Question

QUESTION 1

1. Physicians and mid-level practitioners (NPs and PAs) use which coding system to capture their professional fees?

   	A.	DSM-5
   	B.	CPT/HCPCS
   	C.	ICD-10-PCS
   	D.	ICD-10-CM

10 points   

QUESTION 2

1. Choose the best answer.

   Because each CPT/HCPCS code has its own separate fee, are coders allowed to code all services separately?

   	A.	Yes. In order to properly capture all charges, every CPT and HCPCS code should be coded separately to optimize reimbursement.
   	B.	No. A coder can only choose those CPT/HCPCS codes the provider has marked on the encounter form or superbill.
   	C.	No. Bundling of related services sometimes occurs within the CPT/HCPCS system, and also with code edits like Correct Coding Initiative (CCI).
   	D.	Yes. A coder should code all CPT separately, even if this violates published coding guidelines from AMA or CMS.

10 points   

QUESTION 3

1. Bill, a 51-year-old male, has a remote history of aortic valve replacement, pacemaker insertion, bradycardia, and cardiomyopathy. He presents to the emergency department with bilateral lower extremity swelling of 6 days duration. He also expresses shortness of breath. The ED physician documents that Bill does not follow a cardiac diet of any kind and does not exercise because it is too difficult for him to walk. The patient's records indicate that he has not been seen by a cardiologist or primary care physician in over 2 years. After examination in the ED, a chest x-ray, and labs, the ED physician determines that Bill has congestive heart failure. He increases the patient's Lasix and asks the patient to comply with follow-up to cardiology and primary care within the week.

   According to ICD-10-CM coding guidelines for outpatient services, associated signs and symptoms are not coded separately when a definitive diagnosis has been established. Of the following, which would the coder exclude from coding in order to comply with this guideline?

   	A.	Bradycardia and cardiomyopathy
   	B.	Shortness of breath and lower extremity swelling
   	C.	Congestive heart failure and pacemaker status
   	D.	Aortic valve replacement status and pacemaker status

10 points   

QUESTION 4

1. On the day of Max's discharge from the hospital, the attending physician asked him questions and provided information such as Max's final diagnosis, prognosis, the results of various diagnostic tests, and necessary follow-up in the outpatient setting. The provider created two medical records for this same date of service. A progress note for the day of discharge records the physicians review of diagnostic tests, assessment of the patient's condition, and decision to discharge home. The discharge summary provides an overview of the patient's hospital stay and records anticipated follow-up treatment, as well as documentation of the provider's time on the floor and at bedside. The provider also requested that two E/M services be billed to the patient's insurance: one for a subsequent hospital visit, and another for discharge from the hospital.

   According to CPT guidelines, which of the following services would be coded and submitted for payment?

   	A.	99217 (Observation Care Discharge Services)
   	B.	99231-99233 (Subsequent Hospital Care)
   	C.	99238-99239 (Hospital Discharge Services)
   	D.	99212-99215 (Office or Other Outpatient Services, Established Patient)

10 points   

QUESTION 5

1. Wiesha is seen in the hospital outpatient clinic for headaches and abnormal gait for many years. The treating physician refers her to neurologist for consultation. The treating physician documents "? Parkinson's" as the final assessment. According to ICD guidelines, the hospital coder should report which of the following codes for this encounter?

   	A.	G20
   	B.	Z03.89
   	C.	R51; R26.81
   	D.	Z13.89

10 points   

QUESTION 6

1. Select the proper ICD-10-CM coding and sequencing for the following medical record entry:

   Patient History: Suprapubic pain and difficulty urinating. Denies allergies.

   Exam: Temp-97, pulse 80, resp-18, BP 150/90

   HEENT: Normal. Chest is clear. Abdomin shows suprapubic tenderness and distention.

   Ordering UA with culture and sensitivity. Also requesting foley insertion.

   Assessment: acute urinary retention due to englarged prostate.

   	A.	N40.1, R33.8
   	B.	N40.3, R33.8
   	C.	R33.8, N40.0
   	D.	R33.8, N40.1

10 points   

QUESTION 7

1. Martha presents to the hospital outpatient department with orders for the following diagnostic examinations:

   AP and lateral chest x-ray, 12-lead EKG, Qualitative troponin, and pulse oximetry.

   All these diagnostic tests are accomplished and records created. Following CPT coding guidelines, which codes should the hospital coder report for the facility's bill?

   	A.	84484, 82803, 93000, 71035
   	B.	94762, 93010, 71010 X 2, 84484-90
   	C.	71020, 93005, 84512, 94760
   	D.	71010, 71010-26, 93010, 84512, 84484, 94761

10 points   

QUESTION 8

1. A 23-year-old male patient suffers from bursitis. He has elected to try steroid injections in his shoulder at his physician's office. The provider documents injection of a mixture of anesthetic and steroids into the patient's right shoulder. Which CPT would the provider select for this service?

   	A.	20600-50
   	B.	20610-RT
   	C.	20611-RT
   	D.	20605

10 points   

QUESTION 9

1. A 23-year-old male patient suffers from bursitis. He has elected to try steroid injections in his shoulder at his physician's office. The provider documents injection of a mixture of anesthetic and steroids into the patient's right shoulder.

   As a physician coder, what other documentation would be required for accurate charge capture?

   	A.	Which shoulder was injected
   	B.	The steroid and anesthesia mixture and dosage
   	C.	The number of times this patient will have the injection
   	D.	How many minutes the provider spent with the patient

10 points   

QUESTION 10

1. An obstetric patient receives a transabdominal ultrasound at 23 weeks' gestation for a determination of placental location. Which procedure code should be selected for claim?

   	A.	76815
   	B.	76817
   	C.	76805
   	D.	76811

10 points   

QUESTION 11

1. A patient in the hospital outpatient clinic area receives an IM injection of 250mg of Amikacin sulfate for bacterial colitis. Which code captures the administration of the drug?

   	A.	96373
   	B.	96365
   	C.	96374
   	D.	96372

10 points   

QUESTION 12

1. A hospital employee presents to Employee Health for vaccination against hepatitis A and B. A combination vaccine is administered intramuscularly. Which codes would Employee Health need to capture for the services provided?

   	A.	90471, 96372
   	B.	90471, 90636
   	C.	90460, 90461, 90632, 90748
   	D.	96372, 90471

10 points   

QUESTION 13

1. Due to EKG changes, a 57-year-old male receives a cardiac stress test via pharmacological induction. Dobutamine is administered, followed by dipyridamole, and the stress test is accomplished.

   Which of the following codes would be reported by the hospital for performing the diagnostic test?

   	A.	93015
   	B.	93017
   	C.	93018
   	D.	93016

10 points   

QUESTION 14

1. A physician practice manager believes that the office is losing revenue based on its failure to capture specific codes for extra work done by or on behalf of the clinical staff.

   For example, physicians sometimes extend office hours to meet patient needs. This can include staying later than posted office hours, scheduling weekend hours for patients, or emergency walk-ins that disrupt the provider's normal schedule.

   Of the following, which codes capture these unusual circumstances?

   	A.	99090-99091
   	B.	99366-99368
   	C.	99050, 99051, 99058
   	D.	99354-99357

10 points   

QUESTION 15

1. A physician practice manager believes that the office is losing revenue based on its failure to capture specific codes for extra work done by or on behalf of the clinical staff.

   Since laboratory specimens must be taken by courier to the hospital for analysis, which of the following codes may generate some additional revenue for the practice?

   	A.	99000
   	B.	99027
   	C.	99600
   	D.	99444

10 points   

Answer 1

Answer: CPT/HCPCS

Physicians and mid-level practitioners (NPs and PAs) use CPT coding system to capture their professional fees. This is because the NPs are not paid their fees like the other physician.