s3.amazonaws.com file · Web viewLaurie has a malignant secondary tumor of the Bartholin’s gland. Her doctors do not know where this cancer started in Laurie’s system. She is

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Medical Coding Exam System - Week 2 Day 2 Practice Exam Questions 137 - 172

137. Jim lost control of his car while driving on an icy highway and hit a parked car. He was trans-ported to a local emergency room for treatment. He suffered a greenstick fracture of six ribs and at-electasis. How would you report this?

a. V43.52XA, J98.3, N90.0, S22.49XA, J98.11 b. V43.52XA, Y92.411, S22.39XA, J98.19c. Y92.411, S22.39XA, J98.11, V43.52XA d. S22.49XA, J98.11, V43.52XA, Y92.411

138. Laurie has a malignant secondary tumor of the Bartholin’s gland. Her doctors do not know where this cancer started in Laurie’s system. She is coming in today for radiation of the secondary site. How would you report her diagnoses for today’s treatment?

a. Z51.0, C79.82, C80.1 b. C79.82, Z51.0c. C51.0, C79.82d. D49.5, C79.82, Z51.0, C80.1

139. What is the correct external cause code for the therapeutic use of wintergreen oil?

a. T49.3X1Ab. T49.3X5Ac. T46.2X4A, T49.3X1Ad. T49.2X1A, T36.1X3A

140. Nancy has been suffering with abdominal cramping pain in the belly area, persistent watery di-arrhea, fever, and fatigue. She underwent a colonoscopy and was diagnosed with Crohn’s disease of the large bowel and colon. How would you report the diagnosis from the colonoscopy?

a. R10.9, R19.7, R53.83, R50.9 b. K50.10c. R10.9, K50.911d. K50.911, R19.7, R53.83, R50.9, R10.9

141. A patient received a 12 sq. cm. dermal tissue substitute of human origin, without other bioengi-neered elements, without metabolically active elements. This treatment was completed due to a burn on the abdomen. How would you report the supply?

a. C1762 b. J7 3 42c. C1763d. J7344

142. During an emergency room visit, Sally was diagnosed with pneumonia. She was admitted to the hospital observation unit and treated with 500 mg of Zithromax through an IV route. How would you report the supply of this drug?

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a. J0456 b. Q0144c. J1190 x 2 d. J2020 x 2

143. Report an initial Medicare Annual Wellness Exam (AWV) with a established E & M Visit, EPF Hx and Exam and LOW MDM (the CC was GERD and HTN)

a. 99213, G0438 b. G0438 Onlyc. 99213, G0438-33d. This is a sick visit so only report 99213.

144. Which code describes an addition to the lower extremity, knee disarticulation, and leather socket?

a. L5624 b. L5640 c. L5105 d. L5850

145. A nursing home’s x-ray machine was not working. A portable x-ray machine and personnel was transported to the nursing home to test nine patients. How would you report the transportation of equipment?

a. 76499 b. S9999c. R0070 x 9 d. R0075

146. What modifier would most likely be used for a blepharoplasty to the upper right eyelid?

a. E1 b. 51 c. E3 d. RT

147. When using the CPT index to locate procedures, which of the following are considered primary classes for main entries?

a. Procedure or service; organ or other anatomic site; condition;b. Synonyms, eponyms, and abbreviationsc. Abbreviations; signs and symptoms, anatomic site; and code assignment d. Conventions; code ranges; modifying termse. Procedure or service; modifiers; clinical examples; and definitions

148. Which of the following code and modifier combinations are correct?

a. 0165T-25


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b. 15003-24 c. 93571-51d. None of the above

149. How are the diagnoses sequenced when coding for multiple fractures?

a. Multiple fractures are sequenced according to anatomic location.b. Multiple fractures are sequenced in accordance with the severity of the fracture. c. Multiple fractures are sequenced in accordance with the longest bone first.d. Multiple fractures are always sequenced with pathologic fractures.

150. When coding for a liver transplantation, what are the three distinct components of the physi-cian’s work?

a. Cadaver biopsy, cholecystectomy, reconstruction of the liver graftb. Cadaver/living donor hepatectomy, backbench work, recipient liver allotransplantationc. Preparations of the common bile duct, trisegment split, management of liver hemorrhage with re-exploration of post operative abscessd. Hemorrhoidopexy, ligation and hepatectomy, cholecystectomy

151. Full‐blown AIDS sets in as

a. HIV virus concentration decreasesb. helper T‐cell concentration decreasesc. immunity to HIV increasesd. CD4 receptors increase

152. Gas exchange in the lungs takes place at the

a. alveolib. bronchiolesc. trachead. bronchi

153. Diastole occurs when

a. the atria contractb. cardiac insufficiency is presentc. the ventricles contractd. the ventricles fill

154. A disease of the ear that causes vertigo is

a. Menire diseaseb. mastoiditis c. labyrinthitis d. A and C

155. Cervical dysplasia is the abnormal growth of cells on the surface of the cervix. Which of the fol-lowing pap smear results indicates the most advanced form of dysplasia?


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a. CIN I b. CIN II c. CIN IIId. None of the above

156. Which of the following best describes tuberculosis

a. a chronic, systemic disease whose initial infection is in the lungsb. an acute bacterial infection of the lungc. an ordinary lung infectiond. it is a viral infection of the lungs

157. Which of the following sequences correctly depicts the flow of blood through the heart to the lungs?

a. right ventricle, right atrium, pulmonary artery, lungs b. right atrium, right ventricle, pulmonary artery, lungs c. right ventricle, right atrium, lungs, pulmonary artery d. right atrium, right ventricle, lungs, pulmonary artery

158. Necrosis extending down to the underlying fascia is characteristic of a decubitus ulcer in stage

a. One b. Two c. Three d. Four

159. Cancer derived from epithelial tissue is classified as a

a. adenomab. lipomac. carcinomad. sarcoma

160. The presence of fluid in the alveoli of the lungs is characteristic of

a. tuberculosisb. Crohn's diseasec. pneumoniad. COPD

161. Physicians who are members of the Surgery Committee meet to review surgical casesreferred for quality issues and deviations from standard care norms. This type of review in whicha physicianʼs record is reviewed by his or her professional colleagues is known as a (an)

a. concurrent reviewb. clinical pertinence reviewc. incident screeningd. peer review


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162. You want to know the amount of time 8 employees had spent on coding this month. Youhave the following information. It took 12 minutes to code 1 chart, and 725 charts were coded inthe month. There was a total of 1,280 hours worked by the 8 employees. What percentage oftime did the 8 employees spend on coding?

a. 14.7%b. 6.8%c. 8.8%d. 11.3%

163. 42 Code of Federal Regulations Part 2 refers to

a. Medicareb. Medicaidc. Prospective Payment Systemd. Confidentiality rules for alcohol and drug abuse patients

164. When the coding supervisor audits charts to make sure that the codes selected reflect thedocumentation in the record, she is checking for

a. timeliness of codingb. validity of codingc. use of 5th digitsd. reliability of coding

165. Initial efforts in health record standardization were led by the:

a. American Health Information Management Associationb. American College of Surgeonsc. American Medical Associationd. Centers for Medicare and Medicaid Services

166. Where in the health record would the following statement be located? "MicroscopicDiagnosis: Liver (needle biopsy) ‐ metastatic adenocarcinoma"

a. operative reportb. pathology reportc. anesthesia reportd. radiology report

167. While performing routine quantitative analysis of a record, a medical record employee findsan incident report in the record. The employee brings this to the attention of her supervisor. Thesupervisor should

a. remove the incident report and send it to the patientb. tell the employee to leave the report in the recordc. remove the incident report and have nursing personnel transfer all documentation from thereport to the medical recordd. refer this record to the Risk Manager for further review and removal of the incident report


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168. Release of information without the patient's authorization is permissible in which of thefollowing circumstances?

a. release to an attorneyb. release to third party payersc. release to state workers' compensation agenciesd. release to insurance companies

169. A method of documenting progress notes by recording only abnormal or unusual findings ordeviations from the prescribed plan of care is called:

a. auto authenticationb. charting by exceptionc. open record reviewd. charting by abnormality

170. Your facility had a hacker break in and data was altered in your facility's electronicinformation. What is the best way to ensure someone from the outside cannot do this again?

a. passwordb. trainingc. audit traild. firewall

171. It takes approximately 18 minutes to code an average inpatient chart. If there are 15,620discharges for the month, how many personnel hours are needed for this volume of work?

a. 2,891b. 4,686c. 5,496d. 3,394

172. Which of the following acts was passed to stimulate the development of standards tofacilitate electronic maintenance and transmission of health information?

a. Health Insurance for the Agedb. Health Insurance Portability and Accountability Actc. Conditions of Participationd. Hospital Survey and Construction Act


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Medical Coding Exam System - Week 2 Day 2 Practice Exam Answers 137 - 172

137. d. Section II of the ICD-10-CM Official Guidelines for coding and reporting, Chapter 19, a.1., “An E code may be used with any code in the range of 001- V848.8, which indicates an injury, poi-soning, or adverse effect due to an external cause.”

138. a. When radiation therapy is the reason for the encounter, this is the primary diagnosis, followed by the site being treated. The code C80.1 is reported to indicate the unknown primary site of the cancer.

139. b. You can find this answer in the Table of Drugs and Chemicals in the ICD-10-CM manual.

140. b. You can find this answer in the index of the ICD-10-CM manual under Crohn’s disease. Re-view of the code K50.10 includes Crohn's disease of large intestine without complications. All of the sign and symptoms are part of this disease process and would not be reported.

141. a. C1762; You can find this answer in the index of the HCPCS Level II manual by looking up the term Tissue, human origin. Carefully, read the code descriptors for codes J7344 and J7342 the difference is the word “without metabolically…”

142. a. You can find this answer by referring to the Table of Drugs in the HCPCS Level II manual.

143. C Use MOD-33 for Medicare initial preventive physical exam (G0402) and AWV visits, G0438 and G0439. Do NOT use MOD-33 for services specifically identified as preventive: screening mam-mography, 77057; screening colonoscopy, G0105 or G0121; or prostate screening with PSA, G0103. The AWV has very specific Hx and documentation requirements (see Medicare website)and many common complaints (DM, HTN, OA) could be compliantly reported in addition with a level III code.

144. b. You can find this answer in the index of the HCPCS Level II manual under Prosthetic addi-tions, lower extremity. Once you find this code range, review the codes to determine the correct code.

145. d. You can find this answer in the index HCPCS Level II manual under Transportation, x-ray(portable). Review of code R0075, indicates “. . . more than one patient seen.”

146. c. Modifier -E3 describes upper right eyelid. You can find this modifier in the HCPCS Level IImanual or the front inside cover of the CPT Professional Edition.

147. a. You can find the four primary classes of main entries listed at the beginning of the index sec-tion in the CPT Professional Edition.

148. d. The coding concepts for modifiers are complicated. In this question none of the codes and modifier combinations are correct. All of the codes listed in this question are add-on codes. Modifier descriptors are also incorrect with the codes listed: Modifiers 24 and 25 could be attached only to an evaluation and management code, and modifier -51 should not be attached to add-on codes. See the definitions of these modifiers in Appendix A of the CPT Professional Edition.


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149. b. According to the ICD-10-CM Coding Guidelines, Multiple fractures sequencing …”Multiple fractures are sequenced in accordance with the severity of the fracture. The provider should be asked to list the fracture diagnoses in the order of severity.”

150. b. You can find this answer in the CPT Professional Edition under Liver Transplantation sub-category guidelines.

151. b.

152. a.

153. d.

154. d.

155. c.

156. a.

157. b.

158. c.

159. d.

160. c.

161. d.

162. d. Remember to convert the hours to minutes;725 x 12 minutes = 8700 minutes1,280 hours x 60 minutes = 76,800 minutes8,700 minutes on coding / 76,800 minutes worked = 11.3% spent on coding

163. d. 42 Code of Federal Regulations (CFR) Part 2 refers to regulations on confidentiality ofAlcohol and Drug Abuse Patient Records

164. b. Reliability refers to the extent to which the data can be reproduced by various coders.Timeliness refers to the extent to which the coded data are available within specified timeframes.

165. b. The American College of Surgeons started the standardization movement and later wasinstrumental in establishing the Joint Commission.

166. b. Pathology reports consist of a microscopic and/or macroscopic description of tissueremoved from a patient during surgery, or during a specialized procedure (biopsy) to providetissue for pathological analysis, or after death when an autopsy (or necropsy) is performed.

167. d. The incident, or occurrence report should not be treated as part of the patient's record.They are to be used by the risk management department and/or attorneys to investigate


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incidents that have the potential to become claims against the organization or individualprovider. They are also used in the quality improvement process to identify shortcomings andsuggesting possible solutions.

168. c. To release information to an attorney, third party payers or insurance companies a validrelease of information from the patient is necessary. The authorization for release of informationis given to the government agency by the patient when the patient applies for workerscompensation.

169. b. Autoauthentication is the process that allows dictated reports to be automaticallyconsidered signed unless the health information management department is notified thatrevisions are needed.

170. d. A fire wall is a system to prevent access to a private network from the outside or limitaccess to the outside from within.

171. b. To determine the number of hours needed to perform a volume of work or "serviceunits," in this case, discharges (15,620) are multiplied by the "time standard" (18 minutes) andthen divided by the number of minutes per hour (60). (15,620 x 18) = 281,160 divided by 60 =4,686.

172. b. As part of the Health Insurance Portability and Accountability Act (HIPAA), Congressadded a new section to Title XI of the Social Security Act.


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s3.amazonaws.com file · Web viewLaurie has a malignant secondary tumor of the Bartholin’s gland. Her doctors do not know where this cancer started in Laurie’s system. She is