ICD-10-CM and HCPCS Coding Guidelines for Medical Professionals, Exams of Medicine

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Medical Coding CPC Exam Questions

and Answers.

Patients receiving a diagnostic service (e.g. ultrasound, MRI, diagnostic colonoscopy), with additional diagnosis, is reported in what sequence? - \Report the condition or problem as the primary code to indicate the reason for the test, codes for other diagnosis, like chronic conditions or history are reported as additional diagnosis. Who are the parties responsible for providing the ICD-10-CM guidelines? - \NCHS and CMS What is the sequencing order when coding a sequela? - \The residual condition is coded first, and the code for the cause of the late effect are coded as secondary. If the subterms are not listed when looking in the ICD-10-CM Alphabetic Index (ex. Impending menopause, there is no subterm for menopause under impending) then what do you code? - \If the subterm is not listed then code the symptoms. What is an example of an eponym? - \Paget's disease When coding for an ambulatory surgical procedure, how is the diagnosis determined? - \Code the postoperative diagnosis because it is the most definitive. If no bilateral code is provided and the condition is bilateral, how are the codes assigned? - \Assign separate codes for both left and right sides. If a bilateral code is provided, and both left and right sides are stated, how are the codes assigned? - \You report the bilateral code, do not report two separate codes. When the admission/encounter is for management of dehydration due to the malignancy or therapy, or a combination of both, and only the dehydration is being treated; how is this sequenced? - \The dehydration is sequenced first, followed by the code for the malignancy.

According to ICD-10-CM guidelines, when a patient is seen for management of anemia due to malignancy, how is it reported? - \The malignancy is reported first, followed by the code for the anemia. When do you code acute respiratory failure as a secondary diagnosis? - \When it occurs after admission. According to ICD-10-CM guidelines, what is the maximum length of time for a myocardial infarction to be considered acute? - \Four weeks (28 days) When a migraine does not respond to medication it is considered what? - \Intractable In ICD-10-CM what condition is reported as the default code when the provider documents urosepsis? - \The provider must be queried before an ICD-10-CM code can be applied. When we are not given more information as to a specific type of tumor, whether its benign or malignant, what do we code it as? - \Unspecified Behavior When it is documented that the patient is both using tobacco and has a dependence on tobacco, hos is this reported in ICD-10-CM? - \The dependence on tobacco is the only code reported based on the hierarchy in the ICD-10-CM guidelines. What does MRSA stand for? - \Methicillin Resistant Staphylococcus Aureus According to the ICD-10-CM guidelines, how is bilateral glaucoma of the same type and stage reported? - \A bilateral code can be used to report the type of glaucoma and the stage of glaucoma. In which circumstances would an external cause code be reported? - \Causes of injury or health condition. How are poisoning codes sequenced? - \First by the poison code, and then followed by the condition or manifestation. Superficial injuries such as abrasions or contusions are not coded when associated with what? - \More severe injuries to the same site. What is a TRUE statement in reporting pressure ulcers? -

\Two codes are assigned when a patient is admitted with a pressure ulcer that evolves to another stage during the admission. How do you find a passenger who is involved in an MVA in the ICD-10-CM External Cause Codes? - \Go to Accident/transport/car occupant/passenger/collision After an abortion, if there are retained products of conception, then what type of abortion is this classified as? - \Incomplete abortion If the documentation states that the pressure ulcer is completely healed, what code is assigned? - \No code is assigned if a pressure ulcer is healed. What is NOT an example of active treatment for pathological fractures? - \Cast change Pregnancy after age 35 is considered an elderly pregnancy, which means you should always report what code? - \A code from category O09.52-. When a patient is seen for a pre-operative evaluation due to a specific diagnosis, while during the evaluation some type of other health diagnosis is made (such as hypertension), how is the coding sequenced? - \First code the pre-procedural z code, followed by the reason for the surgery. Then code any diagnoses made during the pre-procedural evaluation. If the pain is not specified as acute or chronic, do not assign codes from what category?

\G When looking for pleural effusion, where do you look in the ICD-10-CM Alphabetic Index? - \Look under Pleurisy/Effusion. If a patient has hyperthyroidism with an uninodular goiter, where do you look in the ICD- 10-CM Alphabetic Index? - \Hyperthyroidism/with/goiter/nodular/uniodoular What is an Eponym? - \Disease or syndrome named after a person. What agency maintains and distributes HCPCS Level II codes? - \CMS

What three components contribute to the calculation of Relative Value Units? - \Physician work, Practice expense, Malpractice insurance. How are ambulance modifiers used? - \They identify ambulance place of origin and destination. What type of print indicates new additions and revisions in the CPT codebook each year? - \Green print What does the acronym HCPCS stand for? - \Healthcare Common Procedure Coding System CPT Category III codes reimburse at what level? - \Reimbursement, if any, is determined by the payer. Which statement is TRUE regarding the instruction for use of the CPT codebook? - \Select the name of the procedure or service that accurately identifies the service performed. The Table of Drugs in the HCPCS Level II book indicates various medication routes of administration. What abbreviation represents the route where a drug is introduced into the subdural space of the spinal cord? - \IT How many days does it take CMS to implement HCPCS Level II Temporary Codes that have been reported as added, changed or deleted? -
How often are HCPCS Level II permanent national codes updated? - \Annually What temporary HCPCS Level II codes are required for use by Outpatient Prospective Payment System (OPPS) Hospitals? - \C codes HCPCS Level II includes code ranges that consist of what type of codes? - \Permanent national codes, miscellaneous codes and temporary national codes. What modifier is used to report the termination of surgery following induction of anesthesia due to extenuating circumstances or those that threaten the well-being of the patient? - \Modifier 53 What does "non-facility" describe when calculating Medicare Physician Fee Schedule payments? -

\Non-hospital owned physician practices. What type of CPT code is "modifier 51 exempt" even though there is no modifier 51 exempt symbol next to it? - \Add-on codes If a CPT code and a HCPCS Level II code exist for the same service, which one does Medicare prefer to report? - \HCPCS Level II code The Global Surgical Package applies to services performed in what setting? - \Hospitals, Ambulatory Surgical Centers, and Physicians Offices. What codes are voluntarily reported to payers and provide evidence-based performance-measure data? - \CPT Category II codes What procedures are "mandated" by third party payers, what modifier would you use? -
What chapter in the HCPCS Level II code book lists the code for Wheelchairs? - \Durable Medical Equipment (E0100-E8002) What surgical status indicator represents the Global Surgical Package for endoscopic procedures (without an incision) where there is no postoperative period after the day of the surgery? -
What publications does the AMA copyright and maintain? - \CPT codebook and CPT assistant Where is the starting point for selective catheter placement for the vascular families in Appendix L in the CPT codebook? - \Aorta What is the appropriate modifier to use when two surgeons perform separate distinct portions of the same procedure? -
Services provided in the home by an agency are considered? - \Facility services When coding a rhomboid flap, what do you have to look under? - \Tissue transfer, because it is considered an adjacent tissue transfer. Is Seborrheic keratosis a benign or malignant lesion? -

\Benign