,TESTBANK for 3 3-2-1 Code It! 2024 Edition,
12th Edition Michelle A. Green
Notes
1- All Chapters are step by step.
2- We have shown you 10 pages.
3- The file contains all Appendix and Excel
sheet if it exists.
4- We have all what you need, we make
update at every time. There are many
new editions waiting you.
5- If you think you purchased the wrong file
You can contact us at every time, we can
replace it with true one.
Our email:
Our website:
testbanks-store.com
,Name: Class: Date:
Chapter 01: Overview of Coding
1. A coder acquires a working knowledge of coding systems, coding conventions and guidelines,
government regulations, and third-party payer requirements to ensure that documented diagnoses,
services, and procedures are coded accurately for __________, research, and statistical purposes.
a. compliance
b. continuity of care
c. quality assurance
d. reimbursement
ANSWER: d
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.2 - Summarize the training, job responsibilities,
and career path for a coder.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
2. Which is the most likely reason a student would be terminated from the internship site, fails internship
course, or suspended and/or expelled from the academic program?
a. arriving late due to weather conditions
b. breaching patient confidentiality
c. contacting the site about an absence
d. dressing in a business casual style
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.2 - Summarize the training, job responsibilities,
and career path for a coder.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
3. Which professional is employed by third-party payers to review health-related claims to determine
whether the costs are reasonable and medically necessary based on the patient’s diagnosis?
a. health information technician
b. insurance specialist
c. liability underwriter
d. medical assistant
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.2 - Summarize the training, job responsibilities,
Copyright Cengage Learning. Powered by Cognero. Page 1
,Name: Class: Date:
Chapter 01: Overview of Coding
and career path for a coder.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
4. Which represents an online professional network about a variety of topics and issues?
a. application service provider
b. listserv
c. place-bound conference
d. wide area network
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.3 - Identify professional associations available
to coders and medical assistants.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
5. Which organizes medical nomenclature according to similar conditions, diseases, procedures, and
services, and contains codes for each?
a. classification system
b. data dictionary
c. hybrid record
d. medical nomenclature
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 11/16/2023 11:50 PM
6. Coding is the assignment of codes to diagnoses, services, and procedures based on __________.
a. federal government regulations
b. health information management
c. patient record documentation
d. third-party payer requirements
ANSWER: c
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
Copyright Cengage Learning. Powered by Cognero. Page 2
,Name: Class: Date:
Chapter 01: Overview of Coding
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
7. Which is used to classify diagnoses in any health care setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: c
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
8. Which is used to classify procedures in an inpatient hospital setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: d
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
9. Which is published by the AMA and used to classify procedures and services in an outpatient setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
Copyright Cengage Learning. Powered by Cognero. Page 3
,Name: Class: Date:
Chapter 01: Overview of Coding
DATE MODIFIED: 9/13/2023 10:44 AM
10. Which is managed by CMS and used to classify medical equipment, injectable drugs, transportation
services, and other services in an outpatient setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
11. The Centers for Medicare & Medicaid Services (CMS) is a(n) __________ in the federal Department
of Health and Human Services (DHHS).
a. administrative agency
b. compliance section
c. private organization
d. third-party payer
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
12. Which is an example of a medical nomenclature?
a. CPT
b. DSM-5
c. ICD-10-CM/PCS
d. SNOMED CT
ANSWER: d
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.5 - Identify other classification systems and
databases.
DATE CREATED: 9/13/2023 10:44 AM
Copyright Cengage Learning. Powered by Cognero. Page 4
,Name: Class: Date:
Chapter 01: Overview of Coding
DATE MODIFIED: 9/13/2023 10:44 AM
13. The process of standardizing data by assigning alphanumeric values to text or other information is
called __________.
a. encoding
b. mapping
c. potentiating
d. sequencing
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
14. The HIPAA small code set collects information concerning _____.
a. actions taken to prevent, diagnose, treat, and manage diseases and injuries
b. causes of injury, disease, impairment, or other health-related problems
c. diseases, injuries, impairments, and other health-related problems
d. race, ethnicity, type of facility, and type of unit
ANSWER: d
POINTS: 1
DIFFICULTY: Difficult
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
15. The HIPAA large code set collects information concerning _____.
a. actions taken to prevent, diagnose, treat, and manage diseases and injuries
b. privacy and security standards for health information
c. race, ethnicity, type of facility, and type of unit
d. waste, fraud, and abuse in health insurance and health care delivery
ANSWER: a
POINTS: 1
DIFFICULTY: Difficult
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
Copyright Cengage Learning. Powered by Cognero. Page 5
,Name: Class: Date:
Chapter 01: Overview of Coding
16. Which is an example of a third-party payer?
a. BlueCross BlueShield
b. Centers for Medicare and Medicaid Services
c. Department of Health and Human Services
d. Workers’ compensation
ANSWER: a
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
17. Which is an example of another health care professional who performs procedures or provides
services to patients?
a. clearinghouse staff
b. health information technician
c. medical assistant
d. nurse practitioner
ANSWER: d
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
18. A third-party administrator (TPA) is an entity that __________ and may contract with a health care
clearinghouse to standardize data for claims processing.
a. combats waste, fraud, and abuse in health insurance and health care delivery
b. improves portability and continuity of health insurance coverage in group/individual markets
c. processes health care claims and performs related business functions for a health plan
d. simplifies the administration of health insurance by creating unique identifiers
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
19. Concurrent coding is the review of records and/or use of encounter forms and chargemasters to assign
Copyright Cengage Learning. Powered by Cognero. Page 6
,Name: Class: Date:
Chapter 01: Overview of Coding
codes __________.
a. after the patient has been discharged from care
b. during an inpatient stay or outpatient encounter
c. following the submission of health insurance claims
d. that results in continuity of the patient’s health care
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
20. Which contains a computer-generated list of procedures, services, and supplies and corresponding
revenue codes along with charges for each?
a. chargemaster
b. encounter form
c. insurance claim
d. uniform bill
ANSWER: a
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
21. Coders are prohibited from performing assumption coding, which is the assignment of codes based on
assuming, from a review of clinical evidence in the patient’s record, that the patient has certain diagnoses
or received certain procedures/services even though the __________.
a. responsible physician was contacted to confirm diagnoses, procedures, and services
b. physician query process was not implemented by the health care facility or physician
c. provider did not specifically document those diagnoses or procedures and services
d. risk for health care fraud and abuse is assumed by the health care facility or physician
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
Copyright Cengage Learning. Powered by Cognero. Page 7
, Name: Class: Date:
Chapter 01: Overview of Coding
22. When coders have questions about documented diagnoses or procedures/services, they use a physician
query process to contact the responsible physician to __________.
a. confirm diagnoses, procedures, and services already documented in the record
b. eliminate the risk for fraud and abuse even though assumed by the facility or physician
c. request clarification about documentation and the code(s) to be assigned
d. document diagnoses, procedures, or services that will increase reimbursement
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
23. A physician lists “viral pneumonia” as the final diagnosis. However, the coder notes that laboratory
results state “gram-negative bacteria.” There is also documentation of chest pain, fever, and dyspnea due
to pneumonia. What should the coder do?
a. Assign a code to the final diagnosis of viral pneumonia
b. Code bacterial pneumonia, chest pain, fever, and dyspnea
c. Query the physician regarding the diagnosis of pneumonia
d. Report symptom codes for chest pain, fever, and dyspnea
ANSWER: c
POINTS: 1
DIFFICULTY: Difficult
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.6 - Explain how documentation serves as the
basis for assigning codes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
24. The purpose of a clinical documentation improvement (CDI) program is to help health care facilities
comply with government programs and other initiatives with the goal of improving health care quality.
Thus, a CDI specialist initiates concurrent and retrospective reviews of inpatient records to identify
__________ provider documentation.
a. abusive and fraudulent
b. conflicting, incomplete, or nonspecific
c. illegible physician queries and
d. redacted health insurance claims and
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
Copyright Cengage Learning. Powered by Cognero. Page 8
12th Edition Michelle A. Green
Notes
1- All Chapters are step by step.
2- We have shown you 10 pages.
3- The file contains all Appendix and Excel
sheet if it exists.
4- We have all what you need, we make
update at every time. There are many
new editions waiting you.
5- If you think you purchased the wrong file
You can contact us at every time, we can
replace it with true one.
Our email:
Our website:
testbanks-store.com
,Name: Class: Date:
Chapter 01: Overview of Coding
1. A coder acquires a working knowledge of coding systems, coding conventions and guidelines,
government regulations, and third-party payer requirements to ensure that documented diagnoses,
services, and procedures are coded accurately for __________, research, and statistical purposes.
a. compliance
b. continuity of care
c. quality assurance
d. reimbursement
ANSWER: d
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.2 - Summarize the training, job responsibilities,
and career path for a coder.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
2. Which is the most likely reason a student would be terminated from the internship site, fails internship
course, or suspended and/or expelled from the academic program?
a. arriving late due to weather conditions
b. breaching patient confidentiality
c. contacting the site about an absence
d. dressing in a business casual style
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.2 - Summarize the training, job responsibilities,
and career path for a coder.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
3. Which professional is employed by third-party payers to review health-related claims to determine
whether the costs are reasonable and medically necessary based on the patient’s diagnosis?
a. health information technician
b. insurance specialist
c. liability underwriter
d. medical assistant
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.2 - Summarize the training, job responsibilities,
Copyright Cengage Learning. Powered by Cognero. Page 1
,Name: Class: Date:
Chapter 01: Overview of Coding
and career path for a coder.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
4. Which represents an online professional network about a variety of topics and issues?
a. application service provider
b. listserv
c. place-bound conference
d. wide area network
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.3 - Identify professional associations available
to coders and medical assistants.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
5. Which organizes medical nomenclature according to similar conditions, diseases, procedures, and
services, and contains codes for each?
a. classification system
b. data dictionary
c. hybrid record
d. medical nomenclature
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 11/16/2023 11:50 PM
6. Coding is the assignment of codes to diagnoses, services, and procedures based on __________.
a. federal government regulations
b. health information management
c. patient record documentation
d. third-party payer requirements
ANSWER: c
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
Copyright Cengage Learning. Powered by Cognero. Page 2
,Name: Class: Date:
Chapter 01: Overview of Coding
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
7. Which is used to classify diagnoses in any health care setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: c
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
8. Which is used to classify procedures in an inpatient hospital setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: d
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
9. Which is published by the AMA and used to classify procedures and services in an outpatient setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
Copyright Cengage Learning. Powered by Cognero. Page 3
,Name: Class: Date:
Chapter 01: Overview of Coding
DATE MODIFIED: 9/13/2023 10:44 AM
10. Which is managed by CMS and used to classify medical equipment, injectable drugs, transportation
services, and other services in an outpatient setting?
a. CPT
b. HCPCS level II
c. ICD-10-CM
d. ICD-10-PCS
ANSWER: b
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
11. The Centers for Medicare & Medicaid Services (CMS) is a(n) __________ in the federal Department
of Health and Human Services (DHHS).
a. administrative agency
b. compliance section
c. private organization
d. third-party payer
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
12. Which is an example of a medical nomenclature?
a. CPT
b. DSM-5
c. ICD-10-CM/PCS
d. SNOMED CT
ANSWER: d
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.5 - Identify other classification systems and
databases.
DATE CREATED: 9/13/2023 10:44 AM
Copyright Cengage Learning. Powered by Cognero. Page 4
,Name: Class: Date:
Chapter 01: Overview of Coding
DATE MODIFIED: 9/13/2023 10:44 AM
13. The process of standardizing data by assigning alphanumeric values to text or other information is
called __________.
a. encoding
b. mapping
c. potentiating
d. sequencing
ANSWER: a
POINTS: 1
DIFFICULTY: Easy
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
14. The HIPAA small code set collects information concerning _____.
a. actions taken to prevent, diagnose, treat, and manage diseases and injuries
b. causes of injury, disease, impairment, or other health-related problems
c. diseases, injuries, impairments, and other health-related problems
d. race, ethnicity, type of facility, and type of unit
ANSWER: d
POINTS: 1
DIFFICULTY: Difficult
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
15. The HIPAA large code set collects information concerning _____.
a. actions taken to prevent, diagnose, treat, and manage diseases and injuries
b. privacy and security standards for health information
c. race, ethnicity, type of facility, and type of unit
d. waste, fraud, and abuse in health insurance and health care delivery
ANSWER: a
POINTS: 1
DIFFICULTY: Difficult
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
Copyright Cengage Learning. Powered by Cognero. Page 5
,Name: Class: Date:
Chapter 01: Overview of Coding
16. Which is an example of a third-party payer?
a. BlueCross BlueShield
b. Centers for Medicare and Medicaid Services
c. Department of Health and Human Services
d. Workers’ compensation
ANSWER: a
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
17. Which is an example of another health care professional who performs procedures or provides
services to patients?
a. clearinghouse staff
b. health information technician
c. medical assistant
d. nurse practitioner
ANSWER: d
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
18. A third-party administrator (TPA) is an entity that __________ and may contract with a health care
clearinghouse to standardize data for claims processing.
a. combats waste, fraud, and abuse in health insurance and health care delivery
b. improves portability and continuity of health insurance coverage in group/individual markets
c. processes health care claims and performs related business functions for a health plan
d. simplifies the administration of health insurance by creating unique identifiers
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
19. Concurrent coding is the review of records and/or use of encounter forms and chargemasters to assign
Copyright Cengage Learning. Powered by Cognero. Page 6
,Name: Class: Date:
Chapter 01: Overview of Coding
codes __________.
a. after the patient has been discharged from care
b. during an inpatient stay or outpatient encounter
c. following the submission of health insurance claims
d. that results in continuity of the patient’s health care
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
20. Which contains a computer-generated list of procedures, services, and supplies and corresponding
revenue codes along with charges for each?
a. chargemaster
b. encounter form
c. insurance claim
d. uniform bill
ANSWER: a
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
21. Coders are prohibited from performing assumption coding, which is the assignment of codes based on
assuming, from a review of clinical evidence in the patient’s record, that the patient has certain diagnoses
or received certain procedures/services even though the __________.
a. responsible physician was contacted to confirm diagnoses, procedures, and services
b. physician query process was not implemented by the health care facility or physician
c. provider did not specifically document those diagnoses or procedures and services
d. risk for health care fraud and abuse is assumed by the health care facility or physician
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
Copyright Cengage Learning. Powered by Cognero. Page 7
, Name: Class: Date:
Chapter 01: Overview of Coding
22. When coders have questions about documented diagnoses or procedures/services, they use a physician
query process to contact the responsible physician to __________.
a. confirm diagnoses, procedures, and services already documented in the record
b. eliminate the risk for fraud and abuse even though assumed by the facility or physician
c. request clarification about documentation and the code(s) to be assigned
d. document diagnoses, procedures, or services that will increase reimbursement
ANSWER: c
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.4 - Summarize coding systems and processes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
23. A physician lists “viral pneumonia” as the final diagnosis. However, the coder notes that laboratory
results state “gram-negative bacteria.” There is also documentation of chest pain, fever, and dyspnea due
to pneumonia. What should the coder do?
a. Assign a code to the final diagnosis of viral pneumonia
b. Code bacterial pneumonia, chest pain, fever, and dyspnea
c. Query the physician regarding the diagnosis of pneumonia
d. Report symptom codes for chest pain, fever, and dyspnea
ANSWER: c
POINTS: 1
DIFFICULTY: Difficult
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
LEARNING OBJECTIVES: 3-2-1_Green_25_1.6 - Explain how documentation serves as the
basis for assigning codes.
DATE CREATED: 9/13/2023 10:44 AM
DATE MODIFIED: 9/13/2023 10:44 AM
24. The purpose of a clinical documentation improvement (CDI) program is to help health care facilities
comply with government programs and other initiatives with the goal of improving health care quality.
Thus, a CDI specialist initiates concurrent and retrospective reviews of inpatient records to identify
__________ provider documentation.
a. abusive and fraudulent
b. conflicting, incomplete, or nonspecific
c. illegible physician queries and
d. redacted health insurance claims and
ANSWER: b
POINTS: 1
DIFFICULTY: Moderate
QUESTION TYPE: Multiple Choice
HAS VARIABLES: False
Copyright Cengage Learning. Powered by Cognero. Page 8
