the CPT manual? a. Evaluation and management b. Integumentary system c. Surgery d. Medicine - Correct Answer-b. Integumentary system There are two types of CPT codes: stand alone and _______. a. sub codes b. parent codes c. stand aside codes d. indented codes - Correct Answer-d. indented codes In CPT coding, the words following the semicolon may indicate all of the following EXCEPT _______. a. alternative anatomic site b. alternative procedure c. lesser important procedures d. extent of procedure - Correct Answer-c. lesser important procedures CPT surgical packages are used only by _______. a. third party payers b. physicians c. anesthesiologists d. radiologists - Correct Answer-a. third party payers Which of the following is NOT included in the CPT surgery package? a. The operation b. The surgery c. Normal follow-up care d. General anesthesia - Correct Answer-d. General anesthesia Which of the following indicates a co-surgeon? a. - b. - c. - d. -62 - Correct Answer-d. -

When using CPT codes to indicate an unlisted procedure, the last digit will usually be a _______. a. 9 b. 2 c. 3 d. 4 - Correct Answer-a. 9 Claims including codes for an unusual, new, seldom performed or unlisted procedure should include a _______. a. duplicate copy b. written medical report c. written description by the code number d. numerical summary - Correct Answer-b. written medical report In the CPT index, main terms are listed by _______. a. procedure or service b. organ or anatomic site c. condition, synonym, eponym or abbreviation d. all answers are correct - Correct Answer-d. all answers are correct At the beginning of the CPT index are ________. a. diagrams b. instructions c. definitions d. anatomical listings - Correct Answer-b. instructions Even if only one code is listed for the desired procedure in the index of the CPT manual, the user _______. a. can select that code b. must refer to the main text c. can expect cross references d. notes that code on the claim form - Correct Answer-b. must refer to the main text A cholera vaccination for the product only is coded as _______. a. 90725 b. 82438 c. 82435 d. 90757 - Correct Answer-a. 90725 The code for ordinary replacement of contact lens is _______. a. 92311 b. 92340 c. 92326 d. 92352 - Correct Answer-c. 92326

The key components of documentation that support levels of E/M codes include the following EXCEPT _______. a. history b. examination c. counseling and coordination of care d. medical decision-making - Correct Answer-c. counseling and coordination of care Components of a medical history include all of the following EXCEPT _______. a. medical decision making b. chief complaint c. family history d. review of systems - Correct Answer-a. medical decision making A key component in coding medical decision-making is _______. a. patient childhood diseases b. level of complexity c. the physician's level of education d. the amount of time the physician spends with the patient - Correct Answer-b. level of complexity Physician counseling is considered a key component for selecting the level of code assignment for Evaluation and Management services only when _______. a. the physician is a psychiatrist b. counseling exceeds 50% of the time spent c. the physician does not take a history or perform a physical examination d. the physician is a psychologist - Correct Answer-b. counseling exceeds 50% of the time spent Critical care is coded _______. a. in quarter hour units b. each time the patient is seen in a 24 hour period c. the minute the patient is determined to have a life threatening emergency d. ventilator management is included - Correct Answer-d. ventilator management is included In a case requiring critical care coding, _______. a. the coder is expected to unbundle b. no other services are included c. ventilator management is not included d. ventilator management is included - Correct Answer-d. ventilator management is included A code indicating a vaginal delivery only, not including obstetric care, is _______. a. 59409 b. 59410 c. 59610

d. 59561 - Correct Answer-a. 59409 Physician telephone calls are usually _______. a. coded according to area codes b. not paid by third party payers c. paid by third party payers d. coding using HCPCS Level II codes - Correct Answer-b. not paid by third party payers Care Plan Oversight Services for hospice and homebound patients _______. a. require vast documentation and are typically not paid by third party payers b. are usually paid by third party payers c. are not listed services in CPT d. are coded once for every 24 hour period the patient is seen - Correct Answer-a. require vast documentation and are typically not paid by third party payers Which of the following conditions would not require critical care? a. Cardiac arrest b. Labor leading to childbirth c. Shock d. Respiratory failure - Correct Answer-b. Labor leading to childbirth Anesthesia codes are divided by _______. a. medication b. anatomical site c. drug name d. number of anesthesiologists - Correct Answer-b. anatomical site For anesthesia coding purposes, physical status modifiers are used to indicate _______. a. age of patient at time of surgery b. patient's status upon admittance c. patient's status at the time of anesthesia d. patient's status at the time of completion of surgery - Correct Answer-c. patient's status at the time of anesthesia Where in the CPT manual are codes for anesthesia provided under difficult circumstances? a. Anesthesia guidelines b. Medicine c. Surgery d. Both anesthesia guidelines and medicine are correct answers - Correct Answer-d. Both anesthesia guidelines and medicine are correct answers Which section of the CPT manual is the largest? a. Medicine

b. Evaluation and Management c. Surgery d. Radiology - Correct Answer-c. Surgery When one fee is used for a surgical procedure and uncomplicated follow-up care, this is called a(n) _______. a. surgical unit b. global surgical package c. general procedure d. cluster - Correct Answer-b. global surgical package Surgeries which are prolonged or extremely difficult are coded with the modifier _______. a. - b. - c. - d. -52 - Correct Answer-c. - A code used to indicate that a physician assisted the primary surgeon in a major procedure is _______. a. - b. - c. - d. -51 - Correct Answer-b. - The following are subsections of the surgery section of the CPT manual EXCEPT

---

a. musculoskeletal b. cardiovascular c. radiology d. female genital - Correct Answer-c. radiology For coding purposes, information about the size of a lesion should come from _______. a. the physician report b. the medical assistants' measurements c. radiology report d. pathology report - Correct Answer-a. the physician report Free skin grafts are coded by _______. a. degree of burn b. type of wound c. recipient site and size of defect d. length of grafted area - Correct Answer-c. recipient site and size of defect For a breast biopsy, the placement of a wire marker is _______. a. coded separately

b. included in the excision code c. coded by size of the wire gauge d. coded by the depth the marker is placed - Correct Answer-a. coded separately Fractures are coded by _______. a. application of casts and strapping procedures b. cast material and type c. site and treatment d. cause of injury - Correct Answer-c. site and treatment To code diagnostic endoscopy procedures _______. a. code each area that is passed with the scope b. never code more than one procedure in an operative setting c. select the code that reflects the farthest extent of the procedure d. ignore the approach - Correct Answer-c. select the code that reflects the farthest extent of the procedure Code groupings for arteries and veins vary according to _______. a. procedure b. surgical instruments c. function d. directional flow - Correct Answer-a. procedure Codes for the digestive system are arranged by site, beginning with the mouth and ending with the _______. a. feet b. anus c. rectum d. sigmoid - Correct Answer-b. anus A surgical endoscopy always includes _______. a. an x-ray b. a diagnostic endoscopy c. a -51 modifier d. a sigmoidoscopy - Correct Answer-b. a diagnostic endoscopy When coding -ostomies, it is critical to _______. a. indicate the anastomosis b. use a medical dictionary c. identify the site from which it originated d. determine the type of material used - Correct Answer-c. identify the site from which it originated When an exploratory laparotomy is used as a surgical approach for another procedure, it is _______. a. always coded separately

b. not coded separately c. considered the most definitive procedure d. considered the primary procedure - Correct Answer-b. not coded separately In the CPT index, hernia codes are listed _______. a. by anatomic site of hernia b. by type of repair c. by patients' gender d. under "Protrusion" - Correct Answer-a. by anatomic site of hernia The code for a total hysterectomy includes removal of the _______. a. uterus b. ovaries c. fallopian tubes d. all answers are correct - Correct Answer-d. all answers are correct Codes for the nervous system subsection of the CPT manual are divided _______. a. by specific names of nerves b. by body region c. by anatomic site and type of procedure d. alphabetically by nerve type - Correct Answer-c. by anatomic site and type of procedure When coding spinal procedures, consider all of the following EXCEPT _______. a. the segments involved b. unilateral or bilateral orientation c. approach d. condition - Correct Answer-b. unilateral or bilateral orientation If a radiologist is reading films taken at another facility _______. a. use a modifier to indicate the technical component b. use a modifier to indicate the professional component c. a global code is used d. an outpatient code is used - Correct Answer-b. use a modifier to indicate the professional component When contrast material is injected by a radiologist, the injection procedure code is taken from the _______. a. surgery section b. radiology section c. anesthesiology section d. E/M section - Correct Answer-a. surgery section Codes in the Diagnostic Radiology subsection are arranged _______. a. by amount of radiation given b. by anatomic site

c. alphabetically d. technologically - Correct Answer-b. by anatomic site When coding radiation oncology, consider all of the following EXCEPT _______ a. treatment type b. level of treatment planning c. age of the patient d. number of ports and blocks - Correct Answer-c. age of the patient Considerations when coding urinalysis and chemistry laboratory procedures include all of the following EXCEPT _______. a. names of specific tests b. number of test done c. specification of qualitative or quantitative results d. brand names for lab equipment - Correct Answer-d. brand names for lab equipment Level I pathology code 88300 identifies specimens that normally do not need to be viewed under a microscope such as _______. a. a tooth b. malignant uterus tissue c. fluid from a breast biopsy d. neoplastic tissue - Correct Answer-a. a tooth If a physician spends 50 minutes with a patient after he or she has been admitted for a suicide attempt in connection with depression, the psychotherapy coding would be _______. a. bundled b. separate from initial care c. considered outpatient d. disregarded - Correct Answer-b. separate from initial care The major factor for coding psychiatry is _______. a. time b. physician credentials c. inpatient outpatient status d. counseling - Correct Answer-a. time The Physical Medicine codes are indication of types of modalities and _______. a. temperature b. location c. time d. method - Correct Answer-c. time When coding trauma cases, the most severe injury is _______. a. bundled with all other injuries b. the only one coded

c. coded first d. coded last - Correct Answer-c. coded first The code for a simple drainage of a finger abscess is _______. a. 26011 b. 26010 c. 26951 d. 26034 - Correct Answer-b. 26010 The appropriate code for an indirect laryngoscopy with removal of foreign body is _______. a. 31505 b. 31530 c. 31511 d. 31512 - Correct Answer-c. 31511 The code for the complicated removal of a subcutaneous foreign body of the foot is _______. a. 28190 b. 28192 c. 28193 d. 11010 - Correct Answer-c. 28193 The code for a percutaneous needle core breast biopsy (without imaging) is _______. a. 19100 b. 76095 c. 19101 d. 19102 - Correct Answer-a. 19100 The appropriate code for a gastrojejunostomy without vagotomy is _______. a. 43820 b. 43810 c. 43860 d. 48547 - Correct Answer-a. 43820 The code for a complex arthrotomy of the knee (lateral) with meniscectomy is _______. a. 27332 b. 27332- c. 27333 d. 27333-22 - Correct Answer-b. 27332- The range of codes for newborn care (that includes normal newborn care) is _______. a. 99400- b. 99460- c. 99292- d. 99466-99467 - Correct Answer-b. 99460-

The code for Subsequent Hospital Care which indicates physician visits for a patient in stable condition is _______. a. 99231 b. 99232 c. 99233 d. 99238 - Correct Answer-a. 99231 Which Emergency Department Services code indicates a need for urgent evaluation without the presence of a life-threatening condition? a. 99285 b. 99284 c. 99238 d. 99282 - Correct Answer-b. 99284 The code for harvesting a small bone graft when the graft is not already listed as a part of the procedure is _______. a. 27170 b. 20930 c. 20936 d. 20900 - Correct Answer-d. 20900 The code for a simple repair of a superficial scalp wound not exceeding 2.5 cm in length is _______. a. 12001 b. 12011 c. 12031 d. 13100 - Correct Answer-a. 12001 The code for repair of a flexor tendon of the leg is _______. a. 27650 b. 27658 c. 27658 x 2 d. 27659 - Correct Answer-b. 27658 The preoperative placement of a needle localization wire in the breast is coded _______. a. 19100 b. 19291 c. 19290 d. 19295 - Correct Answer-c. 19290 If an arthroplasty is performed for reasons of a fractured ankle, it is coded _______. a. 20605 b. 27700 c. 27870

d. 29891 - Correct Answer-b. 27700 Which code describes a surgical thoracoscopy with excision-plication of bullae as well as pleural procedures? a. 32650 b. 32601 c. 32655 d. 32656 - Correct Answer-c. 32655 The code for a coronary artery bypass graft using three arterial grafts is _______. a. 33535 b. 33534 c. 33533 d. 33510 - Correct Answer-a. 33535 The code for a partial colectomy with anastomosis is _______. a. 44140 b. 44141 c. 44140 - d. 44150 - Correct Answer-a. 44140 Which code describes a laparoscopy, surgical, with vaginal hysterectomy (uterus 250 g or less) with the removal of the ovaries? a. 58545 b. 58262 c. 58552 d. 58553 - Correct Answer-c. 58552 The CPT that appropriately describes a set of obstetric laboratory tests for the first obstetric visit is _______. a. 59409 b. 80050 c. 80055 d. 86762 - Correct Answer-c. 80055 The highest level of pathology coding which would include examination of neoplastic tissue or very involved specimens is _______. a. 88304 b. 88305 c. 88307 d. 88309 - Correct Answer-d. 88309 Which code indicates an immunization for tetanus toxoid? a. 90703 b. 90698 c. 90700

d. 90715 - Correct Answer-a. 90703 If a therapeutic infusion is introduced for up to 1 hour, which code is used? a. 96360 b. 96365 c. 96369 d. 96371 - Correct Answer-b. 96365 A hemodialysis procedure requiring repeated evaluations would be coded as _______. a. 90939 b. 90940 c. 90935 d. 90937 - Correct Answer-d. 90937 Codes 92002 to 92014 deal with _______. a. eye surgery b. ophthalmoscopy c. ophthalmological services d. special ophthalmological services - Correct Answer-c. ophthalmological services Prosthetic training (upper or lower) for a session of 15 minutes would be coded as _______. a. 97762 b. 97763 c. 97760 d. 97761 - Correct Answer-d. 97761 A physical performance test or measurement that lasts 30 minutes and includes a written report is coded as _______. a. 97750 x 2 b. 97750 c. 97799 d. 99080 - Correct Answer-a. 97750 x 2 The proper code for a radiological exam of the eye for detection of a foreign body is _______. a. 70190 b. 70200 c. 70140 d. 70030 - Correct Answer-d. 70030 An x-ray of the gastrointestinal tract with a small bowel follow-through is coded _______. a. 74220 b. 74249 c. 74246

d. 74247 - Correct Answer-b. 74249 A bone density study of the appendicular skeleton by DXA is coded as _______. a. 77081 b. 77080 c. 77078 d. 77082 - Correct Answer-a. 77081 Testicular imaging for vascular flow is coded as _______. a. 78730 b. 78761 c. 78799 d. 78800 - Correct Answer-b. 78761 An antibody test (nonspecific type) for herpes simplex virus is coded as _______. a. 86694 b. 86695 c. 86696 d. 86701 - Correct Answer-a. 86694 Which of these is the CPT code for surgical endoscopy of the nose, with dilation of the sphenoid sinus ostium? a. 31295 b. 31296 c. 31297 d. 312.98 - Correct Answer-c. 31297 Repair of a paraesophageal hiatal hernia (including fundoplication) via thoracoabdominal incision with implantation of mesh for an adult is coded as _______. a. 43334 b. 43335 c. 43336 d. 43337 - Correct Answer-d. 43337 Computed tomography of the pelvis and abdomen, without the use of contrast material, is coded as _______. a. 74176 b. 74177 c. 74178 d. 74179 - Correct Answer-a. 74176 A qualitative drug screen (each procedure) that can assess multiple drug classes using a method other than chromatography would be oded as _______. a. 80100 b. 80102 c. 80103

d. 80104 - Correct Answer-d. 80104 The code for intranasal administration of a pandemic formulation of an influenza virus vaccine is _______. a. 90460 b. 90470 c. 90664 d. 90666 - Correct Answer-c. 90664