PROFESSIONAL MEDICAL CODING
AND BILLING FINAL EXAM
QUESTIONS WITH CORRECT
ANSWERS
The patient is a newborn, delivered by cesarean section secondary to persistent
occiput posterior presentation with obstruction. Upon examination the patient was
normal with the exception of caput succedaneum secondary to sitting in the birth
canal for so long. - Answer-Z38.01, P12.81, P03.1
The patient is a 72-year-old male who suffered an adverse reaction of hives after
starting to take the new prescription of Triamterene his physician prescribed three
days ago. - Answer-L50.0, and T50.2X5A
A 42-year-old male patient with AIDS, presents to the Emergency Department for
treatment of an open fracture of the acromial end of the right clavicle. - Answer-
S42.031B and B20
The patient is a 32-year-old female patient with a family history of malignant
neoplasm of the breast who is seen today for a screening mammogram which
revealed microcalcifications of the right breast. - Answer-Z12.31, R92.0, and Z80.3
The patient is a 13 yr. old diabetic with proliferative retinopathy of both eyes who
regularly uses insulin for control of blood sugar. - Answer-E11.3593 and Z79.4
A 36-year-old male patient was admitted to the hospital as an inpatient secondary to
chest pain, lightheadedness and palpitations. On discharge his final diagnosis is
suspected paroxysmal supraventricular tachycardia. - Answer-I47.1
A 45-year-old female patient is seen for chemotherapy to treat metastatic carcinoma
of the spinal column. Patient has a history of breast cancer. - Answer-Z51.11,
C79.51, and Z85.3
A 13-year-old boy was injured playing baseball. His mom took him to see Dr. Torres,
who sent the mother and her son to a hospital to have an x-ray of the left tibia/fibula
taken. The hospital took the x-ray and sent the image back to Dr. Torres. After
reading and interpreting the x-ray, Dr. Torres determined the boy had a fractured left
tibia/fibula. What modifier would Dr. Torres append to CPT® code 73590 for his
services? - Answer-26.-LT
CPT/HCPCS Coding Guidelines: - Answer--
For excision of benign lesions requiring more than simple closure, an intermediate or
complex closure code should be reported in addition to the excision code. - Answer-
True
,Supplies and materials provided by the physician, over and above those usually
included with the procedure rendered, are separately reportable. - Answer-True
When assigning Emergency Department Services E/M codes, there is a distinction
made between new and established patients. - Answer-False
Evaluation and Management codes are submitted for physicians to receive
reimbursement for their services. - Answer-True
The number of minutes a physician spends face-to-face with a patient is one of the
key components in selecting the correct E/M code. - Answer-False
A code designated as a separate procedure can be reported by itself, or under
certain circumstances, in addition to other procedures or services. - Answer-True
Administration of oral and/or rectal contrast alone qualifies as a study with contrast. -
Answer-False
Add-on codes are reported when the same physician or a different physician
performs a procedure or service. - Answer-False
Add-on codes are exempt from the use of modifier 51. - Answer-True
When the description of a code includes the word "bilateral" you append modifier 50
to the CPT® code. - Answer-False
If tests are performed in addition to the tests included in a particular organ panel,
those tests should be reported separately. - Answer-True
When more than one laboratory test is performed on the same day, it is appropriate
to append modifier 51 to the additional laboratory tests. - Answer-False
When a second physician other than the health care professional providing the
diagnostic or therapeutic services provides moderate conscious sedation in a facility
setting, the second physician reports the moderate conscious sedation procedure. -
Answer-True
When multiple procedures (other than E/M services, physical medicine and
rehabilitation services, provision of supplies, or add-on codes) are performed at the
same session, by the same individual, the additional procedure or service is
identified by appending modifier 51 to the additional procedure or service code(s). -
Answer-True
The indented portion of a code description does not include the full code description.
- Answer-True
A 28-year-old female patient with obstructive sleep apnea, nasal obstruction and a
deviated septum went to the ambulatory surgery center today for surgery. She was
taken to the operating room and placed under general anesthesia. The physician
, performed a septoplasty and a complete excision of the inferior turbinates. Code as if
you work for the ambulatory surgery center. - Answer-30520 and 30130
A 45-year-old patient presents for a sigmoidoscopy. The physician inserts a flexible
scope into the patient's rectum and determines the rectum is clear of any polyps. The
scope is advanced to the sigmoid colon and total of three polyps are found. Using
the snare technique the polyps are removed. The remainder of the colon is free of
polyps. The scope is withdrawn. - Answer-45338
PATHOLOGY SPECIMEN: Cervical cone biopsy. The patient was taken to the
operating room and placed in the supine position. The perineum was prepped and
draped with wet towels. Bivalve speculum was placed in the vagina and the cervix
visualized. The cervix was painted with 4% acetic acid and the area of abnormal
epithelium was visualized. The CO2 laser was used at 20 Watts continuous to the
highlighted area 5 mm margin outside. Cervix was infiltrated with Pitressin and the
blades were used to deflect the underlying tissues in the anatomical fashion. The
apex was cut with the laser, and the specimen submitted. A margin 5 mm outside of
the dissected area was bladed down to the depth of 3 mm. Minimal blood loss. She
was taken to the recovery room in good condition with stable vital signs, having
tolerated the procedure well. - Answer-88307
Jennifer, a 29-year-old pregnant female, went to the radiology department at the
hospital for a follow-up ultrasound with documentation. The radiologist interpreted
the ultrasound and sent documentation to the OB-GYN physician. - Answer-76816-
26
A 2-year-old boy was born with a cleft lip and nasal deformity. He was admitted to
the hospital and taken to the operating room. Dr. Mark Sloan performed a primary
complete plastic repair of the cleft lip and nasal deformity, unilateral. - Answer-40700
Which of the following always governs the selection of principal diagnosis? - Answer-
Circumstances of inpatient admission
Which of the following is not a benefit of encoders? - Answer-Elimination of queries
The process of clarifying conflicting, ambiguous, or incomplete information contained
in the patient's medical record. - Answer-Query
When the type of diabetes is not documented, type I should be reported. - Answer-
False
When the physician documents use, abuse and dependence of the same substance,
only the code for dependence is reported. - Answer-True
The second trimester is defined as 12 weeks 0 days to less than 28 weeks 0 days. -
Answer-False
Z codes can only be reported as secondary diagnosis codes. - Answer-False
AND BILLING FINAL EXAM
QUESTIONS WITH CORRECT
ANSWERS
The patient is a newborn, delivered by cesarean section secondary to persistent
occiput posterior presentation with obstruction. Upon examination the patient was
normal with the exception of caput succedaneum secondary to sitting in the birth
canal for so long. - Answer-Z38.01, P12.81, P03.1
The patient is a 72-year-old male who suffered an adverse reaction of hives after
starting to take the new prescription of Triamterene his physician prescribed three
days ago. - Answer-L50.0, and T50.2X5A
A 42-year-old male patient with AIDS, presents to the Emergency Department for
treatment of an open fracture of the acromial end of the right clavicle. - Answer-
S42.031B and B20
The patient is a 32-year-old female patient with a family history of malignant
neoplasm of the breast who is seen today for a screening mammogram which
revealed microcalcifications of the right breast. - Answer-Z12.31, R92.0, and Z80.3
The patient is a 13 yr. old diabetic with proliferative retinopathy of both eyes who
regularly uses insulin for control of blood sugar. - Answer-E11.3593 and Z79.4
A 36-year-old male patient was admitted to the hospital as an inpatient secondary to
chest pain, lightheadedness and palpitations. On discharge his final diagnosis is
suspected paroxysmal supraventricular tachycardia. - Answer-I47.1
A 45-year-old female patient is seen for chemotherapy to treat metastatic carcinoma
of the spinal column. Patient has a history of breast cancer. - Answer-Z51.11,
C79.51, and Z85.3
A 13-year-old boy was injured playing baseball. His mom took him to see Dr. Torres,
who sent the mother and her son to a hospital to have an x-ray of the left tibia/fibula
taken. The hospital took the x-ray and sent the image back to Dr. Torres. After
reading and interpreting the x-ray, Dr. Torres determined the boy had a fractured left
tibia/fibula. What modifier would Dr. Torres append to CPT® code 73590 for his
services? - Answer-26.-LT
CPT/HCPCS Coding Guidelines: - Answer--
For excision of benign lesions requiring more than simple closure, an intermediate or
complex closure code should be reported in addition to the excision code. - Answer-
True
,Supplies and materials provided by the physician, over and above those usually
included with the procedure rendered, are separately reportable. - Answer-True
When assigning Emergency Department Services E/M codes, there is a distinction
made between new and established patients. - Answer-False
Evaluation and Management codes are submitted for physicians to receive
reimbursement for their services. - Answer-True
The number of minutes a physician spends face-to-face with a patient is one of the
key components in selecting the correct E/M code. - Answer-False
A code designated as a separate procedure can be reported by itself, or under
certain circumstances, in addition to other procedures or services. - Answer-True
Administration of oral and/or rectal contrast alone qualifies as a study with contrast. -
Answer-False
Add-on codes are reported when the same physician or a different physician
performs a procedure or service. - Answer-False
Add-on codes are exempt from the use of modifier 51. - Answer-True
When the description of a code includes the word "bilateral" you append modifier 50
to the CPT® code. - Answer-False
If tests are performed in addition to the tests included in a particular organ panel,
those tests should be reported separately. - Answer-True
When more than one laboratory test is performed on the same day, it is appropriate
to append modifier 51 to the additional laboratory tests. - Answer-False
When a second physician other than the health care professional providing the
diagnostic or therapeutic services provides moderate conscious sedation in a facility
setting, the second physician reports the moderate conscious sedation procedure. -
Answer-True
When multiple procedures (other than E/M services, physical medicine and
rehabilitation services, provision of supplies, or add-on codes) are performed at the
same session, by the same individual, the additional procedure or service is
identified by appending modifier 51 to the additional procedure or service code(s). -
Answer-True
The indented portion of a code description does not include the full code description.
- Answer-True
A 28-year-old female patient with obstructive sleep apnea, nasal obstruction and a
deviated septum went to the ambulatory surgery center today for surgery. She was
taken to the operating room and placed under general anesthesia. The physician
, performed a septoplasty and a complete excision of the inferior turbinates. Code as if
you work for the ambulatory surgery center. - Answer-30520 and 30130
A 45-year-old patient presents for a sigmoidoscopy. The physician inserts a flexible
scope into the patient's rectum and determines the rectum is clear of any polyps. The
scope is advanced to the sigmoid colon and total of three polyps are found. Using
the snare technique the polyps are removed. The remainder of the colon is free of
polyps. The scope is withdrawn. - Answer-45338
PATHOLOGY SPECIMEN: Cervical cone biopsy. The patient was taken to the
operating room and placed in the supine position. The perineum was prepped and
draped with wet towels. Bivalve speculum was placed in the vagina and the cervix
visualized. The cervix was painted with 4% acetic acid and the area of abnormal
epithelium was visualized. The CO2 laser was used at 20 Watts continuous to the
highlighted area 5 mm margin outside. Cervix was infiltrated with Pitressin and the
blades were used to deflect the underlying tissues in the anatomical fashion. The
apex was cut with the laser, and the specimen submitted. A margin 5 mm outside of
the dissected area was bladed down to the depth of 3 mm. Minimal blood loss. She
was taken to the recovery room in good condition with stable vital signs, having
tolerated the procedure well. - Answer-88307
Jennifer, a 29-year-old pregnant female, went to the radiology department at the
hospital for a follow-up ultrasound with documentation. The radiologist interpreted
the ultrasound and sent documentation to the OB-GYN physician. - Answer-76816-
26
A 2-year-old boy was born with a cleft lip and nasal deformity. He was admitted to
the hospital and taken to the operating room. Dr. Mark Sloan performed a primary
complete plastic repair of the cleft lip and nasal deformity, unilateral. - Answer-40700
Which of the following always governs the selection of principal diagnosis? - Answer-
Circumstances of inpatient admission
Which of the following is not a benefit of encoders? - Answer-Elimination of queries
The process of clarifying conflicting, ambiguous, or incomplete information contained
in the patient's medical record. - Answer-Query
When the type of diabetes is not documented, type I should be reported. - Answer-
False
When the physician documents use, abuse and dependence of the same substance,
only the code for dependence is reported. - Answer-True
The second trimester is defined as 12 weeks 0 days to less than 28 weeks 0 days. -
Answer-False
Z codes can only be reported as secondary diagnosis codes. - Answer-False
