Medical Coding and Billing Practices, Exams of Clinical Medicine

A wide range of topics related to medical coding and billing practices, including the proper coding of various medical conditions and procedures, the use of coding systems like cpt and icd-10-cm, the role of the correct coding initiative in detecting and preventing improper coding, the importance of accurate documentation and communication between healthcare providers and coders, and the legal and regulatory aspects of medical coding and billing. Detailed explanations and examples to help readers understand the complexities of medical coding and billing, and the importance of adhering to established guidelines and best practices in order to ensure accurate reimbursement and compliance with healthcare regulations. Overall, this document would be a valuable resource for anyone interested in or working in the field of medical coding and billing, including healthcare professionals, students, and researchers.

Typology: Exams

2024/2025

Available from 09/13/2024

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CCS Examination Latest Version
10. A coworker complained of sudden onset of chest pain and went to the emergency
room. A myocardial infarction was ruled out. You would code A. the myocardial
infarction as if it were an established condition. B. both the infarction and the chest pain
and sequence the infarction first. C. as an impending myocardial infarction. D. only the
chest pain. - โœ”โœ”D
11. A(n) ____________ form is used to record the patient's diagnoses and the services
performed for a particular visit. It also includes codes (CPT, HCPCS, and ICD-10-CM)
used specifically by that physician's office. A. authorization B. ABN (Advance
Beneficiary Notice) C. superbill D. EOB (Explanation of Benefits) - โœ”โœ”C
12. Your organization is sending confidential patient information across the Internet
using technology that will transform the original data into unintelligible code that can be
re-created by authorized users. This technique is called A. a firewall. C. a call-back
process. B. validity processing. D. encryption - โœ”โœ”D
13. The special form that plays the central role in planning and providing care at
nursing, psychiatric, and rehabilitation facilities is the A. interdisciplinary patient care
plan. B. medical history and review of systems. C. interval summary. D. problem list. -
โœ”โœ”A
14. In the CPT coding system, when there is no code to properly represent the work
performed by the provider, the coder must use this code. A. not otherwise specified B.
not elsewhere classifiable C. unlisted procedure D. miscellaneous code - โœ”โœ”C
15. The physician listed the diagnoses as congestive heart failure with acute pulmonary
edema. You will code A. the CHF only. B. the edema only. C. both the CHF and the
edema; sequence the CHF first. D. both the CHF and the edema; sequence the edema
first. - โœ”โœ”A
16. When coding multiple wound repairs in CPT, A. only the most complex repair is
reported. B. only the least complex repair is reported. C. up to nine individual repair
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CCS Examination Latest Version

  1. A coworker complained of sudden onset of chest pain and went to the emergency room. A myocardial infarction was ruled out. You would code A. the myocardial infarction as if it were an established condition. B. both the infarction and the chest pain and sequence the infarction first. C. as an impending myocardial infarction. D. only the chest pain. - โœ”โœ”D
  2. A(n) ____________ form is used to record the patient's diagnoses and the services performed for a particular visit. It also includes codes (CPT, HCPCS, and ICD- 10 - CM) used specifically by that physician's office. A. authorization B. ABN (Advance Beneficiary Notice) C. superbill D. EOB (Explanation of Benefits) - โœ”โœ”C
  3. Your organization is sending confidential patient information across the Internet using technology that will transform the original data into unintelligible code that can be re-created by authorized users. This technique is called A. a firewall. C. a call-back process. B. validity processing. D. encryption - โœ”โœ”D
  4. The special form that plays the central role in planning and providing care at nursing, psychiatric, and rehabilitation facilities is the A. interdisciplinary patient care plan. B. medical history and review of systems. C. interval summary. D. problem list. - โœ”โœ”A
  5. In the CPT coding system, when there is no code to properly represent the work performed by the provider, the coder must use this code. A. not otherwise specified B. not elsewhere classifiable C. unlisted procedure D. miscellaneous code - โœ”โœ”C
  6. The physician listed the diagnoses as congestive heart failure with acute pulmonary edema. You will code A. the CHF only. B. the edema only. C. both the CHF and the edema; sequence the CHF first. D. both the CHF and the edema; sequence the edema first. - โœ”โœ”A
  7. When coding multiple wound repairs in CPT, A. only the most complex repair is reported. B. only the least complex repair is reported. C. up to nine individual repair

codes may be reported. D. all wound repairs are grouped and coded, with the most complex reported first. - โœ”โœ”D

  1. Which of the following is coded as a late effect in ICD- 10 - CM? A. tinnitus due to allergic reaction after administration of eardrops B. mental retardation due to intracranial abscess C. rejection of transplanted kidney D. nonfunctioning pacemaker due to defective soldering - โœ”โœ”A
  2. When a patient presents with a primary neoplasm with metastasis and treatment is directed toward the secondary neoplasm only, A. code only the primary neoplasm as the principal diagnosis. B. the primary neoplasm is coded as the principal diagnosis and the secondary neoplasm as an additional diagnosis. C. the secondary neoplasm is coded as the principal diagnosis, and the primary neoplasm as an additional diagnosis. D. code only the secondary neoplasm as the principal diagnosis. - โœ”โœ”C
  3. The autonomic nervous system has two divisions: A. the sympathetic system and the parasympathetic system. B. the sympathetic and the efferent peripheral system. C. the parasympathetic system and the peripheral nervous system. D. the afferent peripheral system and the somatic nervous system - โœ”โœ”A
  4. HPV or human papillomavirus is A. caused by the spirochete Treponema pallidum. B. a vaginal inflammation that is caused by a protozoan parasite. C. also known as genital warts. D. characterized by painful urination and an abnormal discharge. - โœ”โœ”C
  5. A marked loss of bone density and increase in bone porosity is A. lumbago. C. spondylitis. B. osteoarthritis. D. osteoporosis. - โœ”โœ”D
  6. The blood disorder in which red blood cells lack the normal ability to produce hemoglobin is called A. aplastic anemia. C. pernicious anemia. B. hemolytic anemia. D. thalassemia. - โœ”โœ”D
  7. Which diagnostic technique records the patient's heart rates and rhythms over a 24- hour period? A. echocardiography C. Holter monitor B. electrocardiography D. angiocardiography - โœ”โœ”C
  1. A patient is seen in the emergency department following an accident. The physician documents that the wound required multiple layers and extensive undermining. According to CPT definitions, this type of repair would be classified as A. complex. C. simple. B. intermediate. D. advancement flap. - โœ”โœ”A
  2. CMS delegates its daily operations of the Medicare and Medicaid programs to A. the office of the Inspector General. B. the PRO in each state. C. the National Center for Vital and Health Statistics. D. the Medicare administrative contractor (MAC). - โœ”โœ”D
  3. The emergency room discharge diagnosis for this outpatient encounter is "rule out myocardial infarction." The coder would assign A. a code for a myocardial infarction. B. a code for the patient's symptoms. C. a code for an impending myocardial infarction. D. no code for this condition. - โœ”โœ”B
  4. The _______________ are the organizations that contract with Medicare to perform reviews of medical records with the corresponding Medicare claims to detect and correct improper payments. A. Atlas Systems B. medical outcomes study C. recovery audit contractors (RACs) D. adjusted clinical groups (ACGs) system - โœ”โœ”C
  5. _______________________ is a defect characterized by four anatomical abnormalities within the heart that results in poorly oxygenated blood being pumped to the body. A. Atrial septal defect C. Tetralogy of Fallot B. Patent ductus arteriosus D. Coarctation of the aorta - โœ”โœ”C
  6. Urinary frequency, urgency, nocturia, incontinence, and hesitancy are all symptoms of A. BPH. C. salpingitis. B. end-stage kidney disease. D. genital prolapse. - โœ”โœ”A
  7. Down's syndrome, Edwards' syndrome, and Patau syndrome are all examples of _________ defects. A. musculoskeletal C. genitourinary tract B. chromosomal D. digestive system - โœ”โœ”B
  8. The type of anemia caused by a failure of the bone marrow to produce red blood cells is A. acute blood-loss anemia. C. iron-deficiency anemia. B. sickle cell anemia. D. aplastic anemia. - โœ”โœ”D
  1. Which of the following procedures can be identified as "destruction" of lesions in CPT coding? A. removal of skin tags C. laser removal of condylomata B. shaving of skin lesion D. paring of hyperkeratotic lesion - โœ”โœ”C
  2. The chargemaster relieves the coders from coding repetitive services that require little, if any, formal documentation analysis. This is called A. grouping. C. soft coding. B. hard coding. D. mapping. - โœ”โœ”B
  3. A patient has a total abdominal hysterectomy with bilateral salpingectomy. The coder selected the following CPT codes: 58150, 58700, 58700. This type of coding is referred to as A. upcoding. C. maximizing. B. unbundling. D. optimization. - โœ”โœ”B
  4. The APC payment system is based on what coding system(s)? A. AMA's CPT codes B. CPT and ICD- 10 - CM diagnosis and procedure codes C. ICD- 10 - CM diagnosis and procedure codes D. CPT/HCPCS codes - โœ”โœ”D
  5. When is it appropriate to use category Z85, history of malignant neoplasm? A. Primary malignancy recurred at original site and adjunct chemotherapy is directed at the site. B. Primary malignancy has been eradicated and no adjunct treatment is being given at this time. C. Primary malignancy eradicated and the patient is admitted for adjunct chemotherapy to primary site. D. Primary malignancy is eradicated; adjunct treatment is refused by patient even though there is some remaining malignancy. - โœ”โœ”B
  6. The diagnosis reads "first-, second-, and third-degree burns of the right arm." You would code A. the first degree only. C. the third degree only. B. the second degree only. D. each degree of burn separately - โœ”โœ”C
  7. Codes from category O36, known or suspected fetal abnormality affecting the mother, should A. be assigned if the fetal conditions are documented. B. be assigned at the discretion of the physician. C. be assigned when they affect the management of the mother. D. never be assigned. - โœ”โœ”C

reporting. B. clinical documentation improvement (CDI). C. tumor registry (TR). D. evidence-based medicine. - โœ”โœ”B

  1. To enter the results of a urinalysis into the computer system, you would use a(n) A. laboratory system. C. pharmacy system. B. radiology system. D. order entry/results reporting system. - โœ”โœ”A
  2. You have been asked to give an example of a clinical information system. Which one of the following would you cite? A. laboratory information system C. billing system B. financial information system D. Admission, Discharge, Transfer - โœ”โœ”A
  3. Which of the following acts was passed to stimulate the development of standards to facilitate electronic maintenance and transmission of health information? A. Health Insurance for the Aged B. Health Insurance Portability and Accountability Act C. Conditions of Participation D. Hospital Survey and Construction Act - โœ”โœ”B
  4. Alisa has trouble remembering her password. She is trying to come up with a solution that will help her remember. Which one of the following would be the BEST practice? A. using the word "password" for her password B. using her daughter's name for her password C. writing the complex password on the last page of her calendar D. creating a password that utilizes a combination of letters and numbers - โœ”โœ”D
  5. The purpose of the notice of privacy practices is to A. notify the patient of uses of PHI. B. notify the patient of audits. C. report incidents to the OIG. D. notify researchers of allowable data use. - โœ”โœ”A
  6. Before a user is allowed to access protected health information, the system confirms that the patient is who he or she says they are. This is known as A. access control. C. authorization. B. notification. D. authentication. - โœ”โœ”D
  7. Which of the following can be released without consent or authorization? A. summary of patient care B. de-identified health information C. personal health information D. protected health information - โœ”โœ”B