Question

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   

QUESTION 16

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 instance, when patients require completion of Family Medical Leave Act (FMLA) reports and similar administrative reporting, the physicians are not currently billing the patient or insurance carrier.

   As the lead coder in the practice, which codes would you recommend for this type of service?

   	A.	99450
   	B.	99080
   	C.	99374
   	D.	99495

10 points   

QUESTION 17

1. A patient presents to the hospital outpatient surgery department for treatment of esophageal varices. During the EGD procedure, the patient experiences hypotension. As a result, the physician terminates the procedure and admits the patient to observation status. The patient's history and physical for surgery documents the following conditions: bleeding esophageal varices, chronic alcohol usage, and hypertension.

   Of the following, which diagnosis would the hospital report as the first-listed diagnosis for these encounters?

   	A.	Hypotension
   	B.	Bleeding esophageal varices
   	C.	Hypertension
   	D.	Chronic alcohol abuse

10 points   

QUESTION 18

1. A college student presents to Student Health for a physical examination. As part of that preventive medicine visit, the physician orders HIV antibody, the results of which come back positive. Since the HIV blood work must be sent off-campus, the results were not immediately available at the time of coding the preventive medicine visit. During the preventive medicine visit, the record indicates the patient expressed no complaints. As a result, you must code the lab services and their medical necessity.

   Of the following, which is the most accurate way to capture charges for HIV antibody tests sent to an outside lab which came back positive after a preventive health examination.

   	A.	86701-90, Z00.01, Z21
   	B.	86701, Z11.4, Z21
   	C.	86701-91, B20
   	D.	86701, R75, Z00.00

10 points   

QUESTION 19

1. Evaluate the following diagnostic statement:

   "Metastatic disease to liver and lung from pancreas."

   Which of the following codes would be accurate to report (choose only 1).

   	A.	C78.89
   	B.	C22.9
   	C.	C78.7
   	D.	C34.90

10 points   

QUESTION 20

1. A homeless patient presents to the hospital emergency department complaining of abdominal pain, diarrhea, and nausea. The ED attending physician documents that the patient has been seen 3 times in the past 10 days for the same problem. After significant review of the patient's diagnostic tests, imaging results, physical examination and past ED visit notes, the physician documents the following:

   "Upon entry to ED bay 16, this patient was found pilfering through draws and medical supplies. The patient had in her hand 5 unused syringes, several packets of gauze, and IV tubing. When confronted, the patient confessed that she sold the medical supplies to drug users in order to make money. I requested that social services visit with the patient prior to discharge and their note may be found in the record. Final diagnosis: malingering."

   Which ICD code would be captured as the first-listed diagnosis?

   	A.	Z76.5
   	B.	R10.9
   	C.	R11.0
   	D.	R19.7

Answer 1

QUESTION 4

Ans:

99238-99239 (Hospital Discharge Services)

Hospital Discharge 99238 - 99239

** Discharge management includes:
** Final exam of patient
** Discussion of hospital stay
** Discharge instruction (including time to instruct family or other caregivers)
** Preparation of discharge records, prescriptions and referral forms
** Time – 30 minutes or less ~ 99238
** Time – More than 30 minutes ~ 99239
** Include all time even if not continuous on the same date

QUESTION 5

ans:

Applicable To

• Hemiparkinsonism
• Idiopathic Parkinsonism or Parkinson's disease
• Paralysis agitans
• Parkinsonism or Parkinson's disease NOS
• Primary Parkinsonism or Parkinson's disease

Type 1 Excludes

• dementia with Parkinsonism (G31.83)

The following code(s) above G20 contain annotation back-references that may be applicable to G20:

• G00-G99  Diseases of the nervous system

Approximate Synonyms

• Dementia associated with parkinson's disease
• Dementia in parkinsons disease
• Parkinsonism
• Parkinsons disease
• Restrictive lung disease due to parkinsons disease
• Restrictive lung mechanics due to parkinsons disease

QUESTION 6

ANS

B. N40.1, R33.8

Enlarged prostate with lower urinary tract symptoms'

QUESTION 7

ANS

B.94762, 93010, 71010 X 2, 84484-90

QUESTION 8

ANS

B.20610-RT

QUESTION 9

ANS

B. The steroid and anesthesia mixture and dosage

QUESTION 10

ANS

76811

QUESTION 11

KINDLY GIVE SOME MORE TIME TO COMPLETE ANSWER THIS QUESTION