Deck 45: Medical Coding

Question 1

Which of the following types of history focuses mainly on the chief complaint?

A) Detailed history
B) Comprehensive history
C) Problem-focused history
D) Expanded problem-focused history

Answer 1

Problem-focused history

Question 2

In the index of the CPT manual, which of the following may modifying terms NOT identify?

A) Condition
B) Procedure
C) Anatomic location
D) Time allotted for a procedure

Answer 2

Time allotted for a procedure

Question 3

Describe how to use the most current procedural coding system

Answer 3

not answered

Question 4

How often should the medical office purchase new code books or computer code sets?

A) Annually
B) Every 2 years
C) Every 6 months
D) Every time there is a new edition of the CPT manual

Question 5

Medical Office Business Procedures/Management

Question 6

Describe how to use the most current HCPCS coding

Question 7

Which of the following is NOT a primary factors determining the level of service?

A) Coordination of care
B) The extent of the history
C) The extent of the physical examination
D) The complexity of medical decision-making

Question 8

What is the format of most CPT codes?

A) Two-digit code
B) Five-digit code
C) Four-digit code
D) Three-digit code

Question 9

Which organization compiled the first disease classification system in the United States?

A) American Board of Internists
B) American Medical Association
C) American College of Surgeons
D) Department of Health and Human Services

Question 10

What would be added to a code for a procedure that was extensive or unusual or that required an assistant?

A) A two-digit modifier
B) A two-letter modifier
C) A three-digit modifier
D) A three-letter modifier

Question 11

If the patient has multiple problems and is seriously ill, what type of medical decision making is probably necessary?

A) Straightforward
B) Low-complexity
C) High-complexity
D) Moderate-complexity

Question 12

For which reason are procedure codes NOT used?

A) To set fees
B) To identify and/or justify medical services a patient received
C) To collect statistics about frequency and effectiveness of procedures
D) To determine how frequently certain diseases occur in the population

Question 13

What do CPT Category II and Category III codes consist of?

A) Five digits
B) Five letters
C) Four digits and one letter
D) Five digits and two letters

Question 14

What coding system is used by the Centers for Medicare and Medicaid Services for services and equipment that are not usually covered by ordinary health insurance?

A) CPT
B) DRG
C) HCPCS Level II
D) ICD-9-CM

Question 15

Define upcoding and why it should be avoided

Question 16

How does a classification system become a coding system?

A) Names are shortened to abbreviations.
B) Names are arranged in alphabetic order.
C) Names are replaced by numbers and letters.
D) Letters in the names of items are rearranged.

Question 17

What is the first section of the CPT manual?

A) Surgery
B) Radiology
C) Anesthesia
D) Evaluation and Management

Question 18

Describe how to use the most current diagnostic coding classification system

Question 19

Dr. Barry Manning is an internist. In which section of the CPT manual would his charges for office visits be found?

A) Surgery
B) Medicine
C) Radiology
D) Evaluation and Management

Question 20

Who publishes the CPT manual for procedure codes?

A) Various publishers
B) World Health Organization
C) American Medical Association
D) The U.S. Department of Health

Question 21

Which of the following diagnostic tests is/are included in the Radiology section of the CPT manual?

A) Standard angiography
B) Computed tomography
C) Magnetic resonance imaging
D) Standard radiologic procedures
E) All of the above

Question 22

During a routine examination, the physician decides to have an electrocardiogram (ECG) performed on the patient. How should this be coded?

A) As a separate visit
B) As a separate procedure
C) In the code for the office visit
D) Only if the physician interprets the ECG

Question 23

How is an established patient defined?

A) A patient who has been seen in consultation
B) A patient who has been seen in the past three years
C) A patient who has made a payment to the office
D) A patient who has a medical record in the office

Question 24

What is the meaning of the "10" in the abbreviation ICD-10-CM?

A) 10th edition
B) Began to be used in 2010
C) Up to 10 characters in a code
D) 10 times more codes than ICD-9-CM

Question 25

Which of the following is an addition in the ICD-10 compared to the ICD-9?

A) Greater number of codes
B) Expansion of injury codes
C) Additional digits and letters
D) More information related to ambulatory care
E) All of the above

Question 26

In order to give more specificity to the cause of a problem, the letters E and M are used in ICD-9-CM. What is the letter E used to identify?

A) Age of the patient
B) Cause of a wound
C) Structure and form of the wound
D) Abnormal growth of tissue

Question 27

In an anesthesiologist's practice, which type of modifiers indicate the patient's condition at the time of the administration of the anesthesia?

A) Standard modifiers
B) Complexity modifiers
C) Conditional modifiers
D) Physical status modifiers

Question 28

What is the format of HCPCS Level II codes?

A) Five-digit codes
B) It depends on the code
C) One letter followed by four digits
D) Three digits followed by a decimal point and then one or two additional digits

Question 29

What organization first published and continues to manage the International Classification of Diseases?

A) The Joint Commission
B) American Medical Association
C) The World Health Organization
D) The U.S. Department of Health and Human Services

Question 30

When procedure codes are used to bill an insurance company, which of the following is an example of upcoding?

A) A medical office bills for performing a urinalysis in the office
B) A medical office charges for venipuncture performed in the office
C) A physician sends a patient to an outside laboratory and the laboratory bills the insurance company
D) A medical office uses a separate code for each lab test in a panel when all tests in the panel were performed

Question 31

Which of the following is most likely to require a HCPCS Level II code?

A) Spirometry
B) Metal crutches
C) Electrocardiogram
D) Removal of a lesion

Question 32

Which type of anesthesia does not receive a separate code?

A) Epidural or spinal anesthesia
B) Anesthesia by intravenous infusion
C) Anesthesia administered by inhalation
D) Local anesthesia administered by infiltration

Question 33

In which section of the CPT manual is there an attempt to link reimbursement to the completeness of the examination and the amount of skill required to manage the patient's problems?

A) Primary Care
B) Initial Consultation
C) Diagnosis Establishment
D) Evaluation and Management

Question 34

Which part of the ICD-9 code makes it most specific?

A) The letter (if any) at the beginning
B) The first three digits
C) The first digit after the decimal point
D) The second digit after the decimal point

Question 35

What is a panel?

A) A group of laboratory tests that are done together
B) A group of individuals who review insurance claims
C) A radiologic test that is done with the patient lying on the back
D) A set of five codes that are used together for certain diagnostic tests

Question 36

Which of the following is NOT a factor used to calculate payment for anesthesia services?

A) The patient's age and physical status
B) The base value of the anesthesia code
C) The type of facility at which the services were provided
D) The duration, in hours and minutes, during which the services were provided

Question 37

What problems with CPT codes may cause insurance claims to be rejected?

A) Modifiers are used to describe special circumstances.
B) The code has been selected from the list of codes in the manual.
C) The service is not backed up with documentation in the patient record.
D) All of the above.
E) None of the above.

Question 38

Why were diagnosis codes developed?

A) To track disease processes
B) To classify the cause of disease
C) To collect data for medical research
D) To evaluate hospital service utilization
E) All of the above

Question 39

If the medical assistant is coding for the removal of a lesion, what might influence selection of the proper code?

A) Type of lesion
B) Size of the lesion
C) Location of the lesion
D) Method of removal of the lesion
E) All of the above

Question 40

What is included in the code for a surgery?

A) Local or topical anesthesia
B) The six-month postoperative checkup
C) The initial office visit before the decision for surgery has been made
D) Care for any complications that occur because of the surgery
E) All of the above

Question 41

What type of diagnosis codes are used when a patient comes to the office for a physical examination in ICD-9?

A) E codes.
B) M codes.
C) V codes.
D) A diagnosis code is not necessary.

Question 42

How are most diseases or conditions arranged in the tabular section of the ICD-10 manual?

A) Alphabetically
B) By age group affected
C) By severity of symptoms of effects
D) By classification of disease or condition

Question 43

In the ICD-10, which term indicates that a condition is not coded here, and the patient cannot have this condition in addition to the condition listed above it?

A) Includes
B) Code first
C) Excludes 1
D) Excludes 2

Question 44

How do insurance companies use diagnosis codes?

A) To determine the level of care received by the patient
B) To determine whether the patient was well taken care of
C) To decide whether the care given corresponds to the patient's disease
D) To decide whether there is adequate information in the medical record

Question 45

In the ICD-10 code M84.50xA, what is the function of the "x"?

A) It is a placeholder for information that is not specified.
B) It makes the code more specific by indicating right or left.
C) It indicates whether it the visit is the initial visit, or a subsequent visit.
D) It determines the number of sites of involvement for the condition.

Question 46

Which of the following is NOT a possible subclassification requiring additional characters in ICD-10 codes?

A) Body parts
B) Right or left side
C) Different diseases
D) Initial encounter or subsequent encounter

Question 47

In which chapter of the ICD-10 manual would you expect to find the diagnosis code for an adolescent who comes to the office for a physical examination before enrolling in a school sports program?

A) The last chapter
B) The first chapter
C) The chapter dedicated to adolescents
D) The chapter dedicated to physical examinations

Question 48

If the Evaluation and Management code on an insurance claim reflects a higher level of care than is reflected in the patient's medical record, the claim is an example of upcoding.

Question 49

What is the format of the first three characters of an ICD-10 code?

A) Five digits
B) Three digits
C) One letter followed by two digits
D) One letter followed by four digits

Question 50

The medical assistant must look up CPT codes for most office visits and office procedures in the CPT manual before entering patient charges into the computer.

Question 51

What is the penalty (if any) if a medical office is found to have a practice of upcoding?

A) No penalty is leveed.
B) The practice must pay a large fine.
C) Claims in question are simply not paid.
D) Billing personnel may be given a jail sentence.

Question 52

The section of the CPT manual that contains the most codes is the Evaluation and Management section.

Question 53

If a diagnosis is listed by the physician as "wedge compression fracture of the fifth lumbar vertebra," which word should be referenced in the alphabetic index of the ICD-10 manual?

A) Wedge
B) Lumbar
C) Fracture
D) Compression

Question 54

When a seventh character is used in an ICD-10 code, to what does it usually refer?

A) Specific bone
B) Coexisting conditions
C) Age of onset of the condition
D) Initial or subsequent encounter

Question 55

HCPCS Level I codes include the current CPT codes.

Question 56

How many characters are contained in category codes (ICD-10 codes)?

A) Two
B) Four
C) Five
D) Three

Question 57

What is the purpose of external cause codes in the ICD-10?

A) They usually only contain four characters.
B) They are used as first-listed diagnosis codes.
C) They are used to gather statistics about causes and severity of injury.
D) They are required on insurance forms in order to obtain reimbursement.

Question 58

Which of the following abbreviations or punctuation indicates that a more specific ICD-9 or ICD-10 code cannot be identified?

A) NOS
B) NEC
C) [ ] (brackets)
D) ( ) (parentheses)

Question 59

In the CPT manual, a code that provides only text to replace the words after a semicolon in the code above it is called an indented code.

Question 60

Category II CPT codes represent services that represent emerging technology.

Question 61

The standards of electronic transmission and require code sets had to be changed in order to accommodate ICD-10 codes.

Question 62

For ICD-10 codes, the instruction "code first" tells the coder to use another code as the first code because it identifies the underlying cause or condition.

Question 63

The term "upcoding" can be defined as using codes incorrectly in order to obtain more reimbursement.

Question 64

When coding the diagnosis "tachycardia, R/O angina pectoris," the medical assistant should look up the code in the index under "angina."