Medical Coding And Billing Sample

Medical Coding And Billing Sample Certification Questions

4.   Which one of the following statements accurately represents the practice known as unbundling?

A. Combination codes are assigned separately in ICD-10-CM.   B. Codes that should be grouped into one code are broken into separate codes to maximize physician reimbursement.   C. ICD-10-PCS codes are broken into separate codes for congruent assignment.   D. Codes listed as separate procedures are assigned individually.

 

5.   Placing a catheter into the aorta or directly into an artery or vein is called

A. brachiocephalic manipulation.   B. third order placement.   C. selective catheter placement.   D. nonselective catheter placement.

 

6.   What ICD-10-CM code would be assigned for a patient with acute tubule-interstitial nephritis?

A. L50.0   B. Z02.6   C. N10   D. B96.2

 

7.   The suffix -sis means

A. inflammation.   B. drooping.   C. condition.   D. process.

 

8.   The concept of meaningful use pertains to

A. medical office protocol and document organization.   B. electronic health record implementation.   C. resource management in the inpatient setting.   D. categorization of patient information.

 

9.   In what CPT code range is Surgical Pathology found?

A. 88400–80499   B. 88000–80299   C. 88300–88309   D. 88515–88598

 

10.   According to the CMS National Physician Fee Schedule, what is the conversion factor for basic life support mileage?

A. $32.4726   B. $34.5741   C. $28.8457   D. $36.0666

 

11.   A patient who was involved in a motor vehicle accident is taken to the hospital by ambulance and admitted to the hospital in critical care. The physician sees the patient for 74 minutes in critical care. The physician leaves to attend to other patients in the ICU and the NICU of the same hospital. Five hours later, the physician returns to the patient and continues to treat the patient in critical care for an additional 30 minutes. The patient spends a total of 104 minutes in critical care. What codes are assigned?

A. 99291, 99292   B. 99292, 99293   C. 99291, 99291   D. 99292, 99292, 99293

 

12.   The prefix endo- means

A. beneath.   B. outside of.   C. adjacent to.   D. within.

 

13.   What is the CPT code for a three-view x-ray of the mandible?

A. 70200   B. 70100   C. 70150   D. 70240

 

14.   Rules of evidence control the

A. amount of evidence that may be admitted during a civil trial.   B. processes and procedures for question and answer sessions.   C. documents that can be considered during jury trial.   D. length of criminal court proceedings, but not civil court proceedings.

 

15.   The ampulla, isthmus, interstitium, and fimbria are examples of

A. implantation sites of ectopic pregnancy.   B. incision sites for pacemaker insertion.   C. membranes in the abdomen.   D. bones in the ankle.

 

16.   Code J9165 is assigned for intravenous diethylstilbestrol diphosphate. According to the code description, what dosage was administered?

A. 20 mg   B. 50 mg   C. Up to 0.5 mg   D. 250 mg

 

17.   Members of the uniformed services, their families and survivors, and retired members and their families qualify for

A. TRICARE.   B. OIG Recovery.   C. Medicare.   D. Medicaid.

 

18.   A patient comes to the emergency room complaining of abdominal pain. She was previously diagnosed with type I diabetes. She also complains of watery eyes, congestion, pressure in the sinuses, and difficulty breathing. Her final diagnoses are right lower quadrant abdominal pain, type I diabetes, acute sinusitis, and asthma. What CPT and ICD-10-CM codes are assigned?

A. 99222, R18.91, E16.9, J01.91, J45.919   B. 99221, R17.41, E17.9, J01.90, J45.909   C. 99221, R10.31, E10.9, J01.90, J45.909   D. 99223, R14.31, E15.9, J01.90, J45.929

 

19.   Under HIPAA, health care facilities must

A. follow up with patients who repeatedly miss scheduled appointments for mandatory services.   B. keep records of patients who refill prescriptions more than once within a three-month timeframe.   C. maintain a clean, safe working environment.   D. choose a privacy officer in accordance with HIPAA policies and procedures.

 

20.   What is the ICD-10-CM code for unspecified acute pericarditis?

A. I30.89   B. I30.9   C. I30   D. I30.79

 

21.   What is the full code description for 25515?

A. Open treatment of radial shaft fracture, includes internal fixation, when performed   B. Closed treatment of ulnar shaft fracture; without manipulation   C. Closed treatment of radial shaft fracture; without manipulation   D. Open treatment of radial shaft fracture, includes internal fixation, when performed, and open treatment of distal radioulnar joint dislocation (Galeazzi fracture/dislocation), includes internal fixation, when performed, includes repair of triangular fibrocartilage complex

 

22.   Which of the following anatomical locations would contain the diaphysis?

A. Metatarsal   B. Diaphragm   C. Septum   D. Tibia

 

23.   A patient recently became eligible for health insurance through her employer. Her health insurance is considered to be an 80-20 policy. Under the terms of an 80-20 policy, the insurer pays 80 percent and the insured pays 20 percent of expenses. This 80-20 policy is an example of

A. coinsurance.   B. prospective payment.   C. capitation.   D. case management.

 

24.   The Outpatient Prospective Payment System (OPPS) pays

A. an established rate for outpatient services in specific hospitals.   B. a percentage of the national average for the same surgery performed in a different geographic location.   C. 65% of the schedule C rate for all surgeries.   D. subsidies to contain health care costs in rural facilities.

 

25.   The study of disease is called

A. physiology.   B. pathology.   C. urology.   D. neurology.

 

26.   Superficial injuries such as abrasions or contusions are

A. not coded when associated with more severe injuries of the same site.   B. queried to determine if the injuries are confined to the same site.   C. coded when associated with more severe injuries of the same site.   D. coded only when debridement is performed.

 

27.   Another name for XXY syndrome is

A. Turner’s syndrome.   B. Cooley’s anemia.   C. Klinefelter syndrome.   D. Huntington’s chorea.

 

28.   The method that physicians use to bill for each service or visit individually rather than on a pre-paid basis is called

A. fee-for-service.   B. capitation.   C. pre-paid care.   D. managed care.

 

29.   A physician has a meeting with a pharmaceutical sales representative. During the course of the conversation, the physician reveals the diagnosis and past family, medical, and social history of a patient currently being treated with one of the medications that the sales representative is selling. In this situation, the doctor could be sued for

A. invasion of privacy.   B. malfeasance.   C. undue harm and fraud.   D. malice.

 

30.   A patient is prescribed a medication that narrows the blood vessels and raises her blood pressure. The medication is most likely a

A. tranquilizer.   B. cardiogenic.   C. vasoconstrictor.   D. cardiotonic

 

31.   Physicians typically refer to anatomical locations using directional terms, which are often

A. paired in opposites.   B. used primarily by chiropractors.   C. used to describe surgical incisions.   D. referenced horizontally.

 

32.   The study of tissue disease using macroscopic or microscopic analysis is called

A. immunology.   B. histopathology.   C. cytopathology.   D. microbiology.

 

33.   A physician obtains cells from the bone marrow cavity using a needle and a syringe. How would this procedure be coded?

A. 36575   B. 37328   C. 38220   D. 35092

 

34.   What is Medicare Part D?

A. The component of Medicare Part A that covers outpatient surgeries   B. Add-on coverage for prescription drugs provided through insurance companies approved by Medicare   C. Supplemental coverage for war veterans and their dependents   D. Add-on coverage for dental procedures

 

35.   A female patient is seen for her annual gynecological examination. During the examination, the physician performs a test to detect cervical cancer. This test is called a/an

A. immunoassay test.   B. Pap smear.   C. carcinoembryonic antigen test.   D. mycobacterial culture.

 

36.   A physician is called to the intensive care unit for a patient with second-degree burns sustained on 55% of his body while cooking in the kitchen where he works. The physician sees the patient in the critical care unit for two hours, leaves the unit, and returns later the same day to provide an additional hour of critical care. What ICD-10-CM and CPT codes would be assigned?

A. L91.8, 99291 × 2, 99292 × 4   B. R53.81, 99291, 99293 × 5   C. Z30.09, 99293, 99294 × 2   D. T31.50, 99291, 99292 × 4

 

37.   A change in the tissues and cells within a specific area on or in the body is called a

A. lesion.   B. cyst.   C. neoplasm.   D. tumor.

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