Deck 6: Code Sets

Question 1

Items with which every coder should be familiar are:

A) ICD-10-CM Official Guidelines for Coding and Reporting
B) Standards of Ethical Coding
C) Their facility's corporate compliance plan and coding compliance plan
D) All of the above

Answer 1

All of the above

Question 2

An example of an HCPCS code is:

A) C1715
B) 0DJD8ZZ
C) I20
D) 43251

Answer 2

C1715

Question 3

The NDC codes have which of the following segments?

A) Labeler code
B) Product code
C) Packaging code
D) All of the above

Answer 3

All of the above

Question 4

When are ICD-10-CM coding changes issued?

A) January of each year
B) April of each year
C) October of each year
D) April and October of each year

Question 5

HCPCS is composed of Level I and Level II codes; the differences between the two levels are:

A) Level I codes are used to report outpatient procedures and services, whereas Level II codes are used to report products, supplies, and services not included in Level I.
B) Level I codes are maintained by the AMA, whereas Level II codes are developed by hospitals as part of their chargemaster.
C) Level I codes are submitted separately from Level II codes for reimbursement.
D) Insurance companies need Level II codes to process claims; insurers do not process Level I codes.

Question 6

CPT-4 code changes become effective _____ of each year.

A) January
B) April
C) October
D) April and October

Question 7

Some common uses for coded data include all of the following EXCEPT:

A) Case mix analysis
B) Comparative analysis
C) Reimbursement
D) All of the above are common uses.

Question 8

An example of a CPT-4 code is:

A) C1715
B) 0DJD8ZZ
C) I20
D) 43251

Question 9

The second character of an ICD-10-PCS code indicates which of the following?

A) The procedure was on the upper arm.
B) An endoscopy device was used.
C) The procedure was performed on the gastrointestinal body system.
D) The approach was through the natural opening.

Question 10

Because the patient record is a highly personal document, and therefore must be treated respectfully with regard to the coded data assigned, AHIMA has issued which of the following guidelines?

A) HIPAA Official Guidelines for Coding and Reporting
B) Standards of Ethical Coding
C) standards for code sets
D) Federal Register

Question 11

An example of an ICD-10-CM category code is:

A) C1715
B) 0DJD8ZZ
C) I20
D) 43251

Question 12

Current code sets under HIPAA include all of the following EXCEPT:

A) ICD-9-CM, Volumes I, II, and III
B) National Drug Codes
C) HCPCS and CPT-4
D) ICD-10-PCS

Question 13

O32.1XX2 is an example of a code from which code set?

A) ICD-9-CM
B) NDC
C) ICD-10-CM
D) CPT

Question 14

What coding classification or nomenclature system or systems are used to code professional and technical services by physicians and other health care professionals for services performed in outpatient settings?

A) ICD-O
B) CPT-4
C) ICD-9-CM
D) SNOMED-CT

Question 15

Which of the following code sets are alphanumeric?

A) ICD-10-PCS
B) ICD-10-CM
C) CPT
D) SNOMED-CT
E) Both a and b
F) All of the above

Question 16

Representatives of which of the following groups of entities or organizations comprise the "Cooperating Parties?"

A) AHA, AHIMA, CMS, NCHS
B) AHA, AHIMA, AMA, NCHS
C) AHA, AMA, CMS, NCHS
D) AHIMA, AMA, CMS, NCHS

Question 17

Which of the following is NOT a common coding function?

A) Reimbursement
B) Compliance
C) Medical testing
D) Research

Question 18

The fifth character of an ICD-10-PCS code indicates which of the following?

A) The procedure was on the upper arm.
B) An endoscopy device was used.
C) The procedure was performed on the gastrointestinal body system.
D) The approach was through the natural opening.

Question 19

A standard in which data are able to be transmitted, communicated, and understood by the sending and receiving computer systems, allowing the exchange of information, is also called:

A) Electronic data interchange
B) Transaction code set
C) Standards for code sets
D) Healthcare Common Procedure Coding System

Question 20

SNOMED-CT is a(n) _____ system.

A) multi-axial
B) classification
C) nomenclature
D) alphanumeric

Question 21

There are two levels of HCPCS; Level I is also known as __________ and Level II is known as __________.

Question 22

What does SNOMED-CT stand for?

Question 23

Coder can use the ________________ algorithm to assist in mapping SNOMED-CT codes to the more specific ICD-10-CM code set.

Question 24

Under HIPAA, _____________ are sets of codes used to communicate the diagnosis
and procedure codes, data elements, and medical concepts used in electronic health
care transactions transferred through an electronic data interchange (EDI). Some examples are ICD-10-CM and ICD-10-PCS, CPT-4, and NDC.

Question 25

Name the two levels of HCPCS.

Question 26

National drug codes (NDC) is a transaction code set that identifies ____________, ____________, and _____________.

Question 27

All of the following organizations develop, report, and maintain code sets for health care purposes except the:

A) Joint Commission
B) American Medical Association
C) American Psychiatric Association
D) International Health Terminology Standards Development Organization

Question 28

_____________ must be used under HIPAA for the electronic exchange of data for certain transactions, namely encounter and payment data.

Question 29

A code set that is established by HIPAA guidelines used in electronic data transfer to ensure that the information transmitted is complete, private, and secure is known as a ___________.

Question 30

An example of a CDT code is:

A) C1715
B) D5410
C) I20
D) 43251

Question 31

A _____________ is a statistical distribution of patients according to their utilization of resources. It also refers to the grouping of patients by clinical department or other meaningful distribution, such as health insurance type.

Question 32

ICD-10-CM is coordinated and maintained by a group of four organizations collectively called the ______________; proposed changes are published in the __________.

Question 33

DSM-5 resembles _______________ for data analysis of patients with psychiatric disorders, but is not used for reimbursement purposes.

Question 34

__________ is the assignment of alphanumerical values to a word, phrase, or other nonnumerical expression. In health care, coding is the assignment of numerical values to diagnosis and procedure descriptions.

Question 35

All of the following are examples of multiaxial classification systems EXCEPT:

A) SNOMED
B) ICD-10-PCS
C) ICD-O
D) ICD-10-CM

Question 36

In the ICD-O codes set, ____________ codes and _____________ codes are found.

Question 37

A group of like data elements compiled to provide information about the group is called ___________.

Question 38

In a multi-axial code structure, such as ICD-10-PCS, each position of a ___________ has specific meaning.

Question 39

Match the following terms with their definitions.
a. HCPCS
b. ICD-10-CM
c. SNOMED-CT
d. ICD-O
e. ICD-10-PCS
f. DSM-IV
g. CPT
h. NDC
i. UHDDS
j. CDT
1. Level II of the Health Care Common Procedure Coding System used to report drugs, equipment, supplies, and other auxiliary health care services rendered
2. A nomenclature and coding system developed and maintained by the American Medical Association in order to facilitate billing for physicians and other services
3. A code set used for the diagnosis of diseases
4. A code set used for coding procedures in the acute care setting
5. Systematized nomenclature of human and veterinary medicine clinical terms; a reference terminology that, among other things, links common or input medical terminology and codes with the output reporting systems in an electronic health record
6. The coding system used to record and track the occurrence of neoplasms (i.e., malignant tumors, cancer)
7. A code set for coding behavior and mental health care encounters in a structured format
8. A transaction code set used to identify drugs by the firm, labeler, and batch
9. Also known as the Code, it is used for reporting dental services and procedures to payers
10. A data set used to report details of inpatient stays to the government

Question 40

Which of the following classification systems is NOT used for reimbursement?

A) DSM-5
B) ICD-9-CM
C) ICD-O
D) Both a and c

Question 41

Match the following organizations with the data sets they maintain.
a. AMA
b. APA
c. WHO
d. IHTSDO
e. CMS
f. ADA
g. WHO
h. FDA
11. ICD-10-CM
12. ICD-10-PCS
13. SNOMED
14. CPT
15. CDT
16. ICD-O
17. DSM-VI
18. NDC

Question 42

SNOMED-CT is designed for use in and support of the EHR. SNOMED-CT's design does NOT include:

A) Codes embedded in the EHR
B) All of the detail needed to derive ICD-10-CM codes
C) Codes assigned during the course of patient care
D) All of the above are included.

Question 45

What is used when a certain ICD-10-CM code requires a seventh character data field but does not have enough characters? Provide an example.

Question 46

Describe the difference between nomenclature and classification.

Question 47

How does case mix analysis help health care providers plan for the future?

Question 48

What are the seven different categories in each ICD-10-PCS code? List them in order from left to right.

Question 49

What two parts make up the ICD-10-CM code set? Where can the conventions and guidelines for ICD-10-CM be found? When is this code set updated?

Question 50

How can coding assist health care facilities in analyzing their patient needs? Please list and discuss at least three reasons.

Question 51

Can a health care facility choose to use only SNOMED instead of ICD-10-CM? Why or why not? How can these two data sets complement each other?

Question 52

CPT-4 is copywritten by what organization?